Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Japan.
J Infect Chemother. 2018 Jan;24(1):31-35. doi: 10.1016/j.jiac.2017.08.013. Epub 2017 Oct 21.
Central line-associated bloodstream infections (CLABSIs) are among the most serious complications especially in blood cancer patients. In January 2013, Centers for Disease and Prevention (CDC) introduced a new surveillance definition of mucosal barrier injury-associated laboratory-confirmed bloodstream infection (MBI-LCBI). This study was to determine the impact of MBI-LCBI on CLABSIs and compare the clinical characteristics of MBI versus non-MBI-LCBI cases.
We retrospectively reviewed the records of 250 consecutive patients. They were admitted in department of hematology at Aichi Medical University Hospital. We applied the revised 2013 CLABSI surveillance protocol to all CLABSI cases identified during the 47-months period from May 2012 through June 2016.
A total of 44 CLABSIs were identified. The median patient age was 65 years (range, 12 to 89). Among 44 patients, 31 patients were diagnosed as leukemia (70.5%) and 12 patients as lymphoma (27.3%). Six patients underwent bone transplantation for leukemia or myelodysplastic syndrome (13.6%). A total of 20 patients (45.5%) were classified as MBI-LCBI and 24 (54.5%) were classified as non-MBI-LCBI. The primary disease type (P = 0.018), neutropenic within 3 days before CLABSI (MBI-LCBI vs. non-MBI-LCBI: 95.0% vs. 26.3%, P = <0.0001), line(s) removed owing to CLABSI (15.0% vs. 54.2%, P = 0.011) and Gram-negative organisms cultured (70.0% vs. 37.5%, P = 0.004) showed significantly difference between the groups.
Our data showed that MBI-LCBI cases account for 45.5% of the CLABSI cases identified in blood cancer patients, and constituted a significant burden to this high-risk patient population.
中心静脉导管相关血流感染（CLABSIs）是最严重的并发症之一，尤其是在血液癌症患者中。2013 年 1 月，疾病控制与预防中心（CDC）引入了一种新的黏膜屏障损伤相关实验室确诊血流感染（MBI-LCBI）监测定义。本研究旨在确定 MBI-LCBI 对 CLABSIs 的影响，并比较 MBI 与非 MBI-LCBI 病例的临床特征。
我们回顾性分析了 250 例连续患者的记录。他们在爱知医科大学医院血液科住院。我们应用 2013 年修订后的 CLABSI 监测方案，对 2012 年 5 月至 2016 年 6 月期间的 47 个月内所有 CLABSI 病例进行监测。
共发现 44 例 CLABSIs。中位患者年龄为 65 岁（范围，12 至 89 岁）。44 例患者中，31 例诊断为白血病（70.5%），12 例诊断为淋巴瘤（27.3%）。6 例患者因白血病或骨髓增生异常综合征接受骨髓移植（13.6%）。20 例（45.5%）患者被归类为 MBI-LCBI，24 例（54.5%）患者被归类为非 MBI-LCBI。主要疾病类型（P=0.018）、CLABSI 前 3 天内中性粒细胞减少（MBI-LCBI 与非 MBI-LCBI：95.0%与 26.3%，P<0.0001）、因 CLABSI 而移除的导管数（15.0%与 54.2%，P=0.011）和培养出的革兰氏阴性菌（70.0%与 37.5%，P=0.004）在两组间有显著差异。
我们的数据显示，MBI-LCBI 病例占血液癌症患者中 CLABSIs 病例的 45.5%，对这一高危人群构成了重大负担。
