Pandit Priyanka, Sahni A K, Grover Naveen, Dudhat Vaibhav, Das N K, Biswas A K
Assistant Professor (Microbiology), Command Hospital (Southern Command), Pune 411040, India.
Brig Med, HQ 15 Corps, C/o 56 APO, India.
Med J Armed Forces India. 2021 Jan;77(1):38-45. doi: 10.1016/j.mjafi.2019.07.002. Epub 2019 Oct 15.
Intravascular devices have significant potential for producing iatrogenic diseases resulting in catheter-related blood stream infections (CRBSIs). A study was undertaken to find the prevalence of CRBSI among patients in acute wards and to analyze the associated risk factors, causative pathogens with their antibiotic susceptibility (ABST) patterns.
Randomly ten days per month were chosen, for a period of two years. All the acute wards patients who were on indwelling blood catheters were identified. Those fulfilling the CRBSI criteria were further worked up for confirmation of diagnosis by differential time to positivity. The catheter tip was cultured by Maki's semiquantitative method. ABST of the isolates obtained was performed by Kirby-Bauer disk diffusion method.
The prevalence of CRBSI was found to be 39.25% with the most common organism isolate being (23.81%). The immunocompromised status of the patients and catheterisation time were significant risk factors. Methicillin resistance was found to be 33.33% in coagulase-negative staphylococci. The resistance to vancomycin among the isolates was found to be 33.33%. Among the gram negatives, resistance to aminoglycosides, fluoroquinolones and third-generation cephalosporins was high.
The study highlights the importance of regular surveillance programs, an efficient infection control program, strict adherence to antiseptic measures and use of a rational antibiotic policy for the early diagnosis and better management of CRBSI.
血管内装置极有可能引发医源性疾病，导致导管相关血流感染（CRBSIs）。开展了一项研究，以确定急性病房患者中CRBSI的患病率，并分析相关风险因素、致病病原体及其抗生素敏感性（ABST）模式。
在两年时间里，每月随机选择10天。确定所有留置血导管的急性病房患者。对符合CRBSI标准的患者，通过差异阳性时间进一步检查以确诊。导管尖端采用Maki半定量方法培养。对获得的分离株进行ABST检测，采用 Kirby-Bauer 纸片扩散法。
发现CRBSI的患病率为39.25%，最常见的分离菌为（23.81%）。患者的免疫功能低下状态和置管时间是重要的风险因素。凝固酶阴性葡萄球菌的耐甲氧西林率为33.33%。在分离株中，对万古霉素的耐药率为33.33%。在革兰阴性菌中，对氨基糖苷类、氟喹诺酮类和第三代头孢菌素的耐药率较高。
该研究强调了定期监测计划、有效的感染控制计划、严格遵守消毒措施以及采用合理抗生素政策对于CRBSI早期诊断和更好管理的重要性。
