家庭での輸液療法を受けている患者の針なしの静脈注射システムに関連する血流感染症
L E Danzig1, L J Short, K Collins
1Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
JAMA
|June 21, 1995
まとめ
全腸内栄養と腸内脂質療法と組み合わせた無針輸液システムは,自宅で静脈注射療法を受けている患者の血流感染症 (BSI) のリスクを高めました. 7日毎の注射カップの交換は,このリスクと関連していました.
科学分野:
- 感染症 感染症は感染症です.
- ヘルスケア エピデミオロジー
- 患者の安全性についてです.
背景:
- 血流感染症 (BSI) は,自宅で静脈注射療法を受けている患者にとって重大なリスクをもたらします.
- 特定の危険因子を特定することは,アウトブレイクを予防し,ホームヘルスケア環境で患者のアウトカムを改善するために不可欠です.
研究 の 目的:
- 家庭内静脈注射療法を受けている患者の間で発生した血流感染症 (BSI) に関連する危険因子を調査する.
- この患者集団におけるBSIの発達に寄与する特定のデバイスと治療法を特定する.
主な方法:
- この研究では,ケース・コントロールと遡及的なコホートデザインを使用した.
- 1993年1月から12月まで,特定の家庭医療機関から自宅で静脈注射療法を受けた患者からデータを収集した.
- 方法としては,BSI患者と対照群を比較し,中枢静脈カテーテル (CVC) 患者の分析,注射キャップ液の培養が含まれていました.
主要な成果:
- BSIの患者は,中央静脈カテーテル (CVC) または全腸内栄養および腸内脂質療法 (TPN/IL) を通して治療を受けた可能性が高くなりました.
- CVC患者では,TPN/ILおよび針なしの輸液システムの使用がBSIの危険因子として特定されました.
- TPN/ILとニードレスデバイスの組み合わせは,BSIの開発と有意に関連していました. 針なしデバイスのキャップからのルミナル液は,より高い陽性培養率を示しました.
結論:
- TPN/IL療法と併用した無針装置の使用は,BSIのリスクの増加と関連しています.
- 7日おきに注射カップを交換することは,このリスクの増加に寄与する可能性があります.
- 発見は,感染を予防するために,家庭医療における輸液システムと治療法の慎重な管理の必要性を強調しています.
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