Hansell D T, Park R, Jensen R, Davidson L, Henderson G, Gray G R
Surg Gynecol Obstet. 1986 Nov;163(5):469-74.
Catheter related sepsis (CRS) is the most serious complication of total parenteral nutrition. Frequently, however, low rates of CRS are associated with a high incidence of infection of the catheter tip, the clinical significance of which is unclear. The relationships between CRS, infection of the catheter tip and infection at the site of catheter insertion have been investigated in 283 catheters of 257 patients receiving total parenteral nutrition. CRS occurred in only ten patients (3.5 per cent) whereas organisms were isolated from 108 catheter tips (38.2 per cent). The most common organism isolated was Staphylococcus epidermidis (66.7 per cent). Eight catheter tips were colonized from a distant septic focus. Organisms were isolated from 90 catheter tips which were removed electively from patients who displayed no clinical evidence of sepsis. There was a poor correlation between infected catheter tips and infected catheter insertion sites. Asymptomatic infection of the catheter tip appears to be of little clinical relevance, resulting in no patient morbidity. Contamination of the catheter tip during or after removal seems to account for a significant proportion of these infections.
导管相关败血症（CRS）是全胃肠外营养最严重的并发症。然而，CRS发生率低时常伴有较高的导管尖端感染发生率，其临床意义尚不清楚。我们对接受全胃肠外营养的257例患者的283根导管进行了研究，以探讨CRS、导管尖端感染和导管插入部位感染之间的关系。仅10例患者发生CRS（3.5%），而从108个导管尖端分离出微生物（38.2%）。分离出的最常见微生物是表皮葡萄球菌（66.7%）。8个导管尖端的细菌来自远处的感染灶。从90个导管尖端分离出微生物，这些导管是从无败血症临床证据的患者中择期拔除的。感染的导管尖端与感染的导管插入部位之间相关性较差。导管尖端的无症状感染似乎临床意义不大，不会导致患者发病。这些感染中很大一部分似乎是由于拔除导管期间或之后导管尖端受到污染所致。
