血液净化中心静脉导管感染病原菌检测结果分析

Analysis of pathogen test results for infections of central venous catheter for blood purification

目的对血液净化中心静脉导管感染病原菌检测结果进行回顾性分析,以期能为临床诊治提供参考。方法收集2011年6月-2013年6月321例血液净化中心静脉导管下血液透析患者临床资料,分析送检标本进行细菌培养及药物敏感试验结果,采用SPSS 17.0软件进行统计分析。结果共培养出病原菌132株,其中13例患者为混合感染,感染病原菌中革兰阳性菌、革兰阴性菌、真菌分别占50.76%、31.06%、18.18%;检出革兰阳性菌中金黄色葡萄球菌、溶血葡萄球菌、表皮葡萄球菌对青霉素耐药率为100.00%,革兰阴性菌中鲍氏不动杆菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌对哌拉西林、头孢曲松、庆大霉素、妥布霉素耐药率菌>50.00%,真菌中光滑假丝酵母菌对两性霉素B耐药率为0。结论血液净化中心静脉导管感染病原菌以革兰阳性菌所占比例最高,其次为革兰阴性菌及真菌,病原菌对临床常用抗菌药物耐药率普遍较高。

OBJECTIVE To retrospectively analyze pathogen test results for infections of central venous catheter for blood purification,in order to provide reference for clinical diagnosis and treatment.METHODS Clinical data of321 cases undergoing hemodialysis by central venous catheters for blood purification during Jun.2011 to Jun.2013 were collected,the results from specimens of bacterial culture and drug sensitivity test were analyzed.The software SPSS17.0was used for statistical analysis.RESULTS Totally 132 pathogenic strains were cultured,including gram-positive bacteria（50.76%）,gram-negative bacteria（31.06%）,and fungi（18.18%）,and 13 patients had mixed infections.Among gram-positive bacteria,Staphylococcus aureus,Staphylococcus haemolyticus,and Staphylococcus epidermidis had resistant rate of 100.00% to penicillin;among gram-positive bacteria,Acinetobacter baumannii,Pseudomonas aeruginosa,Escherichia coli,and Klebsiella pneumoniae had resistant rate of50.00%to piperacillin,ceftriaxone,gentamicin,and tobramycin;among fungi,Candida albicans had resistant rate of 0to amphotericin B.CONCLUSION Gram-positive bacteria take the highest proportion among pathogens for infection of central venous catheter for blood purification,followed by gram-negative bacteria and fungi,pathogen resistance to antimicrobial agents commonly used in clinical rates were generally high.