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干细胞接受者中导管相关血流感染的发生率——我们应该“挑剔”吗?

Incidence of Catheter-Associated Bloodstream Infections in Stem Cell Recipients-Should We Be "PICCy"?

作者信息

Milczarek Sławomir, Kulig Piotr, Piotrowska Oliwia, Zuchmańska Alina, Wilk-Milczarek Ewa, Machaliński Bogusław

机构信息

Department of Hematology and Transplantology, Pomeranian Medical University, 71-252 Szczecin, Poland.

Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland.

出版信息

Cancers (Basel). 2024 Mar 21;16(6):1239. doi: 10.3390/cancers16061239.

Abstract

The management of patients undergoing HSCT requires a multipurpose central venous catheter. Peripheral catheters (PCs), such as peripherally inserted central catheters (PICCs) and MidLine catheters (MLCs), appear to be adequate vascular catheters to be used for stem cell infusion, although their utilization in this indication is not yet common. We analyzed the infectious complications such as blood stream infection (BSI), febrile neutropenia (FN) and central line-associated bloodstream infection (CLBSI) in patients undergoing stem cell infusion through PC and conventionally inserted central catchers (CICCs), and evaluated their impacts on transplantation outcomes. Our results reveal no statistically significant differences between different types of catheter in terms of FN, BSI and CLABSI. Moreover, transplantation outcomes were comparable between the groups. Interestingly, according to our data, there were no differences in terms of abovementioned infectious complications between individuals who received antibiotic prophylaxis and those who did not. Our study has shown that infection complications are independent of the intravenous device and antibiotic prophylaxis. Considering that PCs are not associated with life-threatening complications, they should be considered more frequently in the stem cell transplantation setting.

摘要

接受造血干细胞移植(HSCT)的患者管理需要使用多功能中心静脉导管。外周导管(PCs),如外周静脉穿刺中心静脉导管(PICCs)和中线导管(MLCs),似乎是用于干细胞输注的合适血管导管,尽管它们在该适应症中的应用尚不普遍。我们分析了通过外周导管和传统插入的中心导管(CICCs)进行干细胞输注的患者的感染并发症,如血流感染(BSI)、发热性中性粒细胞减少症(FN)和中心静脉导管相关血流感染(CLBSI),并评估了它们对移植结果的影响。我们的结果显示,在FN、BSI和CLABSI方面,不同类型的导管之间没有统计学上的显著差异。此外,两组之间的移植结果相当。有趣的是,根据我们的数据,接受抗生素预防的个体与未接受抗生素预防的个体在上述感染并发症方面没有差异。我们的研究表明,感染并发症与静脉装置和抗生素预防无关。鉴于外周导管不会引发危及生命的并发症,在干细胞移植中应更频繁地考虑使用它们。

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Infusion Therapy Standards of Practice, 8th Edition.《输液治疗实践标准》第8版
J Infus Nurs. 2021;44(1S Suppl 1):S1-S224. doi: 10.1097/NAN.0000000000000396.

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