Douard M C, Arlet G, Leverger G, Paulien R, Waintrop C, Clementi E, Eurin B, Schaison G
Département d'Anesthesiologie, Hôpital Saint-Louis, Paris, France.
Intensive Care Med. 1991;17(1):30-5. doi: 10.1007/BF01708406.
Paired quantitative blood cultures collected simultaneously via catheter and peripheral vein in Isolator 1.5 ml tubes, were performed in 50 febrile hematology children. Samples were taken to diagnose catheter-related sepsis (CRS) without catheter removal and to monitor the therapeutic efficiency of antimicrobials administered through the infected device by infusion and/or by the antibiotic lock technique (ALT). In 7 children (14%) the colony counts from catheter blood samples were 30-fold higher than the colony counts from peripheral samples, suggesting CRS; in 7 other patients (14%), identical colony counts in both samples suggested sepsis was not catheter-related. One patient (2%) had septicemia caused by E. coli found in the urinary tract; only the peripheral blood cultures were positive. In 6 patients (12%), the Isolator system was not effective for diagnosing bacteremia or CRS; in 29 patients (58%) the febrile episode was not microbiologically documented. All episodes of CRS were cured whatever the treatment was: infusion or ALT.
在50名发热的血液学患儿中，通过隔离器1.5毫升试管同时经导管和外周静脉采集配对的定量血培养样本。采集样本用于在不拔除导管的情况下诊断导管相关败血症（CRS），并监测通过感染装置经输液和/或抗生素封管技术（ALT）给予的抗菌药物的治疗效果。在7名儿童（14%）中，导管血样本的菌落计数比外周样本的菌落计数高30倍，提示存在CRS；在另外7名患者（14%）中，两个样本的菌落计数相同，提示败血症与导管无关。1名患者（2%）患有由泌尿道中发现的大肠杆菌引起的败血症；仅外周血培养呈阳性。在6名患者（12%）中，隔离器系统对诊断菌血症或CRS无效；在29名患者（58%）中，发热发作未得到微生物学记录。无论采用何种治疗方法（输液或ALT），所有CRS发作均得到治愈。
