长效抗菌材料对留置导尿管患者感染病原菌及血清炎症因子的影响

Effects of long-acting antimicrobial material on pathogenic distribution and serum inflammatory factor concentration in patients with indwelling catheter

背景:长效抗菌材料为有机硅季铵盐新型高分子活化剂,在抗感染方面具有明显的优势。目的:分析长效抗菌材料对留置导尿管患者感染病原菌及血清炎症因子水平的影响。方法:纳入2014年1月至2018年1月海南西部中心医院诊治的留置导尿管男性患者100例,年龄35-55岁,按随机数字表法分为2组,每组100例:对照组给予常规的尿道口护理,观察组在常规尿道口护理的基础上使用长效抗菌材料喷洒尿道口、导尿管及集尿袋接口。检测置入导尿管后1,3,5,7 d的感染率,以及置入导尿管后7 d的感染病原菌类型与血清炎症因子水平变化情况。试验获得海南西部中心医院伦理委员会批准(批准号:2013120602)。结果与结论:①与对照组相比,观察组置入导尿管后1,3,5,7 d的感染率均明显降低(P<0.05);②对照组共分离病原菌20株,其中革兰阳性菌13株(占65.0%),革兰阴性菌7株(占35.0%);观察组患者共分离病原菌7株,其中革兰阳性菌5株(占71.4%),革兰阴性菌2株(占28.6%);③与置入导尿管前比较,对照组和观察组置入导尿管后的血清炎症因子白细胞介素1β、白细胞介素2、同型半胱氨酸、降钙素原水平均明显升高(P<0.05);对照组置入导尿管后的上述因子水平均高于观察组(P<0.05);④结果表明,长效抗菌材料能有效降低留置导尿管患者的病原菌感染率,降低患者血清中炎症因子水平。

BACKGROUND:Long-acting antimicrobial material is a new polymer activator of organosilicon quaternary ammonium salt and has obvious advantages in anti-infection.OBJECTIVE:To investigate the effects of Jieyoushen,a long-acting antimicrobial material,on pathogenic distribution and serum inflammatory factors in patients with indwelling catheters.METHODS:A total of 200 male patients with indwelling catheter who received treatment during January 2014 to January 2018 in Hainan West Central Hospital,China were included in this study.These patients were aged 35-55 years and were randomly divided into two groups:a control group(n=100)and an observation group(n=100).Patients in the control group were given routine urethral orifice nursing.Patients in the observation group were sprayed with long-acting antimicrobial material“Jieyoushen”on the urethral orifice,catheter and catheter bag interface.Infection was detected at 1,3,5 and 7 days after catheterization.The changes of pathogenic bacteria and serum inflammatory factors in two groups were analyzed at 7 days after catheterization.This study was approved by the Medical Ethics Committee,Hainan West Central Hospital,China(approval No.2013120602).RESULTS AND CONCLUSION:Compared with the control group,the infection rates of the patients in the observation group decreased significantly at 1,3,5 and 7 days after catheterization(P<0.05).Twenty pathogenic bacteria were isolated in patients of the control group,including 13 Gram-positive bacteria(65.0%)and 7 Gram-negative bacteria(35.0%).Seven pathogenic bacteria were isolated in patients of the observation group,including 5 Gram-positive bacteria(71.4%)and 2 Gram-negative bacteria(28.6%).Compared with before indwelling catheter,serum levels of interleukin-1β,interleukin-2,homocysteine,and procalcitonin increased significantly in each group after catheterization(P<0.05).After catheterization,serum levels of above-mentioned factors in the control group were significantly higher than those in the observation group(P<0.05).These results suggest that long-acting antimicrobial material"Jieyoushen"can effectively reduce the infection rate of pathogenic bacteria and lower serum levels of inflammatory factors in patients with indwelling catheter.