Jia Lei, Yu Huijie, Lu Jinqi, Zhang Yuqi, Cai Ying, Liu Yuting, Ma Xiefeng
Department of Nosocomial Infection, First Municipal Hospital, Jiaxing 314000, China; Email:
Zhonghua Yi Xue Za Zhi. 2015 Mar 10;95(9):654-8.
To explore the epidemiological characteristics, bacterial composition and risk factors for patients with catheter-related bloodstream infection (CRBSI) in intensive care unit (ICU).
A prospective survey was conduced for 2 605 ICU patients during January 2010 to December 2013. The clinical data of CRBSI and non-CRBSI patients were compared and their relevant risk factors analyzed.
Among them, there were 1 773 cases of arteriovenous catheterization. And 94 cases (5.3%) had CRBSI. The 1 000-day catheter infection rate was 9.8. The mortality rates of CRBSI and non-CRBSI patients were 23.4% and 10.7% respectively. And the difference was statistically significant (χ² = 14.38, P < 0.01). The occurrence of CRBSI was a risk factor for mortality. Logistic regression analysis showed that the occurrence of CRBSI was 3.33 folds for venous catheterization time > 6 days over ≤ 6 days (95% CI: 2.04-5.56), 2.50 folds for trauma patients over non-trauma ones (95% CI: 1.49-4.17), 2.98 folds for malignant tumors patients over non-malignant tumors ones (95% CI: 1.61-5.51) and 4.32 folds for diabetics over non-diabetics (95% CI: 2.07-9.01). For different sites of arteriovenous catheterization, the occurrences of CRBSI were not statistically significant. For CRBSI patients with blood culture, the positive microorganisms were gram-negative bacteria (61.7%), gram-positive bacteria (26%) and fungi (12.3%).
The occurrence of CRBSI is a risk factor for mortality. And diabetes, trauma and arteriovenous catheterization time > 6 days are risk factors for CRBSI. Comprehensive preventive measures should be taken to reduce the incidence of CRBSI.
探讨重症监护病房(ICU)导管相关血流感染(CRBSI)患者的流行病学特征、细菌构成及危险因素。
对2010年1月至2013年12月期间的2605例ICU患者进行前瞻性调查。比较CRBSI患者与非CRBSI患者的临床资料,并分析其相关危险因素。
其中动静脉置管1773例,发生CRBSI 94例(5.3%),千日导管感染率为9.8。CRBSI患者与非CRBSI患者的死亡率分别为23.4%和10.7%,差异有统计学意义(χ² = 14.38,P < 0.01)。CRBSI的发生是死亡的危险因素。Logistic回归分析显示,静脉置管时间>6天者发生CRBSI是≤6天者的3.33倍(95%CI:2.04 - 5.56),创伤患者是非创伤患者的2.50倍(95%CI:1.49 - 4.17),恶性肿瘤患者是非恶性肿瘤患者的2.98倍(95%CI:1.61 - 5.51),糖尿病患者是非糖尿病患者的4.32倍(95%CI:2.07 - 9.01)。动静脉置管不同部位发生CRBSI的差异无统计学意义。CRBSI血培养阳性患者中,阳性微生物为革兰阴性菌(61.7%)、革兰阳性菌(26%)和真菌(12.3%)。
CRBSI的发生是死亡的危险因素。糖尿病、创伤及静脉置管时间>6天是CRBSI的危险因素。应采取综合预防措施降低CRBSI的发生率。