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考虑研究:评估除了重症监护机构之外的导管相关血流感染的风险
Fabio Borgonovo1, Marta Colaneri2, Federico Fassio3
1Department of Infectious Diseases, Unit II, L. Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
导管相关和相关的血流感染 (CABSI和CRBSI) 是常见的非ICU患者与血管接入装置 (VADs). 腹腔营养和多透导管增加了感染风险,需要有针对性的预防策略.
科学领域:
- 传染性疾病 传染性疾病
- 医院流行病学 医院流行病学
- 医疗设备感染 医疗设备感染
背景情况:
- 导管相关和相关的血液感染 (CABSI/CRBSI) 是重要的医院获得的感染.
- 关于非重症监护室 (非ICU) 患者的CABSI/CRBSI发病率和风险因素的数据有限.
研究的目的:
- 确定非ICU住院成年人VAD的CABSI和CRBSI发生率.
- 确定与这些患者群体中这些感染相关的关键风险因素.
主要方法:
- 对1892名非ICU患者的2,326个VAD插入的回顾性研究.
- 使用马脆弱模型和随机生存森林分析CABSI和CRBSI发病率.
- 通过多变量模型识别和验证风险因素.
主要成果:
- CABSI/CRBSI的总发病率为每1000个导管日中的2.97;CABSI的发病率为1.80,CRBSI的发病率为1.24.
- 凝聚酶阴性葡萄球菌是最常见的病原体 (43.9%).
- 腹腔营养 (PN) (HR=4.12) 和多透管 (HR=2.56) 是显著的危险因素. PN (HR=7.42) 强烈预测CRBSI,而静脉药物使用 (HR=7.20) 预测CABSI.
结论:
- 患有VAD的非ICU成年患者经历了CABSI和CRBSI的高发病率.
- 识别PN和静脉药物使用等特定的风险因素对于在非ICU环境中实施有针对性的感染预防策略至关重要.
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