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    find Keyword "血行感染" 2 results
    • 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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    • 先天性心臟病術后中心靜脈導管相關血行感染危險因素分析

      目的討論先天性心臟病患兒術后發生經頸內中心靜脈導管相關血行感染(CRBSI)的危險因素。 方法對2011年11月-2012年9月入住的224例先天性心臟病患兒經頸內中心靜脈置管后發生CRBSI危險因素進行單因素和多因素logistic回歸分析。 結果39例患兒(16.07%)發生CRBSI,單因素logistic回歸分析提示:體外循環時間>60 min(OR=14.400,P<0.001)、經導管操作次數>6次/d(OR=2.692,P=0.006)、導管留置時間>10 d(OR=5.439,P<0.001)、未采取抗生素治療(OR=3.992,P<0.001)是頸內中心靜脈置管患兒發生CRBSI的危險因素。非條件多因素logistic回歸分析顯示:體外循環時間>60 min(OR=14.109,P<0.001)、導管留置時間>10 d(OR=4.878,P=0.001)、未采取抗生素治療(OR=3.828,P=0.005)是頸內中心靜脈置管的獨立危險因素。 結論伴有體外循環時間長,導管留置時間>10 d,應該采取針對性干預及護理措施,以預防導管感染。

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  • 松坂南