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find Keyword "血行感染" 2 results
  • 先天性心脏病术后中心静脉导管相关血行感染危险因素分析

    目的讨论先天性心脏病患儿术后发生经颈内中心静脉导管相关血行感染(CRBSI)的危险因素。 方法对2011年11月-2012年9月入住的224例先天性心脏病患儿经颈内中心静脉置管后发生CRBSI危险因素进行单因素和多因素logistic回归分析。 结果39例患儿(16.07%)发生CRBSI,单因素logistic回归分析提示:体外循环时间>60 min(OR=14.400,P<0.001)、经导管操作次数>6次/d(OR=2.692,P=0.006)、导管留置时间>10 d(OR=5.439,P<0.001)、未采取抗生素治疗(OR=3.992,P<0.001)是颈内中心静脉置管患儿发生CRBSI的危险因素。非条件多因素logistic回归分析显示:体外循环时间>60 min(OR=14.109,P<0.001)、导管留置时间>10 d(OR=4.878,P=0.001)、未采取抗生素治疗(OR=3.828,P=0.005)是颈内中心静脉置管的独立危险因素。 结论伴有体外循环时间长,导管留置时间>10 d,应该采取针对性干预及护理措施,以预防导管感染。

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  • Diagnostic Value of Simultaneous Culture of Central Venous Catheter Blood and Peripheral Blood for Catheter-related Bloodstream Infection

    ObjectiveTo investigate the diagnostic value of simultaneous culture of central venous catheter (CVC) blood and peripheral blood for catheter-related bloodstream infections (CRBSI). MethodsNon-septic patients who were treated with CVC for 1 to 7 days were enrolled from February 2011 to February 2015 in the First Hospital of Wuhan City. Blood were collected from both peripheral vein and CVC for bacterial culture once a day. The CVCs were removed from patients who got CRBSI from the first to sixth day and who did not by the end of the seventh day for semi-quantitative catheter culture, quantitative catheter culture, CVC culture and catheter exit-site pus culture. The diagnosis of CRBSI were based on 4 methods as follows:A, both peripheral and CVC blood were positive and the time of CVC blood positive were 2 hours earlier than peripheral blood; B, the colonies of semi-quantitative catheter cultures were ≥15 CFU and the microorganisms in both CVC and peripheral blood were the same; C, the colonies ratio of CVC and peripheral blood cultures were ≥5:1; D, the microorganisms in both the peripheral blood and catheter exit-site pus were the same. The diagnostic value of the four methods was compared. ResultsA total of 1 086 patients were finally included. From 1 to 7 days, 64 patients were peripheral blood positive, 79 were CVC blood positive. The patients diagnosed as CRBSI using A, B, C, and D methods were 58, 55, 51, and 36, respectively. Sixty patients were diagnosed as CRBSI based on the clinical and laboratory methods. For the number of patients diagnosed with CRBSI, there was no significant difference between A and B (P>0.05), as well as A and C (P>0.05), however, significant difference was found between A and D (P<0.05). In the diagnostic value of CRBSI, A is similar to B (sensitivity:93.33% vs. 91.67%, specificity:99.81% vs. 100%, Youden index:0.93 vs. 0.92). A, B and C had almost similar specificity (all >99%), however, A had higher sensitivity (93.33% vs. 76.67%, 58.33%) and Youden index (0.93 vs. 0.76, 0.58). ConclusionSimultaneous culture of CVC blood and peripheral blood has a good diagnostic value for CRBSI.

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