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无症状血液透析患者隧道式透析导管相关细菌负荷。

Bacterial Load Associated With Tunneled Dialysis Catheters in Symptom-Free Hemodialysis Patients.

机构信息

Department of Cardiovascular Surgery Clinic, 290817Elazığ Fethi Sekin City Hospital, Elazig, Turkey.

出版信息

Vasc Endovascular Surg. 2022 Apr;56(3):253-257. doi: 10.1177/15385744211048296. Epub 2021 Dec 27.

Abstract

OBJECTIVE

This study aimed to evaluate the rate of asymptomatic bacterial infection of tunneled dialysis catheters (TDCs) removed due to maturation of native arteriovenous fistula (nAVF) or catheter dysfunction in hemodialysis patients with no clinically apparent infection.

MATERIALS AND METHODS

A total of 229 patients (43.2% [n = 99] female and 56.8% [n = 130] male), who underwent hemodialysis through a TDC, were included in this study. Tip cultures of TDCs removed in an operating room and under sterile conditions were collected. All patients were asymptomatic for catheter infection and had not received antibiotic therapy for the last month.

RESULTS

The median duration of catheterization was 80 days (min: 5, max: 2880). Bacterial growth was observed in a total of 62 (27.1%) patients. The most common microorganisms were and . The asymptomatic infection rate was highest in catheters placed through the right and left subclavian veins; however, this was not statistically significant due to the small number of patients. Placement and usage time of TDCs were found to be the most significant factors for bacterial growth in the catheter tip culture ( < .001).

CONCLUSION

Prolonged duration and use of the catheter is significant in terms of bacterial load. The use of TDC as vascular access in renal replacement therapy should be avoided as much as possible.

摘要

目的

本研究旨在评估无临床明显感染的血液透析患者因自身动静脉瘘(nAVF)成熟或导管功能障碍而拔除的隧道式透析导管(TDC)无症状细菌感染率。

材料和方法

共纳入 229 例(43.2%[n=99]为女性,56.8%[n=130]为男性)接受 TDC 血液透析的患者。采集手术室无菌条件下拔出的 TDC 尖端培养物。所有患者均无导管感染的症状,且在上个月未接受抗生素治疗。

结果

导管置管时间中位数为 80 天(最短:5 天,最长:2880 天)。共有 62 例(27.1%)患者出现细菌生长。最常见的微生物是 和 。导管尖端培养物中无症状感染率最高的是经右和左锁骨下静脉置管的患者,但由于患者数量较少,这一结果无统计学意义。导管尖端培养物中细菌生长的最显著因素是 TDC 的置管和使用时间(<0.001)。

结论

导管的使用时间和细菌负荷量与导管细菌生长显著相关。应尽可能避免 TDC 作为肾脏替代治疗的血管通路。

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