血液透析患者导管相关性血流感染病原菌及危险因素分析

Pathogens causing catheter-related bloodstream infections in hemodialysis patrents and analysis of risk factors

目的分析血液透析患者导管相关性血流感染病原菌及危险因素,探讨积极的预防措施,降低导管相关性血流感染发生率。方法回顾性分析2005年1月-2012年1月482例行血液透析的颈内静脉和股静脉留置导管患者临床资料。结果 482例颈内静脉和股静脉留置导管血液透析患者,发生血流感染49例,发生率为10.2%;共分离出53株病原菌,其中革兰阳性球菌31株占58.5%,以金黄色葡萄球菌最为多见;革兰阴性杆菌22株,占41.5%,以大肠埃希菌最为多见;血液透析患者导管相关性血流感染的发生与留置时间、基础疾病、插管部位明显相关(P<0.05),而与年龄、性别、插管次数无明显相关性。结论血液透析患者导管相关性血流感染的主要病原菌为金黄色葡萄球菌,而留置时间、基础疾病、插管部位为发生导管相关性血流感染的危险因素。

OBJECTIVE To analyze infectious pathogens and risk factors fof catheter-related bloodstream infections in hemodialysis patients and discuss active precautions so as to reduce the incidence of catheter related bloodstream infections. METHODS From Jan. 2005 to Jan. 2012, the clinical data of 482 cases of hemodialysis patients with jugular and femoral venous catheterization were analyzed retrospectively. RESULTS Among 482 patients with jugular femoral venous catheterization patients who underwent hemodialysis, blood infections occurred in 49 eases, accounting for 10. 2~. Among 53 isolated strains of pathogenic bacteria, 31 strains were gram-positive cocci, accounting for 58. 50//00, of which Staphylococcus aureus was the most common; 22 strains were gram-negative bacilli, accounting for 41. 5~, of which Escherichia coli was the most common. Catheter-related bloodstream infections in hemodialysis patients were related to the indwelling time, underlying diseases, and intuhation location （P〈0. 05）, while it showed no significant relationship with the age, gender, and frequency of intubation. CONCLUSION S. aureus is the major species of pathogen causing the catheter-related bloodstream infections in the hemodialysis patients, and indwelling time, underlying diseases, and intubation location are the main risk factors for the catheter-related bloodstream infections.