内科

目的探讨外科ICU中心静脉导管相关血行感染的细菌定植、感染的发生率、药物敏感性以及相关危险因素，为临床预防和治疗提供依据。方法回顾性分析疑似中心静脉导管感染病例，根据血培养和导管尖端培养结果，观察导管相关感染的发生率和病原菌分布及耐药情况并进行统计分析。结果疑似中心静脉导管感染患者143例中，确诊导管相关性血行感染（CRBSI） 31例，发生率为21.7%（31/143）；共分离出病原菌31株：鲍曼不动杆菌8株（25.8%）、真菌6株（19.3%）、铜绿假单胞菌4株（12.9%）、凝固酶阴性葡萄球菌4株（12.9%）。结论鲍曼不动杆菌和真菌是外科ICU中心静脉导管相关血行感染的主要致病菌，医务人员应加强重视并早期监测，并根据药敏结果适时调整抗菌药物。

ObjectiveTo investigate the colonization, incidence of infection, drug sensitivity and related risk factors of central venous catheter-related bloodstream infection (CRBSI) in SICU (Surgical Intensive Care Unit), providing guidance for clinical prevention and treatment. MethodsA retrospective analysis was performed to review the data of cases suspected with central venous catheter (CVC) infection in the SICU. The incidence of CRBSI, pathogen distribution and drug resistance were observed and analyzed based on the outcomes of blood culture and tip culture. ResultAmong 143 suspected cases, 31 cases (21.7%) were diagnosed as CRBSI. 31 pathogenic strains were separated, including 8 strains of Acinetobacter baumannii (25.8%),6 strains of fungi (19.3%), 4 strains of Pseudomonas aeruginosa (12.9%) and 4 strains of coagulase-negative staphylococci (12.9%). ConclusionsAcinetobacter baumannii and fungi are the main pathogens of central venous catheter-related bloodstream infections in the SICU. Medical staffs should emphasize on early detection and timely adjustment of antimicrobial drugs according to the result of the drug sensitivity test.

ref