产生导管相关血流感染的微生物
Microorganisms responsible for intravascular catheter-related bloodstream infection according to the catheter site *.Brief Reports
Critical Care Medicine. 35(10):2424-2427, October 2007.
Lorente, Leonardo MD, PhD; Jimenez, Alejandro PhD; Santana, Meliton MD; Iribarren, Jose Luis MD, PhD; Jimenez, Juan Jose MD; Martin, Maria M. MD; Mora, Maria L. MD, PhD
Abstract:
Objective: Current guidelines for the management of intravascular catheter-related bloodstream infection (IVC-RBSI) recommend that empirical antimicrobial therapy must have activity against Gram-positive bacteria, but additional empirical coverage for Gram-negative bacteria may be needed for severely ill or immunocompromised patients, and antifungal therapy may be needed in some situations. We hypothesized that the spectrum of etiological microorganisms responsible for IVC-RBSI and, in relation to that, the choice of empirical antimicrobial therapy depends on the catheter insertion site. We therefore compared the proportion of IVC-RBSI due to Gram-negative bacteria and yeasts according to catheter site.
Design: Prospective cohort study from May 1, 2000, to April 30, 2004.
Setting: A 24-bed medical-surgical intensive care unit in a 650-bed tertiary hospital.
Patients: Patients requiring a central venous or arterial catheter.
Measurements and Main Results: We diagnosed 88 IVC-RBSIs, comprising 36 femoral catheter sites (26 femoral venous and ten femoral arterial sites) and 52 other catheter sites (36 jugular venous, 11 subclavian venous, and five radial arterial sites). No differences were found between IVC-RBSI of femoral vs. other catheter sites for age, sex, Acute Physiology and Chronic Health Evaluation II, diagnosis at admission, use of antimicrobials, the time the catheter responsible for IVC-RBSI had been in place, or the duration of intensive care unit stay before IVC-RBSI. The proportion of IVC-RBSIs due to Gram-negative bacteria was higher in femoral, 14 of 36 (38.89%), than in the other catheter sites, 4 of 52 (7.69%) (odds ratio, 7.48; 95% confidence interval, 2.19-25.54; p = .001). Also, the proportion of IVC-RBSIs due to yeasts was higher in femoral, 6 of 36 (16.67%), than in the other catheter sites, 1 of 52 (1.92%) (odds ratio, 10.20; 95% confidence interval, 1.17-88.85; p = .035).
Conclusions: Empirical antifungal therapy would seem to be indicated in patients with suspected femoral catheter-related bloodstream infection. 我试着翻译了下，不妥之处请各位指出。:ok
Microorganisms responsible for intravascular catheter-related bloodstream infection according to the catheter site *.
根据导管位置产生导管相关血流感染的微生物
摘要：
目的：最近的导管相关血流感染(IVC-RBSI)管理指南推荐经验抗菌疗法对革兰阳性细菌有效，但对严重疾病或免疫抑制患者，可能要附加针对革兰阴性细菌的经验抗菌疗法的范围，在某些情况下也需有抗真菌治疗。我们假定引起IVC-RBSI的病原微生物的细菌谱（细菌范围）和经验抗菌疗法的选择依赖于导管插入位点，则我们可通过导管位置比较由革兰阴性细菌和酵母菌引起的IVC-RBSI的比例。
Design: Prospective cohort study from May 1, 2000, to April 30, 2004.
设计：从2000年5月1日至2004年4月30日进行前瞻性队列研究。
Setting: A 24-bed medical-surgical intensive care unit in a 650-bed tertiary hospital.
设定：一所拥有650床位的三级医院的内外科重症监护病房，该病房共24张床位。
Patients: Patients requiring a central venous or arterial catheter.
病人：需中央静脉导管或动脉导管的病人。
方法和主要结果：共诊断了88例IVC-RBSIs，其中36例发生于股动脉（心）导管位置（26例位于股静脉，10例位于股动脉），52例发生于其它导管位置（36例颈静脉位点，11例锁骨下静脉位点以及5例桡动脉位点）。对由以上两大原因引起的IVC-RBSIs的患者进行比较，发现在年龄、性别、急性生理和慢性健康估测评分II、入院诊断、抗菌剂使用、导管放置时间以及发生IVC-RBSI前在重症监护病房的持续时间这些方面两者均无差异。在股动脉位点发生的由革兰阴性细菌引起IVC-RBSIs的比例（36例中有14例，38.89%）高于其它导管位点（52例中有4例，7.69%）（OR，7.48；95%置信区间，2.19-25.54；p=.001）。同样，由酵母菌引起的IVC-RBSIs在股动脉导管处发生的比例（36例中有6例，16.67%）高于其它位置（52例中仅1例，1.92%）（OR，10.20；95%置信区间，1.17-88.85；p=.035）。
Conclusions: Empirical antifungal therapy would seem to be indicated in patients with suspected femoral catheter-related bloodstream infection.
结论：经验抗真菌治疗对于怀疑股动脉导管相关血流感染的病人而言似乎很有效。 嘿嘿,很好啊,您一定经常来哦,非常欢迎您! 请教各位老师，无菌巾要尽量大，有没有具体的规格要求？ 哇！英语水平真的很好！佩服！
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