在中央静脉导管和外围插入的中央导管之间比较微生物殖民率
Vassiliki Pitiriga1, John Bakalis2, Kalliopi Theodoridou1
1Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527, Athens, Greece.
Antimicrobial resistance and infection control
|August 7, 2023
概括
周围插入的中央导管 (PICCs) 在危急病患者中显示出比中央静脉导管 (CVCs) 低得多的殖民率. PICC可能为长期的血管内接入提供更安全的替代方案,可能减少感染.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 中枢静脉导管 (CVC) 和外围插入的中央导管 (PICC) 对重症患者至关重要.
- 导管殖民是中央线相关血流感染 (CLABSI) 的前体.
- 有限的比较数据存在于PICC和CVC之间的殖民率.
研究的目的:
- 在重症患者中比较PICC和CVC之间的导管定居率.
- 分析微生物概况和抗微生物敏感性模式.
- 评估PICC与CVC在殖民化方面的安全性.
主要方法:
- 在两年内对导管殖民期的回顾性分析.
- 包括患有CVC或PICC的危急病患者.
- 半定量培养技术用于病原体检测和Vitek2系统用于识别和耐药性分析.
主要成果:
- PICC殖民率为2.97% (1.71/1000个导管日),而CVC的10.28% (12.48/1000个导管日) (p<0.001).
- 与CVC相比,PICC (0.63/1000导管日) 的多药耐药生物体 (MDRO) 殖民率明显较低 (7.26/1000导管日).
- 主要的CVC殖民者是MDR Acinetobacter baumannii和MDR Klebsiella pneumoniae;PICC殖民者包括Candida spp.,MDR K. pneumoniae和MDR A. baumannii. 这三种类型的菌种.
结论:
- 在PICC中,殖民率明显低于CVC.
- 在重症患者中,PICC可能是延长血管内接入的更安全选择.
- 基于当地微生物生态的有针对性的预防策略可以减少导管殖民和CLABSI.
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