Hodzic Samir, Tihic Nijaz, Smajic Jasmina, Omerbegovic Muhamed, Sljivic Mirsad
Department of Anaesthesiology and Reanimation, University Clinical Center Tuzla, Tuzla, B&H.
Med Arh. 2010;64(4):245-7.
The use of central venous catheters (CVC) carries a risk from local and systemic infectious complications, with prevalence of 6% in patients in Intensive care unit. Microorganisms colonizing the CVC usually originate from patient's or staff member's skin, but the source can also be a contaminated infusion solution or hematogenous dissemination from a distant focus. The infective agents often show increased resistance to antibiotics, which is an additional therapeutic problem. There is no knowledge of the frequency of the colonization of CVC by microorganisms in hospitals in Bosnia and Herzegovina, neither of the types of microorganisms which usually colonize CVC, nor their sensitivity to antimicrobial agents.
During the period 2004-2008, the analysis of 188 CVC samples was performed in patients in ICU at which the doubt for CVC connected infection was present. The microorganism identification was performed by standard microbiological antibiotics sensitivity methods.
Out of 188 checked samples, 101 (54%) had positive cultures and 87 (46%) were sterile. Out of 101 positive microbiological cultures, in 33 (32.67%) the gram-positive bacteria had been found, gram-negative in 62 (61.37%) and Candida albicans in 6 (5.94%) cultures. Gram-ne-gative bacteria were 93.55% sensitive to imipenem, and Gram-positive bacteria were sensitive to vancomycin.
Gram-negative bacilli and Coagulase-negative staphylococci are the most frequent micro-organisms which colonize the CVC. The increase of bacteria antibiotics resistance represents a big problem. All those facts leads to the need for bigger control and supervision over the CVC implantation, its proper maintenance and rational use.
使用中心静脉导管(CVC)存在局部和全身感染并发症的风险,重症监护病房患者中的发生率为6%。定植于CVC的微生物通常源自患者或工作人员的皮肤,但来源也可能是受污染的输液溶液或远处病灶的血行播散。感染病原体对抗生素的耐药性往往增加,这是一个额外的治疗问题。在波斯尼亚和黑塞哥维那的医院中,对于CVC被微生物定植的频率、通常定植于CVC的微生物类型及其对抗菌药物的敏感性均一无所知。
在2004年至2008年期间,对重症监护病房中怀疑存在CVC相关感染的患者的188份CVC样本进行了分析。通过标准微生物学抗生素敏感性方法进行微生物鉴定。
在188份检查样本中,101份(54%)培养结果为阳性,87份(46%)无菌。在101份阳性微生物培养物中,发现革兰氏阳性菌33份(32.67%),革兰氏阴性菌62份(61.37%),白色念珠菌6份(5.94%)。革兰氏阴性菌对亚胺培南的敏感性为93.55%,革兰氏阳性菌对万古霉素敏感。
革兰氏阴性杆菌和凝固酶阴性葡萄球菌是最常定植于CVC的微生物。细菌抗生素耐药性的增加是一个大问题。所有这些事实导致需要对CVC植入、妥善维护和合理使用进行更大程度的控制和监督。