在重症患者中使用银合金凝涂层导管预防尿路感染:单中心前性随机受控研究
Menglong Zhao1, Shike Geng1, Lei Zhang1
1Department of Intensive Care Unit, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui, China.
Journal of intensive medicine
|January 24, 2024
概括
与传统导管相比,银合金水凝涂层 (SAH) 导管显著减少了与导管相关的尿路感染 (CAUTIs) 和严重病患者的细菌生物膜形成. 定期更换仍然是必要的.
科学领域:
- 传染性疾病 传染性疾病
- 医疗器械 医疗器械
- 关键护理医学 关键护理医学
背景情况:
- 导管相关的尿路感染 (CAUTIs) 是一个重大问题,特别是在重症患者中.
- 银合金凝涂层 (SAH) 导管提供了一种新的方法,可以通过微电流生成来防止细菌粘附和殖民.
- 以前的研究证实了SAH导管在一般患者中的有效性,但在重症患者群体中的有效性仍未评估.
研究的目的:
- 评估SAH导管在预防重症患者的CAUTIs方面的有效性.
- 为了比较SAH和常规导管在重症监护室 (ICU) 设置中的CAUTIs和相关指标的发生率.
主要方法:
- 一项前性,单中心,单盲,随机对照研究与132名需要住院导管治疗的重症患者进行.
- 患者被随机分为两组:一组接受SAH导管,另一组接受传统的化乳Foley导管.
- 主要结局是CAUTI发病率;次要结局包括尿液炎症标志物,细菌培养,生物膜分析和死亡率.
主要成果:
- 与传统组相比,SAH导管组在第7天的尿白细胞阳性率 (15.6%与33.8%) 和第10天的阳性尿液培养率 (10.9%与27.9%) 显著降低.
- 到第10天,SAH组的CAUTI发病率显著降低 (7.8%与22.1%相比).
- 在14日SAH组的导管生物膜中,在所有测试段 (尖端,气球,尾部) 中发现活性的细菌数量明显降低 (P <0.001).
结论:
- 在重症患者中,SAH导管有效抑制导管相关的细菌生物膜的形成.
- 与传统的化乳福利导管相比,SAH导管在这个人群中显著降低了CAUTIs的发生率.
- 尽管已证明有效,但仍建议定期更换导管.
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