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三级医院就诊患者中心静脉导管的危险因素及生物膜检测

Risk factors and biofilm detection on central venous catheters of patients attended at tertiary hospital.

作者信息

Pérez-Zárate Pamela, Aragón-Piña Antonio, Soria-Guerra Ruth Elena, González-Amaro Ana María, Pérez-Urizar José, Pérez-González Luis Fernando, Martinez-Gutierrez Fidel

机构信息

Laboratorio de Microbiología, Facultad de Ciencias Químicas, UASLP, San Luis Potosí, SLP, Mexico.

Instituto de Metalurgia, UASLP, San Luis Potosí, SLP, Mexico.

出版信息

Micron. 2015 Nov;78:33-39. doi: 10.1016/j.micron.2015.07.001. Epub 2015 Jul 9.

DOI:10.1016/j.micron.2015.07.001
PMID:26218801
Abstract

AIM

To determinate the significance of risk factors with the presence of biofilm on catheters of patients attended at tertiary hospital cares.

MATERIAL AND METHODS

A total of 126 patients were included, data collection by observing the handling of the CVC, clinical history and microbiological isolation methods of CVCs tips (Roll-plate, sonication and scanning electron microscopy) were evaluated.

RESULTS

Certain factors, such as the lack of proper hand washing, the use of primary barriers and preparing medications in the same hospital service, showed an important relationship between biofilm formation in CVCs. The sonication method presented that most of the samples had isolation of multispecies 29 samples (64%); in contrast with the roll-plate method, just one sample (3%) was isolated.

CONCLUSIONS

The importance of the strict aseptic techniques of insertion and of the handlings of CVC was highlighted, the failure of both techniques was related to the biofilm formation and was evidenced using the scanning electron microscopy. Since this tool is not available in most hospitals, we present the correlation of those evidences with other standard microbiological methods and risk factors, which are necessary for the sensible detection of the different steps of the biofilm formation on CVC and their correct interpretation with clinical evidences.

摘要

目的

确定三级医院护理的患者导管上生物膜存在的风险因素的意义。

材料与方法

共纳入126例患者,通过观察中心静脉导管(CVC)的操作、临床病史以及CVC尖端的微生物分离方法(滚板法、超声处理法和扫描电子显微镜法)进行数据收集和评估。

结果

某些因素,如洗手不规范、使用初级屏障以及在同一医院科室配制药物,与CVC中生物膜形成之间存在重要关联。超声处理法显示,大多数样本分离出多种菌,共29个样本(64%);相比之下,滚板法仅分离出1个样本(3%)。

结论

强调了CVC插入和操作严格无菌技术的重要性,这两种技术的失误均与生物膜形成有关,且通过扫描电子显微镜得以证实。由于大多数医院没有这种工具,我们展示了这些证据与其他标准微生物学方法及风险因素的相关性,这些对于合理检测CVC上生物膜形成的不同步骤及其与临床证据的正确解读是必要的。

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