中心静脉导管相关血流感染危险因素的前瞻性监测研究

Prospective surveillance study for risk factors of central venous catheter-related bloodstream infections.

作者信息

Hosoglu Salih, Akalin Serife, Kidir Veysel, Suner Ali, Kayabas Hasan, Geyik Mehmet Faruk

机构信息

Clinic of Microbiology and Infection, Dicle University Hospital, 21280 Diyarbakir, Turkey.

出版信息

Am J Infect Control. 2004 May;32(3):131-4. doi: 10.1016/j.ajic.2003.10.011.

DOI:10.1016/j.ajic.2003.10.011

PMID:15153923

Abstract

OBJECTIVE

Risk factors of catheter-related bloodstream infection (CR-BSI) caused by central venous catheter (CVC) use at a university hospital were evaluated.

DESIGN

A prospective, observational, hospital-wide study was conducted.

SETTING

The study was conducted at a university hospital with 1050 beds.

METHODS

Nontunneled catheters were used, and double or triple lumen was observed. Catheters were cultured by semi-quantitative method, and blood cultures were performed if necessary. All epidemiologic and clinical data were recorded without intervention during the study.

RESULTS

Over a 1-year period, the study assessed 389 CVCs inserted in 367 patients (mean age 50.9 +/- 18.1 years; 215 [58.6%] men, 152 [41.4%] women). Duration of catheterization was 12.0 +/- 9.9 days. CVCs were inserted into either the subclavian vein (N=263; 67.6%) or the jugular vein (N=128; 32.4%). In 250 episodes (64.3%), antibiotics were used concomitantly. CR-BSI was found in 43 of all CVCs (11.1%). The rate of CR-BSI per 1000 catheter-days was 9.21 for the whole cohort. In multivariable analysis, only renal failure (OR 4.83; CI 1.32-17.66; P=.017) was found to be a risk factor for CR-BSI.

CONCLUSION

Renal failure was an independent risk factor for CR-BSI.

摘要

目的

评估某大学医院中心静脉导管（CVC）使用导致的导管相关血流感染（CR-BSI）的危险因素。

设计

进行一项前瞻性、观察性、全院范围的研究。

背景

研究在一家拥有1050张床位的大学医院开展。

方法

使用非隧道式导管，观察双腔或三腔导管。采用半定量方法对导管进行培养，必要时进行血培养。在研究期间，所有流行病学和临床数据均在无干预的情况下记录。

结果

在1年期间，该研究评估了367例患者插入的389根CVC（平均年龄50.9±18.1岁；男性215例[58.6%]，女性152例[41.4%]）。置管时间为12.0±9.9天。CVC插入锁骨下静脉（N = 263；67.6%）或颈静脉（N = 128；32.4%）。在250例（64.3%）病例中，同时使用了抗生素。所有CVC中有43例（11.1%）发生CR-BSI。整个队列每1000导管日的CR-BSI发生率为9.21。在多变量分析中，仅发现肾衰竭（OR 4.83；CI 1.32 - 17.66；P = 0.017）是CR-BSI的危险因素。