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银混合端口比非银混合端口降低静脉接入端口相关感染率:一项单中心回顾性分析。

Silver-Mixed Port Reduces Venous Access Port Related Infection Rate Compared to Non-Silver-mixed Port: A Single-center Retrospective Analysis.

机构信息

Department of Radiology, The Jikei University School of Medicine, The Jikei University of Second Building 14F, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-0003, Japan.

Department of Radiology, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-ku, Tokyo, 125-8506, Japan.

出版信息

Cardiovasc Intervent Radiol. 2023 Dec;46(12):1696-1702. doi: 10.1007/s00270-023-03583-y. Epub 2023 Oct 30.

Abstract

PURPOSE

Totally implantable venous access ports (TIVAPs) are increasingly used as safe and convenient central venous access devices. However, several TIVAP-related complications occur, with port/catheter infection being most common. Silver-mixed ports have recently been introduced in anticipation of reducing TIVAP infection. This study aimed to investigate the efficacy of this device in reducing port infection by examining groups with and without silver-mixed devices.

MATERIALS AND METHODS

From April 2017 to July 2022, silver-mixed ports (S group) and non-silver-mixed port group (NS group) were reviewed at our institution. The incidence of TIVAP-related infections, patient characteristics, and bacteriological data were evaluated. Univariate and multivariate analyses were used to evaluate risk factors for TIVAP-related infection.

RESULTS

A total of 607 patients (S group, n = 203; NS group, n = 404) were enrolled. The rates of TIVAP-related infection were 3.0% (n = 6) and 7.7% (n = 31) in the S and NS groups, respectively. The incidence of total infection per 1000 catheter-days were 0.114 and 0.214 the S and NS groups, respectively. In the entire group, the rates of infection were 6.1% (n = 37) and the incidence of total infection per 1000 catheter-days was 0.187. Univariate and multivariate analyses revealed a significantly lower TIVAP-related infection rate in S group than NS group (p = 0.0216, odds ratio = 2.88 confidence interval: 1.17-7.08). No gram-negative rods were detected in the S group as port infection.

CONCLUSION

Silver-mixed port may be feasible in preventing port infection.

LEVEL OF EVIDENCE

Level 3, Local non-random sample.

摘要

目的

完全植入式静脉通路端口(TIVAP)作为安全、方便的中心静脉通路装置的应用越来越广泛。然而,TIVAP 会出现多种相关并发症,其中以端口/导管感染最为常见。为了降低 TIVAP 感染,最近引入了含银混合端口。本研究旨在通过比较含银混合端口和不含银混合端口组,探讨该装置降低端口感染的效果。

材料与方法

本研究回顾了 2017 年 4 月至 2022 年 7 月在我院接受治疗的患者。对比分析含银混合端口组(S 组)和非含银混合端口组(NS 组)的 TIVAP 相关感染发生率、患者特征和细菌学数据。采用单因素和多因素分析评估 TIVAP 相关感染的危险因素。

结果

共纳入 607 例患者(S 组,n=203;NS 组,n=404)。S 组和 NS 组的 TIVAP 相关感染率分别为 3.0%(n=6)和 7.7%(n=31)。S 组和 NS 组的 1000 个导管日感染率分别为 0.114 和 0.214。在整个研究组中,感染率为 6.1%(n=37),1000 个导管日感染率为 0.187。单因素和多因素分析均显示 S 组 TIVAP 相关感染率显著低于 NS 组(p=0.0216,比值比=2.88,95%置信区间:1.17-7.08)。S 组中未检测到革兰氏阴性杆菌引起的端口感染。

结论

含银混合端口可能是预防端口感染的一种可行方法。

证据水平

3 级,局部非随机样本。

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