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与三腔血管内导管放置持续时间相关的定植和菌血症

Colonization and bacteremia related to duration of triple-lumen intravascular catheter placement.

作者信息

Ullman R F, Gurevich I, Schoch P E, Cunha B A

机构信息

Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501.

出版信息

Am J Infect Control. 1990 Jun;18(3):201-7. doi: 10.1016/0196-6553(90)90185-u.

Abstract

The increased use of triple-lumen catheters has brought with it an increase in sepsis. We undertook a study to determine whether this increase was related to the length of time a catheter was in place. Culture of the fluid in each of the three lumens of all triple-lumen catheters in the medical intensive care units was done daily for a 6-month period. In 14 of 31 catheters, 28 of 93 lumens showed bacterial or fungal growth. A temporal relationship between the time a catheter was placed and the onset of catheter colonization and patient sepsis was established (p less than 0.01). Catheter colonization preceded sepsis in three of four patients who became bacteremic with the same organisms that were cultured from the lumens and the catheter tips. As a result of this study, centrally placed intravascular lines are now changed every 7 days in our institution with a noticeable decrease in line-related sepsis.

摘要

三腔导管使用的增加导致了脓毒症发生率的上升。我们开展了一项研究,以确定这种增加是否与导管留置时间有关。在6个月的时间里,每天对医疗重症监护病房中所有三腔导管的三个腔中的液体进行培养。在31根导管中的14根中,93个腔中有28个显示出细菌或真菌生长。确定了导管置入时间与导管定植及患者脓毒症发作之间的时间关系(p小于0.01)。在4名因与从管腔和导管尖端培养出的相同微生物发生菌血症的患者中,有3名患者的导管定植先于脓毒症。这项研究的结果是,在我们机构中,现在中心静脉置管每7天更换一次,与置管相关的脓毒症明显减少。

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