ICU中心静脉导管相关性血流感染的危险因素及病原菌分析

doi:10.3969/j.issn.1006-7795.2020.01.024

首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (1): 125-130.doi: 10.3969/j.issn.1006-7795.2020.01.024

ICU中心静脉导管相关性血流感染的危险因素及病原菌分析

乔莉¹, 曹洋², 袁宏勋¹, 王瑶¹

1. 北京大学国际医院重症医学科, 北京 102206;
2. 北京大学国际医院感染控制部, 北京 102206

收稿日期:2019-04-24 出版日期:2020-02-21 发布日期:2020-02-13
通讯作者: 袁宏勋 E-mail:yuanhongxun@pkuih.edu.cn

Risk factors and pathogenic bacteria of catheter-related blood stream infection in ICU

Qiao Li¹, Cao Yang², Yuan Hongxun¹, Wang Yao¹

1. Intensive Care Unit, Peking University International Hospital, Beijing 102206, China;
2. Infection Control Department, Peking University International Hospital, Beijing 102206, China

Received:2019-04-24 Online:2020-02-21 Published:2020-02-13

摘要/Abstract

摘要： 目的了解北京大学国际医院重症医学科（Intensive Care Unit，ICU）中心静脉导管相关性血流感染（catheter-related blood stream infection，CRBSI）的感染率、危险因素、病原菌种类、耐药性及预后分析，对减少CRBSI的发生率提供指导。方法回顾性分析2016年1月1日至2018年12月31日期间北京大学国际医院重症医学科诊断为CRBSI的病例的临床及微生物学资料。结果本研究调查留置中心静脉导管总例数674例，置管总天数6 197 d，发生CRBSI者28例，感染率4.52‰。28名患者共培养36株病原菌，其中革兰阳性（G+）菌18株（50%）；革兰阴性（G-）菌16株（44.4%），真菌2株（5.6%）。G+菌以表皮葡萄球菌为主，G-菌中以鲍曼不动杆菌为主，真菌均为白色念珠菌。Logistic多元回归分析显示：抗生素大量使用以及留置导管时间是ICU内罹患CRBSI的独立危险因素。结论 ICU中CRBSI发生率仍较高，病原菌以G+菌为主，大量使用抗生素、留置导管时间是ICU发生CRBSI的危险因素。

关键词: 中心静脉导管相关性血流感染, 重症医学科, 病原菌

Abstract: Objective To understand the infection rate, risk factors, pathogen species, drug resistance and prognosis of catheter-related blood stream infection (CRBSI) in the Intensive Care Unit (ICU) of Peking University International Hospital, and to provide guidance for reducing the incidence of CRBSI. Methods Clinical and microbiological data of patients diagnosed with CRBSI from January 1, 2016 to December 31, 2018 in the Intensive Care Unit of Peking University International Hospital were retrospectively analyzed. Results This study involved in 674 cases of central venous catheter indwelling, 6 197 days of catheterization, and 28 cases of CRBSI, with an infection rate of 4.52‰. A total of 36 strains of pathogenic bacteria were cultured in 28 patients, including 18 Gram-positive strains (50%).There were 16 Gram-negative bacteria (44.4%) and 2 fungi (5.6%). Staphylococcus epidermidis dominated by G+ bacteria, acinetobacter baumannii dominated by G-bacteria, and candida albicans dominated by fungi. Logistic multiple regression analysis showed that heavy antibiotic use and indwelling catheter duration were independent risk factors for CRBSI in the ICU. Conclusion The incidence of CRBSI in ICU is still high, and the pathogen is mainly G+ bacteria.

Key words: catheter-related bloodstream infection, Intensive Care Unit(ICU), pathogenic bacteria

中图分类号:

R446.5

乔莉, 曹洋, 袁宏勋, 王瑶. ICU中心静脉导管相关性血流感染的危险因素及病原菌分析[J]. 首都医科大学学报, 2020, 41(1): 125-130.

Qiao Li, Cao Yang, Yuan Hongxun, Wang Yao. Risk factors and pathogenic bacteria of catheter-related blood stream infection in ICU[J]. Journal of Capital Medical University, 2020, 41(1): 125-130.

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ICU中心静脉导管相关性血流感染的危险因素及病原菌分析

Risk factors and pathogenic bacteria of catheter-related blood stream infection in ICU

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