Central venous catheter-related bacteremia due to cram-negative bacilli: Significance of catheter removal in preventing relapse
Central venous catheter-related bacteremia due to cram-negative bacilli: Significance of catheter removal in preventing relapse
复制标题
DOI：
10.1086/502455
复制
发表时间：
2004-08-01
影响因子：
4.5
通讯作者：
Raad, I
中科院分区：
文献类型：
--
作者：
Hanna, H;Afif, C;Raad, I
目的：研究导管相关性革兰氏阴性菌血症(GNB)的特点和中心静脉导管(CVC)拔除的作用。设计：这项回顾性研究涉及CVC的微生物科记录和血液培养以及患者的医疗记录。研究对象：德克萨斯大学安德森癌症中心，德克萨斯州休斯敦的一家三级保健医院。治疗：患有导管相关GNB的癌症患者，定义为(1)至少有15个集落形成单位的阳性导管尖端培养，(2)从顶端和外周血培养中分离同一微生物，(3)除CVC外，无其他菌血症来源；(4)感染的临床表现(发热或寒战)。结果：1990年1月至1996年12月，共收治72例导管相关性GNB。大多数患者(67人；93%)因菌血症而切除了他们的CVC。少数患者(5；7%)保留了CVC并接受了适当的抗生素治疗。去除CVCs后，仅有1例(1%)患者复发，而保留CVCs的5例患者均有反应后复发(P
OBJECTIVE: To study the characteristics of catheter-related, gram-negative bacteremia (GNB) and the role of central venous catheter (CVC) removal.DESIGN: This retrospective study involved a search of the microbiological department records of CVC and blood cultures and patients' medical records.SETTING: University of Texas M. D. Anderson Cancer Center, a tertiary-care hospital in Houston, Texas.PATIENTS: Patients with cancer who had catheter-related GNB, defined as (1) a positive catheter tip culture with at least 15 colony-forming units semiquantitatively, (2) isolation of the same organism from the tip and peripheral blood cultures, (3) no other source for bacteremia except the CVC, and (4) clinical manifestations of infection (fever or chills).RESULTS: Between January 1990 and December 1996, 72 cases of catheter-related GNB were available for review. Most of the patients (67; 93%) had their CVCs removed in response to the bacteremia. Few patients (5; 7%) retained their CVCs and were treated with appropriate antibiotics. When CVCs were removed, only 1 patient (1%) relapsed with the same organism, whereas all 5 patients with retained CVCs relapsed after having responded (P