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癌症患者外周静脉穿刺中心静脉导管相关血流感染的患病率及预测因素:一项多中心队列研究。

Prevalence and predictors of peripherally inserted central venous catheter associated bloodstream infections in cancer patients: A multicentre cohort study.

作者信息

Lee Jae Hwan, Kim Min Uk, Kim Eung Tae, Shim Dong Jae, Kim Il Jung, Byeon Jong Hyun, Kim Hyun Beom

机构信息

Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do.

Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul.

出版信息

Medicine (Baltimore). 2020 Feb;99(6):e19056. doi: 10.1097/MD.0000000000019056.

DOI:10.1097/MD.0000000000019056
PMID:32028425
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7015558/
Abstract

Despite increasing use, the exact prevalence and predictors of peripherally inserted central catheter-associated bloodstream infection (PICC-CLABSI) in hospitalized patients with cancer are not elucidated.This retrospective cohort study included consecutive patients who underwent peripherally inserted central catheter (PICC) placement in 4 institutions (during 12 months in 3 hospitals and 10 months in 1 hospital). The prevalence of PICC-CLABSI was evaluated. The association between predictors and PICC-CLABSI were analyzed using Cox proportional hazards regression models and Kaplan-Meier survival analysis with log-rank tests.During the study period, 539 PICCs were inserted in 484 patients for a total of 10,841 catheter days. PICC-CLABSI occurred in 25 (5.2%) patients, with an infection rate of 2.31 per 1000 catheter days. PICC for chemotherapy (hazards ratio [HR] 11.421; 95% confidence interval (CI), 2.434-53.594; P = .019), double lumen catheter [HR 5.466; 95% CI, 1.257-23.773; P = .007], and PICC for antibiotic therapy [HR 2.854; 95% CI, 1.082-7.530; P = .019] were associated with PICC-CLABSI.PICC for chemotherapy or antibiotics, and number of catheter lumens are associated with increased risk of PICC-CLABSI in cancer patients. Careful assessment of these factors might help prevent PICC-CLABSI and improve cancer patients care.

摘要

尽管外周静脉穿刺中心静脉导管(PICC)的使用日益增多,但住院癌症患者中PICC相关血流感染(PICC-CLABSI)的确切患病率及预测因素仍未明确。这项回顾性队列研究纳入了在4家机构接受PICC置管的连续患者(3家医院为12个月,1家医院为10个月)。评估了PICC-CLABSI的患病率。使用Cox比例风险回归模型以及带有对数秩检验的Kaplan-Meier生存分析来分析预测因素与PICC-CLABSI之间的关联。在研究期间,484例患者共置入539根PICC,累计导管留置天数达10841天。25例(5.2%)患者发生了PICC-CLABSI,感染率为每1000导管日2.31例。化疗用PICC(风险比[HR]11.421;95%置信区间[CI],2.434 - 53.594;P = 0.019)、双腔导管[HR 5.466;95% CI,1.257 - 23.773;P = 0.007]以及抗生素治疗用PICC[HR 2.854;95% CI,1.082 - 7.530;P = 0.019]与PICC-CLABSI相关。化疗或抗生素治疗用PICC以及导管腔数与癌症患者发生PICC-CLABSI的风险增加相关。仔细评估这些因素可能有助于预防PICC-CLABSI并改善癌症患者的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/108b/7015558/94e5dcd9b5c2/medi-99-e19056-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/108b/7015558/8d049a01be2c/medi-99-e19056-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/108b/7015558/94e5dcd9b5c2/medi-99-e19056-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/108b/7015558/8d049a01be2c/medi-99-e19056-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/108b/7015558/94e5dcd9b5c2/medi-99-e19056-g005.jpg

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