中心静脉置管相关性感染临床分析及预防

目的分析中心静脉插管相关性感染（CRI）的致病菌分布及相关危险因素，以指导临床的治疗及预防。方法对行中心静脉置管1300例危重患者的临床资料进行回顾性分析。结果多因素分析显示年龄、病种、穿刺次数、穿刺部位、导管口径及导管用途为CRI形成的危险因素。33例导管培养阳性中常见致病菌有葡萄球菌（17／33）和真菌（7／33），1300例中心静脉置管患者总感染率为2．5％（33／1300）。结论CRI的致病菌主要是葡萄球菌及真菌，是院内感染的主要原因，尽量缩短中心静脉导管留置时间对CRI预防有一定临床意义

Characteristics of central venous catheter-related infection:clinical analysis of 1300 cases

Objective To investigate the pathogens and risk factors of central venous catheter-related infections （CRI）. Methods The clinical data of 1300 patients, 880 males and 420 females, aged （48.7±7.39）（1-92）, who underwent central venous catheterization because of traumatic shock, chemotherapy for malignant tumor, open heart surgery, or open chest surgery. hnmediately and 1 week after the catheterization local skin swab and peripheral blood samples were collected to undergo microbial culture. Two weeks later quantitative culture of the catheter tip was performed while the catheters were changed. And blood samples were collected from the central and peripheral veins to undergo microbial culture. Risk-related factors were analyzed. Results The general CRI rate was 2.5% （33/1300）. Staphylococcus aureus, coagulase negative Staphylococcus, Gram-negative bacillus, enterococcus, fungi, and Candida albicans were cultured. Of the CRI cases 48.2% were aged 〈12% or 〉60%, 59.8% needed parenteral nutrition because of gastrointestinal dysfunction, 59.6% had the same pathogens, and most were treated with broad-spectrum antibiotics. Conclusion Being very young or elder, gastrointestinal dysfunction, Staphylococcus aureus and fungi are risk-related factors of CRI.