手术室导管相关性血流感染的病原学特点及碘伏消毒的预防效果研究

Etiological characteristics of catheter-related bloodstream infections in operating rooms and preventive effect of iodine

目的分析手术室导管相关性血流感染的病原学特点,探讨碘伏消毒对感染的预防效果,为临床防治提供参考依据。方法选取2015年2月-2017年5月医院收治的手术患者268例作为研究对象,随机分为研究组与对照组,每组134例,其中研究组患者采用碘伏消毒处理,对照组采用0.5%~1.0%聚维酮碘消毒。比较两组患者术后导管相关性血流感染发生率、感染部位及病原菌分布。结果研究组患者术后发生导管相关血流感染感染率为3.73%(5/134),低于对照组的11.19%(15/134),两组比较差异有统计学意义(P<0.05);研究组患者术后体温、白细胞计数、中性粒细胞比例、住院时间指标均优于对照组(P<0.05);感染病原菌以表皮葡萄球菌及大肠埃希菌为主。结论手术室导管相关性血流感染的主要病原菌为表皮葡萄球菌,碘伏消毒在预防手术室导管相关性血流感染方面疗效确切,值得临床推广应用。

OBJECTIVE To analyze the etiological characteristics of catheter-related bloodstream infection in operating rooms and explore the effect of iodine on prevention of the infection so as to provide guidance for clinical prevention and treatment.METHODS A total of 268 patients who received surgical procedures from Feb 2015 to May2017 were recruited as the study objects and randomly divided into the study group and the control group,with134 cases in each group.The study group was treated with iodine for disinfection,while the control group was treated with 0.5%-1.0% povidone-iodine for disinfection.The incidence of postoperative catheter-related bloodstream infection and distribution of infection sites and pathogens were observed and compared between the two groups of patients.RESULTS The incidence rate of postoperative catheter-related bloodstream infection of the study group was 3.73%（5/134）,significantly lower than 11.19%（15/134）of the control group（P=0.020）.The postoperative body temperature,white blood cell counts,percentage of neutrophils and length of hospital stay were significantly better in the study group than in the control group（all P〈0.05）.Staphylococcus epidermidis and Escherichia coli were dominant among the pathogens causing the infections.CONCLUSION The S.epidermidis is the predominant species of pathogen causing the catheter-related bloodstream infections in operating rooms,the disinfection with iodine may achieve exact effect on prevention of the catheter-related bloodstream infection in operating rooms,and it is worthy to be promoted in the hospital.