Calomino N, Malerba M, Oliva G, Salvestrini F
Istituto di Clinica Chirurgica e Terapia Chirurgica, Università degli Studi, Siena.
Minerva Chir. 1997 Dec;52(12):1481-6.
Many reports from the surgical literature document the incidence of catheter related sepsis varies between 1 and 10 per cent. In many instances sepsis is secondary to contamination from normal saprophyte cutaneous bacteria. In our Institute we set down a standardized methodology to reduce the contamination of venous central access from cutaneous bacteria. Of 31 patients studied, none had bacteria in the last 5 cm of central venous catheter, 2 had streptococcus alpha haemolytic colonies and coagulase negative staphylococcus colonies at the same time on skin over the region of venepuncture. With our paper we had attained one's awareness that it is very difficult to obtain zero per cent in contamination of central venous catheter, mainly in immunodepressed or critical patients, but with careful dressing and with new technology it is possible to reduce the contamination and following sepsis.
外科文献中的许多报告表明,导管相关败血症的发生率在1%至10%之间。在许多情况下,败血症继发于正常腐生皮肤细菌的污染。在我们研究所,我们制定了一种标准化方法,以减少皮肤细菌对中心静脉通路的污染。在研究的31例患者中,没有一例在中心静脉导管的最后5厘米处发现细菌,2例在静脉穿刺部位的皮肤同时出现甲型溶血性链球菌菌落和凝固酶阴性葡萄球菌菌落。通过我们的论文,人们认识到,要使中心静脉导管污染率达到零是非常困难的,尤其是在免疫抑制或危重症患者中,但通过仔细换药和采用新技术,有可能减少污染及随之而来的败血症。