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外周置入中心静脉导管相关性感染的住院成年患者队列研究。

Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients.

机构信息

Radiology Department, Percy Military Teaching Hospital, 101 avenue Henri Barbusse, 92140, Clamart, France.

Military Centre for Epidemiology and Public Health (CESPA), GSBdD, 111 avenue de la Corse - Caserne Audéoud, 13007, Marseille-Aubagne, France.

出版信息

Cardiovasc Intervent Radiol. 2016 Mar;39(3):385-93. doi: 10.1007/s00270-015-1182-4. Epub 2015 Jul 23.

Abstract

PURPOSE

To determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.

MATERIALS AND METHODS

Medical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.

RESULTS

Nine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3%) with a median age of 58 years. 31 (3.4%) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1%) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7%) septic thrombophlebitis, and 1 (3.2%) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2-confidence interval (CI) 95% [1.77-29.5]), auto/allograft (OR 5.9-CI 95% [1.2-29.2]), and anti-coagulant therapy (OR 2.2-95% [1.4-12]).

CONCLUSION

Chemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.

CLINICAL ADVANCE

Chemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections.

摘要

目的

确定经外周中心静脉置管(PICC)相关感染并发症的发生率和危险因素。

材料和方法

回顾我院 2010 年 1 月至 2013 年 10 月期间每位接受 PICC 置管的住院患者的病历。记录所有与 PICC 相关的感染,并分为导管相关血流感染(CR-BSI)、出口部位感染和脓毒性血栓性静脉炎。

结果

在研究期间,共放置了 923 根 PICC 管,涉及 644 位患者,其中大多数为男性(68.3%),中位年龄为 58 岁。31 例(3.4%)PICC 相关感染发生在研究期间,感染率为每 1000 导管日 1.64 例。我们观察到 27 例(87.1%)CR-BSI,感染率为每 1000 导管日 1.43 例,3 例(9.7%)脓毒性血栓性静脉炎和 1 例(3.2%)出口部位感染。多变量逻辑回归分析显示,化疗(比值比(OR)7.2-95%置信区间(CI)[1.77-29.5])、自体/同种异体(OR 5.9-95% CI [1.2-29.2])和抗凝治疗(OR 2.2-95% CI [1.4-12])与更高的 PICC 相关感染率相关。

结论

化疗、自体/同种异体和抗凝治疗与 PICC 相关感染的风险增加相关。对这些危险因素的仔细评估可能对未来预防 PICC 相关感染的成功至关重要。

临床进展

化疗、自体/同种异体和抗凝治疗是 PICC 相关感染的重要预测因素。对这些危险因素的仔细评估可能对未来预防 PICC 相关感染的成功至关重要。

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