Akaishi Tetsuya, Tokuda Koichi, Katsumi Makoto, Fujimaki Shin-Ichi, Aoyagi Tetsuji, Harigae Hideo, Ishii Tadashi
Regional Medicine, Tohoku University Hospital, Sendai, JPN.
Infection Control, Tohoku University, Sendai, JPN.
Cureus. 2023 Jun 9;15(6):e40202. doi: 10.7759/cureus.40202. eCollection 2023 Jun.
Background Central line-associated bloodstream infection (CLABSI) is among the most common bloodstream infections in the university hospital and intensive care unit settings. This study evaluated the routine blood test findings and microbe profiles of bloodstream infection (BSI) by the presence and types of central vein (CV) access devices (CVADs). Methods A total of 878 inpatients at a university hospital who were clinically suspected for BSI and underwent blood culture (BC) testing between April 2020 and September 2020 were enrolled. Data regarding age at BC testing, sex, WBC count, serum C-reactive protein (CRP) level, BC test results, yielded microbes, and usage and types of CVADs were evaluated. Results The BC yields were detected in 173 patients (20%), suspected contaminating pathogens in 57 (6.5%), and 648 (74%) with a negative yield. The WBC count (p=0.0882) and CRP level (p=0.2753) did not significantly differ between the 173 patients with BSI and the 648 patients with negative BC yields. Among the 173 patients with BSI, 74 used CVADs and met the diagnosis of CLABSI; 48 had a CV catheter, 16 had CV access ports, and 10 had a peripherally inserted central catheter (PICC). Patients with CLABSI showed lower WBC counts (p=0.0082) and serum CRP levels (p=0.0024) compared to those with BSI who did not use CVADs. The most commonly yielded microbes in those with CV catheters, CV-ports, and PICC were (n=9; 19%), (n=6; 38%), and (n=8; 80%), respectively. Among those with BSI who did not use CVADs, (n=31; 31%) was the most common pathogen, followed by (n=13; 13%). Conclusion Patients with CLABSI showed lower WBC counts and CRP levels than those with BSI who did not use CVADs. was among the most common microbes in CLABSI and accounted for the majority of yielded microbes in patients who used PICC.
中心静脉导管相关血流感染（CLABSI）是大学医院和重症监护病房中最常见的血流感染之一。本研究根据中心静脉（CV）通路装置（CVAD）的存在情况及类型，评估了血流感染（BSI）的常规血液检查结果和微生物谱。方法：纳入2020年4月至2020年9月期间在某大学医院临床疑似BSI并接受血培养（BC）检测的878例住院患者。评估BC检测时的年龄、性别、白细胞计数、血清C反应蛋白（CRP）水平、BC检测结果、培养出的微生物以及CVAD的使用情况和类型。结果：173例患者（20%）血培养阳性，57例（6.5%）检测出疑似污染病原体，648例（74%）血培养阴性。173例BSI患者与648例血培养阴性患者的白细胞计数（p = 0.0882）和CRP水平（p = 0.2753）无显著差异。在173例BSI患者中，74例使用了CVAD并符合CLABSI诊断；48例有中心静脉导管，16例有中心静脉通路端口，10例有外周静脉穿刺中心静脉导管（PICC）。与未使用CVAD的BSI患者相比，CLABSI患者的白细胞计数（p = 0.0082）和血清CRP水平（p = 0.0024）较低。中心静脉导管、中心静脉通路端口和PICC患者中最常培养出的微生物分别为（n = 9；19%）、（n = 6；38%）和（n = 8；80%）。在未使用CVAD的BSI患者中，（n = 31；31%）是最常见的病原体，其次是（n = 13；13%）。结论：CLABSI患者的白细胞计数和CRP水平低于未使用CVAD的BSI患者。是CLABSI中最常见的微生物之一，在使用PICC的患者中培养出的微生物占大多数。
