天津医药

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导管相关性血流感染的病原菌分布及临床特征分析

刘学花1,吴琦2   

  1. 1. 天津市人民医感染免疫科
    2. 天津市海河医院
  • 收稿日期:2013-03-08 修回日期:2013-06-04 出版日期:2013-08-15 发布日期:2013-08-15
  • 通讯作者: 刘学花

Pathogens and Clinical features of Catheter-related Bloodstream Infection

LIUXue-Hua ,wu qi   

  • Received:2013-03-08 Revised:2013-06-04 Published:2013-08-15 Online:2013-08-15
  • Contact: LIUXue-Hua

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摘要： 摘要 目的:调查中心静脉导管相关血流感染病原菌分布及不同菌种感染的临床特征，为临床经验性治疗提供依据。方法：回顾性分析2011年2月—2012年10月我院CRBSI患者，分析和研究其病原学分布、临床特征、炎性标记物和预后。结果：91例CRBSI，31株真菌（34.1%），31株革兰氏阴性杆菌（34.1%），29株革兰阳性球菌（31.9%），3组病原体构成比差异无统计学意义(P>0.05)。真菌及革兰阴性杆菌CRBSI临床特征表现为高热寒战，革兰阳性球菌表现为中低度热，寒战少见。3组病原体CRBSI炎性标记物均增高，但真菌及革兰阴性杆菌CRBSI炎性反应更重，真菌CRBSI死亡率高（P< 0.05）。结论：真菌、革兰阴性杆菌及革兰阳性球菌均是CRBSI常见致病菌，重视病原学调查的同时应根据临床特征采取经验性治疗，以降低CRBSI病死率。

关键词: 导管相关性血流感染, 病原菌, 临床特征

Abstract: Abstract   Objective     To explore pathogenic etiology and clinical features of catheter-related bloodstream infection(CRBSI), and to provide basis for the empiric therapy of CRBSI．Methods  All patients who had the definite diagnosis of CRBSI were investigated from Feb,2011 to Oct, 2012 in Tianjin People,s Hospital.The pathogens, clinical features, inflammatory markers，and prognosis were analyzed retrospectively．Result  There were 91 pathogenic strains isolated from 91 patients who were diagnosed as CRBSI．In which 31 strains (34.1% ) were fungi, 31 strains (34.1% ) were gram-negative bacilli，29 strains （31.9%）were gram-positive cocci. There was no difference in the constituent ratio between three groups (P>0.05). CRBSI clinical features caused by fungi and gram-negative bacilli present hyperpyrexia with shiver. Low or moderate fever without shiver were more frequent in gram-positive cocci group. Inflammatory markers level in Three groups of pathogens rised, but were more higher in fungi and gram-negative bacilli group.mortality rate was more higher in fungi group（p< 0.05）.Conclusion    Fungi, gram-negative bacilli and gram-positive cocci are equally pathogenic strains of CRBSl. Investigation of pathogens of CRBSI should be strengthened and empiric antibiotic therapy based on clinical features should be given early to reduce mortality rate.

Key words: catheter-related bloodstream infection, pathogens, Clinical features