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心脏直视手术患者的导管尖端培养:与导管部位及患者年龄的关联

Catheter tip cultures on open-heart surgery patients: associations with site of catheter and age of patients.

作者信息

Freeman R, Hjersing N, Burridge A

出版信息

Thorax. 1981 May;36(5):355-9. doi: 10.1136/thx.36.5.355.

Abstract

The results of culture of 668 catheter tips from 422 patients are analysed with relation to the site of the catheter and the age of the patient. Coagulase-negative staphylococci were the most common bacterial isolate, but Gram-negative bacilli were found in the venous lines, femoral artery lines, and peripheral lines. Isolations of Gram-negative bacilli were associated with age, being found mainly in those under 1 year and those over 40 years of age. Typing of coagulase-negative staphylococci revealed that Staphylococcus epidermidis is the only variety found in peripheral lines and in lines inserted after operation for complications (central venous, sub-clavian, and long lines), whereas other types occur (along with Staphylococcus epidermidis) in the other lines (left atrial, arterial, and venous). Use of extra lines for the management of postoperative complications thereby increases the risk of Staphylococcus epidermidis gaining access to the circulation. A subgroup of venous lines used to administer inotropic agents was found to be sterile on culture, and this was the result of the anti-oxidant (sodium metabisulphite) in the inotrope solution acting as an antiseptic.

摘要

对422例患者的668个导管尖端培养结果进行了分析,分析内容涉及导管部位和患者年龄。凝固酶阴性葡萄球菌是最常见的分离细菌,但在静脉导管、股动脉导管和外周导管中发现了革兰氏阴性杆菌。革兰氏阴性杆菌的分离与年龄有关,主要见于1岁以下和40岁以上人群。凝固酶阴性葡萄球菌的分型显示,表皮葡萄球菌是外周导管以及术后并发症(中心静脉、锁骨下和长导管)插入导管中唯一发现的类型,而其他类型(与表皮葡萄球菌一起)出现在其他导管(左心房、动脉和静脉导管)中。因此,使用额外的导管来处理术后并发症会增加表皮葡萄球菌进入循环的风险。发现一组用于输注血管活性药物的静脉导管培养无菌,这是因为血管活性药物溶液中的抗氧化剂(焦亚硫酸钠)起到了防腐剂的作用。

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