Coll P, Iglesias M, Rello J, Solé R, Alonso C, Prats G
Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona.
Enferm Infecc Microbiol Clin. 1991 Jan;9(1):39-42.
612 catheters have been prospectively investigated. In all of them, both the external and the internal surfaces were cultured, the former with the semiquantitative technique of Maki and the latter with the semiquantitative technique of Liñares. 102 of the 469 central venous catheters (22%), 21 of 70 catheters used for parenteral nutrition (30%), and 19 of the 73 arterial catheters (26%) were positive with one or both techniques. The external surface was positive in 95% of central venous catheters, in 90% of the parenteral nutrition catheters, and in 95% of the arterial catheters, whereas the internal surface was positive in only 59%, 62% and 42%, respectively. The routine study of the internal surface of the catheters does not appear as justified. In our opinion, the microbiological study of catheters should be individualized depending on the relative importance of the skin or the connections in a particular catheter type. The quantitative study of the intraluminal surface should only be carried out in those catheters where connections represent a significant pathogenetical route. These catheters constitute only a small proportion of those that we receive for culture in the Microbiology Laboratory; therefore, this approach represents a considerable simplification of our daily routine.
对612根导管进行了前瞻性研究。在所有这些导管中,对其外表面和内表面都进行了培养,前者采用Maki的半定量技术,后者采用Liñares的半定量技术。469根中心静脉导管中有102根(22%)、70根用于肠外营养的导管中有21根(30%)、73根动脉导管中有19根(26%)在一种或两种技术检测下呈阳性。中心静脉导管外表面阳性率为95%,肠外营养导管为90%,动脉导管为95%,而内表面阳性率分别仅为59%、62%和42%。对导管内表面进行常规检查似乎没有道理。我们认为,导管的微生物学研究应根据特定类型导管中皮肤或连接处的相对重要性进行个体化。仅应对那些连接处代表重要致病途径的导管进行腔内表面的定量研究。这些导管在我们微生物实验室接收进行培养的导管中只占一小部分;因此,这种方法极大简化了我们的日常工作。