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目的探讨振荡法获取细菌生物膜对提高经外周中心静脉导管(PICC)相关血源感染病原学检出的意义。方法选择2012年7月至2014年6月入住我院新生儿科并需要PICC置管的新生儿为研究对象,对发生导管相关血源感染(CRBSI)患儿内置的PICC导管末端以漩涡振荡器振荡,进行振荡液培养,与同时送检外周血培养结果进行统计学比较。结果研究期间收治的273例PICC置管患儿中共29例发生CRBSI,导管末端振荡液培养阳性12例(41.4%),外周血培养阳性15例(51.7%),两种培养方法阳性率差异无统计学意义(P>0.05)。共7例经两种方法获得的菌株及耐药性一致,其中肺炎型肺炎克雷伯杆菌4例,近平滑念珠菌2例,粪肠球菌1例。仅管端振荡液培养阳性者5例,分别为白色念珠菌、热带念珠菌、肺炎型肺炎克雷伯杆菌、头葡萄球菌及山羊葡萄球菌各1例;仅外周血培养阳性者8例,人葡萄球菌2例,山羊葡萄球菌、表皮葡萄球菌、头葡萄球菌、肺炎型肺炎克雷伯杆菌、白色念珠菌、黏滞沙雷菌各1例。结论以振荡法获取PICC导管细菌生物膜不能提高PICC置管患儿的CRBSI病原学检测阳性率,对临床用药无明显指导意义。
OBJECTIVE: To explore the significance of the oscillation method in obtaining bacterial biofilms for etiological detection of periprocedural venous catheter (PICC) related blood infection. Methods From July 2012 to June 2014, neonates admitted to neonatal department of our hospital and needing PICC catheterization were selected as study objects. The end of PICC catheter in children with catheter-associated bloodstream infection (CRBSI) , Shaking liquid culture, and the same time the results of peripheral blood culture were submitted for statistical comparison. Results CRBSI occurred in 27 of 273 PICC patients who were treated during the study period, 12 (41.4%) were positive for end-shaking catheterization and 15 (51.7%) were positive for peripheral blood culture. There was no difference between the two culture methods Statistical significance (P> 0.05). A total of seven cases of the two strains obtained by the same strain and drug resistance, including pneumonia-type Klebsiella pneumoniae in 4 cases, 2 cases of Candida parapsilosis, 1 case of Enterococcus faecalis. Only 5 tubes were positive for oscillatory fluid culture, which were Candida albicans, Candida tropicalis, Klebsiella pneumoniae, Staphylococcus aureus and Staphylococcus aureus respectively. Only 8 cases were positive for peripheral blood culture, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus aureus, Staphylococcus aureus, Klebsiella pneumoniae pneumoniae, Candida albicans, and Streptococcus mutans. Conclusion Obtaining PICC catheter bacterial biofilm by oscillatory method can not improve the positive rate of CRBSI etiological detection in children with PICC catheter, and has no obvious guiding significance for clinical medication.