血液肿瘤患者PICC相关真菌感染的危险因素
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尹姣

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R181.3+2

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Risk factors for peripherally inserted central catheterrelated fungal infection in patients with hematological malignancies
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    摘要:

    目的探讨血液肿瘤患者经外周静脉置入中心静脉导管(PICC)相关真菌感染的相关危险因素。方法选取2010年7月—2015年7月某院528例血液肿瘤PICC置管患者,采用回顾性研究方法,根据其是否发生导管相关真菌感染分为血流感染组、穿刺部位感染组和非感染组,采用logistic回归分析PICC真菌感染的危险因素。结果528例血液肿瘤PICC置管患者真菌感染48例,发病率为9.09%,其中单纯导管相关真菌血流感染32例(66.67%),单纯穿刺部位感染6例(12.50%),导管相关真菌血流感染合并穿刺部位感染10例(20.83%);共分离真菌48株,以近平滑假丝酵母菌为主(21株,43.75%)。logistic回归多因素分析,中性粒细胞数≤0.5×109/L、住院时间>10 d、使用抗菌药物、化学治疗次数>3次为引起PICC真菌血流感染的独立危险因素,化学治疗次数>3次、导管维护周期延迟为PICC单纯穿刺点真菌感染的独立危险因素。结论PICC相关真菌感染是多种危险因素共同作用的结果,在护理工作中,应注意全面、动态评估其危险因素,采取有效的干预措施。

    Abstract:

    ObjectiveTo investigate risk factors for peripherally inserted central catheter (PICC)related fungal infection in patients with hematological malignancies.Methods528 patients with hematological malignancies and received PICC in a hospital from July 2010 to July 2015 were selected, through retrospective study and according to whether PICCrelated fungal infection occurred, patients were divided into bloodstream infection(BSI) group, puncture site infection group, and noninfection group, risk factors for PICCrelated fungal infection was performed logistic regression analysis.ResultsAmong 528 hematological malignancies patients with PICC, 48 (9.09%) had fungal infection, 32 cases (66.67%) were with catheterrelated fungal BSI (CRFBSI), 6(12.50%) were with puncture site infection, and 10(20.83%) were with both CRFBSI and puncture site infection; 48 strains of fungi were isolated, mainly Candida parapsilosis (21 strains, 43.75%). Multivariate logistic regression analysis showed that neutrophil count≤0.5×109/L, length of hospital stay>10 days, antimicrobial use, and chemotherapy use>3 times were independent risk factors for bloodstream fungal infection in PICC patients; chemotherapy use>3 times and  delayed catheter maintenance cycle were independent risk factors for infection at puncture site.ConclusionPICCrelated fungal infection results from multiple risk factors, comprehensive and dynamic assessment of risk factors should be paid attention, effective intervention measures needs to be taken.

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尹姣,李佳元,刘玉霞.血液肿瘤患者PICC相关真菌感染的危险因素[J]. 中国感染控制杂志,2018,17(10):918-922. DOI:10.3969/j. issn.1671-9638.2018.10.012.
YIN Jiao, LI Jiayuan, LIU Yuxia. Risk factors for peripherally inserted central catheterrelated fungal infection in patients with hematological malignancies[J]. Chin J Infect Control, 2018,17(10):918-922. DOI:10.3969/j. issn.1671-9638.2018.10.012.

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历史
  • 收稿日期:2017-12-27
  • 最后修改日期:2018-02-25
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  • 在线发布日期: 2018-10-28
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