Hanatani Y, Hasumi T, Asagoe T, Miyoshi H, Takami H, Takada T, Kodaira S
First Department of Surgery, School of Medicine, Teikyo University, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):910-3.
We made an investigation on central venous catheter related sepsis (CRS) in recent 5 years (1987-1991). The incidence of CRS was high; 16.0% (125 out of 782 cases) or 13.1% (135 out of 1029 catheters). CRS occurred frequently during 2-3 weeks after catheter insertion. The incidence of CRS was not affected by the kind of disease (malignant or benign), complication (diabetes, liver cirrhosis, collagen disease) operation or administration of antibiotics. Eight percent out of 91 organisms isolated from culture of catheter tips were so-called resistant strains; multi-drug resistant Staphylococci (16), Pseudomonas aeruginosa (5), fungi (49), etc. Complications (shock, acute renal failure, secondary pneumonia, fungal endophthalmitis) broken out in 18 patients (14.4% out of 125 CRS). Fungi were isolated from 14 out of 18 complicated cases, furthermore fungi were isolated alone in 11 cases. No complication were seen among cases from which gram positive cocci were isolated alone. Body temperature and white blood cell count of complicated cases were significantly higher than those of uncomplicated cases. The duration until removal of catheter from outbreak of fever in complicated cases was significantly longer than that in uncomplicated cases.
我们对近5年（1987 - 1991年）中心静脉导管相关败血症（CRS）进行了调查。CRS的发生率很高；为16.0%（782例中有125例）或13.1%（1029根导管中有135根）。CRS在导管插入后2 - 3周频繁发生。CRS的发生率不受疾病类型（恶性或良性）、并发症（糖尿病、肝硬化、胶原病）、手术或抗生素使用的影响。从导管尖端培养物中分离出的91种微生物中有8%是所谓的耐药菌株；多重耐药葡萄球菌（16株）、铜绿假单胞菌（5株）、真菌（49株）等。18例患者（125例CRS中的14.4%）出现并发症（休克、急性肾衰竭、继发性肺炎、真菌性眼内炎）。18例复杂病例中有14例分离出真菌，此外，有11例单独分离出真菌。仅分离出革兰氏阳性球菌的病例中未出现并发症。复杂病例的体温和白细胞计数明显高于未复杂病例。复杂病例从发热发作到拔除导管的持续时间明显长于未复杂病例。
