Lowder J N, Lazarus H M, Herzig R H
Arch Intern Med. 1982 Aug;142(8):1456-9.
Ninety central venous catheters were inserted into 80 patients undergoing therapy for malignant neoplasms. Bacteremia and fungemia occurred in 18 of 41 treatment courses in patients with acute leukemia and in nine of 55 treatment courses in patients with solid tumors and lymphomas. Although gram-negative organisms accounted for nine (33%) cases of infection, the majority of disseminated infections were caused by gram-positive organisms (12 [45%] cases) or fungi (six [22%] cases). Central venous catheters may be helpful in the treatment of patients undergoing intensive therapy with cytotoxic agents, but the shift in-spectrum of infection to gram-positive bacteremias in patients with these catheters compared with patients treated using peripheral vein access must be appreciated.
90根中心静脉导管被插入80例正在接受恶性肿瘤治疗的患者体内。急性白血病患者的41个疗程中有18例发生菌血症和真菌血症，实体瘤和淋巴瘤患者的55个疗程中有9例发生菌血症和真菌血症。虽然革兰氏阴性菌占9例（33%）感染病例，但大多数播散性感染是由革兰氏阳性菌（12例[45%]）或真菌（6例[22%]）引起的。中心静脉导管可能有助于接受细胞毒性药物强化治疗的患者，但与使用外周静脉通路治疗的患者相比，必须认识到使用这些导管的患者感染谱向革兰氏阳性菌血症的转变。
