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消化道恶性肿瘤患者完全植入式中心静脉输液港感染:发生率及危险因素。

Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors.

机构信息

INSERM Unit 1060, INRA 1235, Unité de Nutrition Clinique Intensive, 103 Grande Rue de la Croix Rousse, University of Lyon, Lyon, France.

出版信息

Am J Infect Control. 2012 Dec;40(10):935-9. doi: 10.1016/j.ajic.2012.01.024. Epub 2012 May 26.

Abstract

BACKGROUND

Central venous access port-related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer.

METHODS

This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI.

RESULTS

A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated.

CONCLUSIONS

In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies.

摘要

背景

中央静脉置管相关血流感染(CVAP-BSI)与癌症患者的发病率和死亡率相关。本研究旨在探讨成人消化系统癌症患者 CVAP-BSI 的发生率和危险因素。

方法

这是一项前瞻性观察性队列研究,于 2007 年至 2011 年在一家大学医院的 2 个肿瘤病房进行。发生率以每 1000 个导管日 CVAP-BSI 的数量表示。采用 Cox 回归模型来确定 CVAP-BSI 的危险因素。

结果

共纳入 315 例患者。41 例(13.0%)患者发生 CVAP-BSI。总体发生率为 0.76/1000 导管日。食管癌(1.28,P=0.05)和胰腺癌(1.24,P=0.007)患者的发生率较高。与 CVAP-BSI 独立相关的危险因素包括:世界卫生组织(WHO)体力状态 2-4 级、前一个月导管使用天数、胰腺癌和肠外营养。凝固酶阴性葡萄球菌和肠杆菌是主要分离的微生物。

结论

在成人消化系统癌症患者中,胰腺癌、累积导管使用天数、WHO 体力状态和肠外营养被确定为 CVAP-BSI 的独立危险因素。具有这些危险因素之一的患者可能是预防策略的候选者。

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