外周动脉导管相关血流性感染的影响因素分析

Analysis of influencing factors of catheter-related bloodstream infection with peripheral arterial

目的分析外周动脉导管相关血流性感染(CRBSI)的影响因素,为临床医护人员控制CRBSI提供理论依据。方法采用横断面调查方法,便利抽样法选取2021年1月至2022年1月在中国人民武装警察部队特色医学中心动脉置管的331例患者为研究对象,收集研究对象一般资料、导管相关感染情况、局部皮肤异常情况、置管状况等资料,以患者拔管后导管尖端微生物培养细菌阳性作为结局指标,分析外周动脉CRBSI的影响因素。结果CRBSI发生率为8.15%(27/331)。调整后Logistic回归显示年龄(OR=3.013,95%CI 1.158~14.365)、局部异常(OR=3.357,95%CI 1.670~9.269)、置管时长(OR=2.338,95%CI 1.127~4.183)、置管位置(下肢)(OR=3.325,95%CI 1.007~3.954)为外周动脉CRBSI的危险因素(均P<0.05)。结论在ICU中年龄≥65岁、局部皮肤异常、置管天数≥14 d及置管部位在下肢的患者易发生外周动脉CRBSI,关注老年人、注意穿刺部位无菌屏障的完整、缩短置管天数及避免下肢穿刺可减少外周动脉CRBSI的发生。

Objective To anaylyze the influencing factors of peripheral arterial catheter-related bloodstream infection(CRBSI),and provide theoretical basis for clinical medical staff to control CRBSI.Methods Adopting cross-sectional survey method.Convenient sampling method was used to select 331 patients with arterial catheterization in Tianjin Beichen Hospital from January 2021 to January 2022.The general status,catheter related infections,local skin abnormalities and catheterization status of the subjects were collected.The positive microbial culture at the tip of the catheter after extubation was taken as the outcome index,the influencing factors of peripheral arterial CRBSI were analyzed.Results The incidence of CRBSI was 8.15%(27/331).Adjusted Logistic regression showed that age(OR=3.013,95%CI 1.158-14.365),local abnormality(OR=3.357,95%CI 1.670-9.269),number of days of catheterization(OR=2.338,95%CI 1.127-4.183)and location of catheterization(lower limb)(OR=3.325,95%CI 1.007-3.954)were the risk factors of peripheral artery CRBSI(all P<0.05).Conclusions Peripheral artery CRBSI is more likely to occur in ICU patients aged≥65 years,with local skin abnormalities,catheterization days≥14 d and catheterization site in lower extremity.Paying attention to the elderly,paying attention to the integrity of the sterile barrier at the puncture site,shortening the catheterization days and avoiding lower extremity puncture can reduce the occurrence of peripheral artery CRBSI.