ICU导管相关性血流感染的调查及达托霉素治疗效果分析

Investigation of Catheter-related Bloodstream Infections in ICU and Clinical Efficacy of Daptomycin

目的调查咸宁市中心医院ICU导管相关性血流感染各病原菌分布情况、不同置管部位感染率及评价达托霉素治疗导管相关性血流感染患者效果。方法统计咸宁市中心医院ICU于2015年1月至2017年1月期间导管相关性血流感染各种病原菌分布情况、不同置管部位感染率,使用达托霉素治疗,观察治疗前后的临床症状、体温变化、实验室检查及不良反应。结果 45例患者共培养出55株G^+菌,股静脉置管感染率最高,以耐甲氧西林金黄色葡萄球菌最多(35/55)。予以达托霉素治疗后,50株被清除,细菌学清除率为90.9%;所有患者在治疗前后其体温、白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)相比较,均显著性下降,差异有统计学意义(P均<0.05)。结论各种病原菌分布以G^+菌为主,达托霉素在治疗G^+菌所致导管相关性血流感染患者有效、安全。

Objective To investigate the distribution of pathogens,infection rate at different catheterization sites and the clinical efficacy of dastomycin in catheter-related bloodstream infections(CRBSI) of ICU ward of Xianning Central Hospital. Methods 45 patients with CRBSI from January 2015 to January 2017 in ICU ward of our hospital were enrolled in the study.The distribution of pathogens,infection rate at different catheterization sites,and the clinical symptoms,such as body temperature,laboratory indexes were detected before and after treatment with daptomycin.Results Fifty strains of G^+ bacteria were removed from 45 patients after treatment with daptomycin,and the clearance rate was 90.9%.Body temperature,the number of white blood cells and levels of C-reactive protein and procalcitonin in all patients were significantly decreased after treatment as compared to those before treatment(P<0.05).Transient adverse reactions occurred in 5 patients during treatment.Conclusion G^+ bacteria are the main pathogens and daptomycin is effective and safe in the treatment of catheter-related bloodstream infections.