Onland Wes, Pajkrt Dasja, Shin Cathy, Fustar Stana, Rushing Teresa, Wong Wing-Yen
Department of Pediatrics, Emma Childrens Hospital, Academic Medical Center, P.O. Box 22700, 1100 DD Amsterdam, The Netherlands.
J Pathog. 2011;2011:826169. doi: 10.4061/2011/826169. Epub 2011 Apr 18.
A retrospective study was conducted, including 61 patients with long-term intravascular devices (IVDs) admitted to the Childrens Hospital Los Angeles with diverse underlying diseases, different types of catheters, and culture-proven catheter-related bloodstream infections (BSIs). Within these patients, 125 catheter-related BSIs occurred, and the incidence of monomicrobial and polymicrobial BSIs was evaluated. Risk factors for polymicrobial BSIs were determined. Forty-two BSIs contained more than one pathogen. These polymicrobial BSIs were observed more often in younger patients (<4.1 years versus ≥4.1 years) and less in patients using venous implanted ports. No other associations were found between the occurrences of polymicrobial BSIs and underlying diseases, other types of catheters, host defense status, parenteral nutrition, recurrences, or catheter removal. Patients with long-term IVDs at a younger age have a higher risk of developing a polymicrobial BSI. Future prospective studies should address the issue of polymicrobial infection in IVDs in more detail.
开展了一项回顾性研究，纳入了61例入住洛杉矶儿童医院的长期血管内装置（IVD）患者，这些患者患有多种基础疾病，使用不同类型的导管，且经培养证实发生了导管相关血流感染（BSI）。在这些患者中，共发生了125例导管相关BSI，并对单微生物和多微生物BSI的发生率进行了评估。确定了多微生物BSI的危险因素。42例BSI包含不止一种病原体。这些多微生物BSI在较年轻患者（<4.1岁与≥4.1岁）中更常观察到，而在使用静脉植入式端口的患者中较少见。在多微生物BSI的发生与基础疾病、其他类型的导管、宿主防御状态、肠外营养、复发或导管拔除之间未发现其他关联。年龄较小的长期IVD患者发生多微生物BSI的风险较高。未来的前瞻性研究应更详细地探讨IVD中多微生物感染的问题。
