患儿导管相关性放射根瘤菌血流感染分析

Analysis of catheter-related blood infections due to Rhizobium radiation in pediatric patients

目的探讨患儿导管相关性放射根瘤菌血流感染因素及预后。方法收集2012年2月至2014年2月1014例使用过各类医用导管的患儿资料，回顾性统计其中发生导管相关性放射根瘤菌血流感染的患儿数量、年龄、导管留置时间、CD4、CD8、CD4／CD8及治疗预后情况，统计分析放射根瘤菌血流感染的危险因素。结果1014例使用过各类医用导管的患儿共发生了26例放射根瘤菌血流感染，感染患儿中小于2岁的21例（80．77％），导管留置时间大于5d的20例（76．92％）。发生放射根瘤菌血流感染患儿相关因素中年龄小于2岁、导管留置时间大于5d、CD4、CD4／CD8与未发生感染患儿相比，差异具有统计学意义（P〈0．01）。26例放射根瘤菌血流感染患儿治疗后发生二次感染的12例，占46．15％，其中二次感染检测病原菌仍然为放射根瘤菌的2例（7．69％），死亡的2例（7．69％）。结论患儿年龄〈2岁、导管留置时间〉5d、免疫力低下是导管相关性放射根瘤菌血流感染的重要危险因素，放射根瘤菌血流感染治疗不当会造成二次感染。

Objective To analyze catheter-related bloodstream infections due to Rhizobium radiation （R. radiobacter） in pediatric patients. Methods Clinical data of 1 014 pediatric patients with intra- vascular catheterization were collected from February 2012 to February 2014, including age, length of time a catheter remained in place, laboratory findings and outcome of R. radiobacter bloodstream infection in order to explore the factors for R. radiobacter infection. Results There were 26 children contracting R. radiobacter bloodstream infection children, and of them, 21 were under 2 years old （ 80.77% ）, and the length of time for catheter dwelt in vessel longer than 5 days in 20 children （76. 92% ）. There were significant differences in age under 2 years old, length of time longer than 5 days for catheter remained in place, CD4 and CD4/ CD8 between 26 children with R. radiobacter infection and uninfected children （P 〈0. 01 ）. The re-infection with different varieties of bacterial strains was found in 12 of all R. radiobacter infection children （46. 15% ） after treatment, and of them, R. radiobacter bloodstream infection was detected twice in 2 children, and 2 died （7.69%）. Conclusions Age under 2 years old, the length of time for intra-vascular catheter remained in place longer than 5 days, and weakened immunity are the important risk factors of R. radiobacter bloodstream infection, and the improper medical care may be the cause of re-infections in pediatric patients with prolonged intra-vascular catheter-dwelling.