家庭肠外营养患者导管相关血流感染的诊断与管理
Diagnosis and management of catheter-related bloodstream infections in patients on home parenteral nutrition.
作者信息
Bond Ashley, Chadwick Paul, Smith Trevor R, Nightingale Jeremy M D, Lal Simon
机构信息
Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, UK.
Microbiology, Salford Royal NHS Foundation Trust, Salford, UK.
出版信息
Frontline Gastroenterol. 2020 Jan;11(1):48-54. doi: 10.1136/flgastro-2018-101094. Epub 2019 Feb 12.
Abstract
Catheter-related bloodstream infections (CRBSIs) commonly arise from a parenteral nutrition catheter hub. A target for a Nutrition Support Team is to have a CRBSI rate of less than 1 per 1000. The diagnosis of CRBSI is suspected clinically by a temperature shortly after setting up a feed, general malaise or raised blood inflammatory markers. It is confirmed by qualitative and quantitative blood cultures from the catheter and peripherally. Treatment of inpatients may involve central venous catheter removal and antibiotics for patients needing short-term parenteral nutrition, but catheter salvage is generally recommended for patients needing long-term parenteral nutrition, where appropriate.
摘要
导管相关血流感染（CRBSIs）通常源于肠外营养导管接头。营养支持团队的目标是使CRBSI发生率低于千分之一。临床怀疑CRBSI是在开始喂养后不久出现体温升高、全身不适或血液炎症标志物升高。通过对导管和外周血进行定性和定量血培养来确诊。对于需要短期肠外营养的住院患者，治疗可能包括拔除中心静脉导管并使用抗生素，但对于需要长期肠外营养的患者，在适当情况下通常建议保留导管。
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