Teoh N, Parr M J, Finfer S R
Intensive Therapy Unit, Royal North Shore Hospital, Sydney, N.S.W.
Anaesth Intensive Care. 1997 Aug;25(4):354-7. doi: 10.1177/0310057X9702500405.
This study reports the incidence of bacteraemia following 106 consecutive bedside percutaneous tracheostomies. Post-tracheostomy blood culture results were compared with other blood cultures from the same population. The incidence of positive post-tracheostomy blood cultures was 10.4% (11/106), compared with 6.6% (7/106) for other blood cultures (odds ratio 1.64, 95% confidence interval 0.61-4.40, P = 0.46). Staphylococcus epidermidis was the most common organism cultured, 7/106 (6.6%) of post-tracheostomy cultures, compared with 3/106 (2.8%) for other cultures (odds ratio 2.43, 95% confidence interval 0.61-9.65, P = 0.33). The other four post-tracheostomy cultures grew an organism cultured from that patient's tracheal secretions. Seventy-four patients were receiving antibiotics at the time of tracheostomy, of these 7 (9.5%)-had positive blood cultures, a similar incidence (4 of 32, 12.5%) to those not receiving antibiotics (odds ratio 0.73, 95% confidence interval 0.20-2.70, P = 0.90). We conclude bacteraemia is a common complication of percutaneous tracheostomy; the causative organisms come from the patients' trachea or skin.
本研究报告了连续106例床旁经皮气管切开术后菌血症的发生率。将气管切开术后血培养结果与同一人群的其他血培养结果进行比较。气管切开术后血培养阳性率为10.4%（11/106），而其他血培养阳性率为6.6%（7/106）（比值比1.64，95%置信区间0.61 - 4.40，P = 0.46）。表皮葡萄球菌是培养出的最常见病原体，气管切开术后培养中有7/106（6.6%）为该菌，而其他培养中为3/106（2.8%）（比值比2.43，95%置信区间0.61 - 9.65，P = 0.33）。另外4例气管切开术后培养结果显示，培养出的病原体与该患者气管分泌物中培养出的病原体相同。74例患者在气管切开时正在接受抗生素治疗，其中7例（9.5%）血培养阳性，这一发生率与未接受抗生素治疗的患者（32例中的4例，12.5%）相似（比值比0.73，95%置信区间0.20 - 2.70，P = 0.90）。我们得出结论，菌血症是经皮气管切开术的常见并发症；致病病原体来自患者的气管或皮肤。
