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社区医院中的胃造口管感染

Gastrostomy tube infections in a community hospital.

作者信息

Pien E C, Hume K E, Pien F D

机构信息

Department of Medicine, Straub Clinic and Hospital, Honolulu, HI 96813, USA.

出版信息

Am J Infect Control. 1996 Oct;24(5):353-8. doi: 10.1016/s0196-6553(96)90022-x.

Abstract

BACKGROUND

Percutaneous gastric feeding tubes are becoming increasingly more common to provide nutrition in debilitated patients, while they decrease the risk of aspiration associated with nasogastric tubes.

METHODS

We reviewed infectious complications of 372 feeding gastrostomy tubes placed in a small urban community hospital over a recent period.

RESULTS

In our study there was an infection rate of 4.8%. Four serious infections occurred: two cases of peritonitis and two deep abscesses, but there were no infectious deaths. The most common infecting organisms were staphylococci, gram negative bacteria, and yeast. Most infections required treatment with parenteral antibiotics, prolonging hospitalization. Two of 17 infected tubes required removal.

CONCLUSION

Percutaneous gastrostomy tubes can produce life threatening infections and deserve serious attention by ICPs in hospitals, long-term care facilities, and home care services. These tubes should only be inserted if they extend meaningful life in patients. Protocols are needed for the care of gastrostomy tubes, and infections must be treated as early and as aggressively as possible to avoid serious consequences.

摘要

背景

经皮胃饲管在为虚弱患者提供营养方面越来越普遍,同时降低了与鼻胃管相关的误吸风险。

方法

我们回顾了近期一家小型城市社区医院放置的372根胃造口饲管的感染并发症情况。

结果

在我们的研究中,感染率为4.8%。发生了4例严重感染:2例腹膜炎和2例深部脓肿,但无感染相关死亡病例。最常见的感染病原体是葡萄球菌、革兰氏阴性菌和酵母菌。大多数感染需要肠外抗生素治疗,这延长了住院时间。17根感染的饲管中有2根需要拔除。

结论

经皮胃造口饲管可引发危及生命的感染,医院、长期护理机构和家庭护理服务中的重症监护医师应予以高度重视。只有当这些饲管能延长患者有意义的生命时才应插入。需要制定胃造口饲管的护理方案,必须尽早且积极地治疗感染以避免严重后果。

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