Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Switzerland.
Swiss Med Wkly. 2011 Nov 21;141:w13294. doi: 10.4414/smw.2011.13294. eCollection 2011.
This prospective, single centre, observational study analysed the rate of catheter related blood stream infections in critically ill patients in intensive care units treated with haemo(dia)filtration. The infection rate was 3.8 per 1000 patient days. All infections were caused by coagulase negative staphylococci.
Temporary central venous catheters in patients undergoing continuous veno-venous haemo(dia)filtration contribute to serious infectious complications. The goal of this study was to assess the incidence of catheter related blood stream infections in critically ill patients treated with continuous veno-venous haemo(dia)filtration.
Prospective observational study of all intensive care unit patients treated with continuous veno-venous haemo(dia)filtration by a central venous catheter at the University Hospital Basel. All patients underwent a standardised anti-infective protocol including screening for nasal colonisation with S. aureus on the day of catheter insertion, antiseptic catheter placement technique and daily disinfection of the insertion site followed by local mupirocin application. Catheter related blood stream infection was diagnosed according to standard guidelines of the Center of Disease Control and Prevention. Primary end point was the incidence of catheter related blood stream infection in all intensive care unit patients treated with continuous veno-venous haemo(dia)filtration.
From 2003 to 2007 a total of 194 consecutive critically ill patients treated with continuous veno-venous haemo(dia)filtration were investigated. 173 patients (63% men) were suitable for final analysis. Median age was 68.6 years (18.9-87.8). Eight patients (4.6%) had positive blood cultures, six of them had a catheter related blood stream infection (incidence 3.8/1000 catheter days). All infections were caused by coagulase negative staphylococci. The duration of catheter use (p = 0.02) and pre-existing chronic skin disease (p = 0.042) were identified as potential risk factors for catheter related blood stream infection.
The incidence of catheter related blood stream infection in critically ill patients on intensive care units treated with continuous veno-venous haemo(dia)filtration was 3.8 per 1000 catheter days. All catheter related blood stream infections were caused by coagulase negative staphylococci.
本前瞻性、单中心、观察性研究分析了在重症监护病房接受血液透析滤过治疗的危重病患者中导管相关血流感染的发生率。感染率为每 1000 个患者日 3.8 例。所有感染均由凝固酶阴性葡萄球菌引起。
接受连续静脉-静脉血液透析滤过治疗的患者的临时中心静脉导管会导致严重的感染并发症。本研究的目的是评估接受连续静脉-静脉血液透析滤过治疗的危重病患者中导管相关血流感染的发生率。
对巴塞尔大学医院接受连续静脉-静脉血液透析滤过治疗的所有重症监护病房患者进行前瞻性观察性研究。所有患者均接受了标准化的抗感染方案，包括在导管插入当天筛查金黄色葡萄球菌的鼻腔定植情况、采用抗菌导管放置技术以及每天对插入部位进行消毒，随后局部应用莫匹罗星。根据疾病控制和预防中心的标准指南诊断导管相关血流感染。主要终点是接受连续静脉-静脉血液透析滤过治疗的所有重症监护病房患者中导管相关血流感染的发生率。
2003 年至 2007 年，共对 194 例连续接受连续静脉-静脉血液透析滤过治疗的连续危重病患者进行了调查。173 例患者（63%为男性）适合进行最终分析。中位年龄为 68.6 岁（18.9-87.8）。8 例（4.6%）患者血培养阳性，其中 6 例为导管相关血流感染（发生率为 3.8/1000 导管日）。所有感染均由凝固酶阴性葡萄球菌引起。导管使用时间（p=0.02）和预先存在的慢性皮肤病（p=0.042）被确定为导管相关血流感染的潜在危险因素。
在重症监护病房接受连续静脉-静脉血液透析滤过治疗的危重病患者中，导管相关血流感染的发生率为每 1000 个导管日 3.8 例。所有导管相关血流感染均由凝固酶阴性葡萄球菌引起。
