Capdevila J A, Segarra A, Planes A M, Ramírez-Arellano M, Pahissa A, Piera L, Martínez-Vázquez J M
Servicio de Medicina Interna-Patologia Infecciosa, Hospital General Vall d'Hebrón, Autonomous University of Barcelona, Spain.
Nephrol Dial Transplant. 1993;8(3):231-4.
Thirty-six Permcath double-lumen catheters implanted in 36 chronic renal failure patients for haemodialysis treatment were prospectively studied. When catheter-related sepsis was suspected a quantitative blood culture was obtained simultaneously from the catheter and from a peripheral vein. If bacterial colonies in the catheter blood specimen were fourfold greater than identical bacterial colonies in the peripheral blood specimen, the test was considered indicative of catheter sepsis and an empirical antibiotic regimen was begun while the central line remained in situ. Eleven patients suffered 13 episodes of catheter-related sepsis. Staphylococcus epidermidis and Pseudomonas aeruginosa accounted for 77% of the strains isolated. All episodes were successfully treated with vancomycin or ciprofloxacin and yielded negative results on follow-up quantitative blood cultures. Fever subsided within the first 48 h of therapy and no complications occurred. None of these patients required catheter removal for cure of the catheter-related sepsis.
对36例慢性肾衰竭患者植入36根Permcath双腔导管进行血液透析治疗进行了前瞻性研究。当怀疑发生导管相关败血症时，同时从导管和外周静脉获取定量血培养。如果导管血标本中的细菌菌落比外周血标本中的相同细菌菌落多四倍，则该检测被认为提示导管败血症，并在中心静脉导管仍留置原位的情况下开始经验性抗生素治疗方案。11例患者发生了13次导管相关败血症发作。表皮葡萄球菌和铜绿假单胞菌占分离菌株的77%。所有发作均用万古霉素或环丙沙星成功治疗，随访定量血培养结果为阴性。发热在治疗的头48小时内消退，未发生并发症。这些患者中无一例因治愈导管相关败血症而需要拔除导管。
