目的:了解外科ICU中心静脉导管相关血流感染(CRBSI)的发病率、病原菌分布及相关危险因素,为临床预防和经验性治疗提供依据.方法:回顾性调查我院外科ICU 2010年1月～2011年8月的中心静脉导管置管病例,根据血培养和导管培养结果分为CRBSI组和非CRBSI组,统计CRBSI的发病率、致病菌；比较CRBSI组与非CRBSI的临床资料,应用多因素Logistic回归分析筛查相关危险因素.结果:共收集249例中心静脉置管病例,CRBSI发病率为8.41例次/千导管日,病原菌分布为G+菌4例,G-菌9例,真菌8例.Logistic回归分析显示导管留置时间(OR 3.298,95％ CI 1.070～10.168,P=0.038)、APACHEII评分(OR1.137,95％CI 1.067～1.213,P=0.000)、完全胃肠外营养(OR 1.117,95％ CI 1.023～1.219,P=0.014)是CRBSI的独立危险因素.结论:导管留置时、APACHEII评分、完全胃肠外营养是发生CRBSI的独立危险因素.%Objective: To analyze the incidence, pathogens distribution and risk factors of centra! venous catheter related-bloodstream infection in surgical intensive care unit. Methods: Patients admitted in surgical intensive care unit of our hospital from January 2010 -August 2011 with CVC were enrolled, and divided into CRBS1 group and non-CRBSI group, on the basis of the outcomes of germicultu-re of blood samples and hub tips. Then, the incidence and pathogens of CRBSI were analyzed retrospectively. The clinical dam of CRBSI group and non-CRBSI group were compared, and a multivariate analysis has been performed with logistic regression to investigate the risk factors. Results: 249 cases with CVC has been collected, and the incidence of CRBSI is 8.41 cases per 1000 catheter days. 21 pathogens were isolated, including 4 gram-positive bacterium, 9 gram-negative bacterium and 8 fungi, and some were antibiotic-resistance strains. Logistic regression analysis showed that duration of cathetenzation (OR 3.298, 95% CI 1.070-10.168, P=0.038), APACHEII score (OR 1.137, 95% CI 1.067-1.213,P=0.000), TPN (OR 1.117, 95% CI 1.023-1.219, P=0.014) were independent risk factors for CRBSI. Conclusion: Duration of catheterization, APACHEII score and TPN were the independent risk factors for CRBSI.
展开▼
