del Pozo J L, Serrera A, Martinez-Cuesta A, Leiva J, Penades J, Lasa I
Division of Infectious Diseases and Clinical Microbiology, University Clinic of Navarra, Pamplona, Spain.
Int J Artif Organs. 2006 Apr;29(4):379-86. doi: 10.1177/039139880602900407.
Vascular catheters are the most frequently used indwelling medical devices and have become necessary tools for patients with chronic or critical illness. Surgically or percutaneously placed venous access ports are used to facilitate long-term intravenous therapy. The widespread use of these devices has resulted in a dramatic increase in catheter-related infections. It implies considerable morbidity, occasional mortality, and an increase in medical costs derived from its diagnosis, treatment, and mainly, prolongation of the patient's in-hospital stay. Treatment of such infections is often difficult due to the presence of biofilms on the port inner surface; inside the biofilms, bacteria are less vulnerable to antimicrobial agents. Current diagnostic strategies are suboptimal, and most successful treatment options require removal of the infected device followed by a course of antimicrobial therapy. There are limited data concerning the efficacy of antibiotic treatment of port-related bloodstream infections without catheter removal.
血管导管是最常用的留置医疗设备，已成为慢性或危重病患者的必备工具。通过手术或经皮放置的静脉通路端口用于促进长期静脉治疗。这些设备的广泛使用导致导管相关感染急剧增加。这意味着相当高的发病率、偶尔的死亡率，以及因诊断、治疗，主要是患者住院时间延长而产生的医疗费用增加。由于端口内表面存在生物膜，此类感染的治疗通常很困难；在生物膜内部，细菌对抗菌剂的敏感性较低。目前的诊断策略并不理想，大多数成功的治疗选择需要移除感染的设备，然后进行一个疗程的抗菌治疗。关于在不拔除导管的情况下抗生素治疗端口相关血流感染的疗效的数据有限。
