中心静脉导管相关血流感染-相关概念普及
本帖最后由 jerkran 于 2023-9-20 03:01 编辑Catheter-related bloodstream infection (CRBSI) - Infectious Diseases Society of America (IDSA) definition: Catheter-related bloodstream infection (CRBSI) is the preferred term used by IDSA. The definite diagnosis of CRBSI requires one of the following: Isolation of the same pathogen from a quantitative blood culture drawn through the central line and from a peripheral vein with the single bacterial colony count at least threefold higher in the sample from the central line as compared to that obtained from a peripheral vein (or) same organism recovered from percutaneous blood culture and from quantitative (>15 colony-forming units) culture of the catheter tip (or) a shorter time to positive culture (>2 hours earlier) in the central line sample than the peripheral sample (differential time to positivity [ DTP ])导管相关血流感染 （CRBSI） - 美国传染病学会 （IDSA） 定义：导管相关血流感染 （CRBSI） 是 IDSA 使用的首选术语。CRBSI的明确诊断需要满足以下条件之一： 从通过中心插管抽取的定量血培养物和从外周静脉中分离出相同的病原体，与从经皮血培养和导管尖端定量（>15个菌落形成单位）培养中获得的单细菌菌落计数相比，从中心插管样本中分离出的单个细菌菌落计数至少高出三倍（或）中心插管样本的阳性培养时间（>早2小时）比外周样本早（阳性时间差异）CLABSI - Centers for Disease Control and Prevention (CDC) definition: CLABSI is a surveillance definition used by the CDC and defined as the recovery of a pathogen from a blood culture (a single blood culture for an organism not commonly present on the skin and two or more blood cultures for organism commonly present on the skin) in a patient who had a central line at the time of infection or within 48 hours before the development of infection. The infection cannot be related to any other infection the patient might have and must not have been present or incubating when the patient was admitted to the facility.CLABSI - 美国疾病控制和预防中心 （CDC） 定义：CLABSI 是 CDC 使用的一个监测定义，定义为从血培养（单次血培养不是皮肤常见的微生物和连续两次及以上培养出皮肤上常见的微生物）中培养出有意义病原体，在感染时或感染前 48 小时内有中心插管的患者感染的发展。感染不能与患者可能患有的任何其他感染有关，并且患者入院时不存在感染或潜伏感染。In the case of tunneled catheters, the accepted definitions for exit site and tunnel infections are as follows:对于隧道式导管，出口部位和隧道感染的公认定义如下：Exit site infection: Signs of inflammation confined to an area (typically < 2 cm) surrounding the catheter exit site and the presence of exudate that proves to be culture positive.出口部位感染：炎症体征局限于导管出口部位周围的区域（通常为 < 2 cm），并且存在被证明为培养阳性的渗出物。Tunnel infection:Inflammation extending beyond 2 cm from the exit site (along with the track or cephalad towards the vein entry site or extending beyond the cuff), typically associated with pain and tenderness along the subcutaneous track and culture-positive exudate at the exit site that may not be seen unless expressed by palpation.隧道感染：炎症从出口部位延伸超过 2 cm（沿着轨道或头颅向静脉入口部位延伸或延伸到袖带外），通常伴有沿皮下通道的疼痛和压痛以及出口部位的培养阳性渗出物，除非通过触诊表达，否则可能看不到。
这里CDC监测标准要宽松些，IDSA诊断更符合临床！！！
感谢分享 不知道各位老师诊断导管相关是按照CRBSI的标准还是按照CLABSI的标准，很好奇。 同问：“不知道各位老师诊断导管相关是按照CRBSI的标准还是按照CLABSI的标准，很好奇。” 已了解，谢谢分享！ 已学习！感谢老师分享！ 这个率到底怎么算{:1_2:} 感谢老师分享，下载学习了 已学习，感谢老师的分享！ 已了解，谢谢分享！ 学习了，感谢老师的分享！ 新规范还要进一步深入学习，谢谢分享 导管相关血流感染 （CRBSI）使用的比较多
学习了，谢谢老师分享。 谢谢老师 学习了 感谢老师的分享 CRBSI 使用较多。感谢老师的分享。 学习了，感谢老师的分享！ 这个图非常清晰，讲课可借用了{:1_9:}
谢谢冉老师分享！ 已学习，感谢老师的分享！
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