文摘大家译:一所大学附属医院的外周静脉导管菌血症的临床流行病学分析

潮水

Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital Summary

Despite enormous clinical experience of using peripheral vascular catheters, there is still controversy over the incidence and clinical relevance of bloodstream infections caused by these devices and the measures for preventing them. We performed a prospective study to determine the clinical epidemiology and outcomes of nosocomial bloodstream infections caused by short- and mid-line peripheral venous catheters among a group of non-intensive care unit patients. Cases of peripheral venous catheter-related bloodstream infections (PVC-BSIs) were compared to cases of central venous catheter-related bloodstream infections (CVC-BSIs). From October 2001 to March 2003, 150 cases of vascular catheter-related bloodstream infections were identified among 147 patients. Seventy-seven episodes (0.19 cases/1000 patient-days) were PVC-BSIs and 73 episodes (0.18 cases/1000 patient-days) were CVC-BSIs. Compared with CVC-BSIs, patients with PVC-BSIs more often had the catheter inserted in the emergency department (0 vs 42%), had a shorter duration from catheter insertion to bacteraemia (mean: 15.4 vs 4.9 days) and had Staphylococcus aureus (33 vs 53%) more frequently as the causative pathogen. Among patients with PVC-BSIs, catheters inserted in the emergency department had a significantly shorter duration in situ compared with those inserted on hospital wards (mean: 3.7 vs 5.7 days). Patients with PVC-BSIs caused by S. aureus had a higher rate of complicated bacteraemia (7%) and higher overall mortality (27%) than patients with PVC-BSIs caused by other pathogens (0 and 11%, respectively). Bloodstream infections remain underestimated and potentially serious complications of peripheral vascular catheterisation. Targeted interventions should be introduced to minimise this complication.

Keywords: Vascular catheter-related bacteraemia; Nosocomial Staphylococcus aureus bloodstream infections; Peripheral vascular catheter-related infections; Staphylococcus aureus vascular catheter-related bacteraemia
Journal of Hospital Infection Volume 67, Issue 1, September 2007, Pages 22-29
这是一篇发表在最新一期的医院传染病杂志上的关于静脉导管感染的论文，请大家参与翻译！

[ 本帖最后由 wzcdcyxh 于 2007-9-17 12:22 编辑 ]

青暮

译的不好，许多地方觉得有点别扭:L ，希望大家多多指导！:ok
一所大学附属医院的外周静脉导管相关性血流感染的临床流行病学分析
      
      尽管对于外周血导管的使用已有了大量的临床经验，但是对于由此引起的临床相关性血流感染的发病率及其预防措施我们仍存在着争论。我们对一组非ICU的病人做前瞻性研究，对由短期和中期外周静脉导管引起的医源性血流感染进行临床流行病学分析。将发生外周静脉导管血流感染（PVC-BSIs）与发生中央静脉导管血流感染（PVC-BSIs）的病例数作比较。从2001年10月至2003 年3月期间，147位病人中发生了150例导管血流感染。其中77例（0.19例/1000住院日）为PVC-BSIs，73例（0.18例/1000住院日）为CVC-BSIs。与 CVC-BSIs相比,发生PVC-BSIs的病人更常在急诊室接受导管插入术（CVC-BSIs和PVC-BSIs为：0%和42%）， 从插入导管到发生菌血症的时间也更短 （平均时间分别为：15.4天和4.9天），并且其病原体常为金黄色葡萄球菌(33% 和 53%) 。同样发生PVC-BSIs的病人,在急诊室进行的插管发生感染的时间远远快于在医院病房中进行的插管（平均时间分别为：3.7天和5.7天）。相较而言，由金黄色葡萄球菌引起PVC-BSIs的病人发生复杂菌血症的概率（7%）更高，其导致的死亡率（27%）也更高。而由其它病原菌引起的PVC-BSIs则相应较低（分别为0%和11%）。血流感染是外周导管插入术的潜在并发症并且依旧被低估。我们必须有目的地干预，将合并症的发生降到最低。

潮水

50 cases of vascular catheter-related bloodstream infections were identified among 147 patients. 这一句是否可以这么译:“150例导管相关性血液感染者被确诊,其中147例发病。”当然也有可能1个病人可以被诊断为2次感染，如何更符合原文，欢迎大家参与讨论！

木瓜

50 cases of vascular catheter-related bloodstream infections were identified among 147 patients. 这一句是否可以这么译:“150例导管相关性血液感染者被确诊,其中147例发病。”当然也有可能1个病人可以被 ... [/quote]
就翻译成”147位病人中发生了150例次血管导管相关血流感染“。

莲雾

文的意思应该是147位病人中发生了150例导管血流感染，没有提到发病。

潮水

道理，内容应该是讲感染。还是CDC的思想在作祟，总是想到感染者（病原携带者）与发病者的概念。