使用带涤纶套隧道导管透析患者表皮葡萄球菌带菌情况分析

摘要

ABSTRACT:Objective To analyze Staphylococcus epidermidis(SE)in the hemodialysis environment of a tertiary care centre and SE on the body surface of hemodialysis(HD)patients with tunneled-cuffed central venous catheters. Methods SE isolated from patients’heparin cap mouth,catheter exit,skin around the catheter,nasal cavity and the air of HD unit were identified and then used for drug susceptibility analysis.Additionally,the homology of SE samples was tested by pulsed-field gel electrophoresis(PFGE)analysis.Results Fifteen strains of SE were isolated in this study, which all exhibited multi-drug resistance.Among the 1 5 strains of SE,there were 9 distinct genotypes and 9 subtypes. Conclusion HD patients treated with tunneled-cuffed central venous catheters would carry SE strains with multi-drug resistance.Such patients are at high risk of catheter-related infections,which are probably caused by SE.Thus,a transmission route of“patient-to-patient”may exist.%目的：分析表皮葡萄球菌（SE）在带涤纶套隧道导管透析患者体表及透析环境中的带菌情况。方法同时采集透析中心带涤纶套隧道导管透析患者肝素帽口、导管皮肤出口处、管周皮肤、鼻腔及透析中心空气细菌标本，分离培养 SE，对分离到的 SE菌株进行细菌鉴定、药敏分析，并进行脉冲场凝胶电泳（PFGE）分析其同源性。结果共分离 SE菌株15株，分离到的 SE表现多重耐药。对15株 SE进行PFGE，得到9个不同基因型，9个亚型。结论使用带涤纶套隧道导管透析患者体表携带多重耐药 SE菌株，为 SE所致导管相关感染的高危人群，可能存在“患者—另一患者”的传播途径。