Holt H M, Andersen S S, Andersen O, Gahrn-Hansen B, Siboni K
Department of Clinical Microbiology, Odense University Hospital, Denmark.
J Hosp Infect. 1995 Aug;30(4):253-60. doi: 10.1016/0195-6701(95)90259-7.
Seventy-eight patients with culture-positive epidural catheters, were studied. Fifty-nine had symptoms of exit site infection and 11 patients had clinical meningitis, two of whom also had an epidural abscess. This corresponds to a local infection incidence of at least 4.3% and an incidence of central nervous system infection of at least 0.7% at Odense University Hospital. This degree of infection is of the same magnitude as that reported for intravascular devices. We found that the patients with generalized symptoms of infection had been catheterized for a longer time, and were older than patients with only local symptoms of infection. The microorganisms isolated from the tips of the epidural catheters were coagulase-negative staphylococci (41%), Staphylococcus aureus (35%), Gram-negative bacilli (14%) and others (10%). The Gram-negative bacilli and S. aureus caused serious infections more frequently than the others. We discuss the symptoms and diagnosis of spinal epidural abscess and suggest a proposal for prophylactic and diagnostic guidelines for epidural catheter-related infections.
对78例导管培养阳性的硬膜外导管患者进行了研究。59例有出口部位感染症状，11例有临床脑膜炎，其中2例还患有硬膜外脓肿。这相当于欧登塞大学医院局部感染发生率至少为4.3%，中枢神经系统感染发生率至少为0.7%。这种感染程度与血管内装置报告的程度相同。我们发现，有全身感染症状的患者留置导管的时间更长，且比仅有局部感染症状的患者年龄更大。从硬膜外导管尖端分离出的微生物为凝固酶阴性葡萄球菌（41%）、金黄色葡萄球菌（35%）、革兰氏阴性杆菌（14%）和其他（10%）。革兰氏阴性杆菌和金黄色葡萄球菌比其他细菌更频繁地引起严重感染。我们讨论了脊髓硬膜外脓肿的症状和诊断，并提出了硬膜外导管相关感染的预防和诊断指南建议。
