肾脏护理中心中心管相关血流感染的频率测定

Safia Moin, Bina Salman, Aasim Ahmad
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摘要

背景:中心管路相关血流感染(CLABSI)是一种严重的感染,通常会增加慢性肾病(CKD)患者的发病率和死亡率。通过正确的插入技术和中心管路(CL)管理可以预防这种感染。然而,降低 CLABSI 感染率的第一步是通过适当的监测来确定问题的严重程度。本研究旨在确定一家专业肾脏护理中心的慢性肾脏病患者发生 CLABSI 的频率:作者开展了一项回顾性观察研究,以确定 2021 年 11 月至 2022 年 9 月期间其所在医院的慢性肾脏病患者发生 CLABSI 的频率。他们纳入了在其研究所登记的所有 CL 患者。原发性 CLABSI 被定义为归因于其医院的 CLABSI,而继发性 CLABSI 被定义为非归因于其医院的 CLABSI:在 310 名 CL 患者和 1,413 个 CL 日中发现了 59 例 CLABSI,即每 1,000 个 CL 日中有 42 例 CLABSI。原发性 CLABSI(36 例 [61%])比继发性 CLABSI(23 例 [39%])更常见。大多数患者都痊愈了(53 [89.8%]),但也有四名患者(6.9%)死亡。大多数痊愈患者拥有永久性血管通路(32 人 [60.4%])、颈内静脉置管(44 人 [83%])和原发性 CLABSI(33 人 [62.3%]),但 p 值不显著:结论:为降低 CLABSI 感染率,需要在置管及其维护过程中严格执行 CLABSI 预防措施,并利用实验室确诊病例进行定期监测。
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Frequency Determination of Central Line Associated Bloodstream Infection at a Renal Care Centre
Background: Central line-associated bloodstream infection (CLABSI) is a serious infection typically increasing morbidity and mortality in patients with chronic kidney disease (CKD). It can be prevented through proper insertion techniques and management of the central line (CL). However, the first step in reducing the CLABSI rate is to define the extent of the problem through proper surveillance. This study aimed to determine the frequency of CLABSI in patients with CKD at a specialised renal care centre. Methods: The authors conducted a retrospective observational study to determine the frequency of CLABSI in patients with CKD between November 2021–September 2022 at their institute. They included all patients with CLs registered at their institute. Primary CLABSI was defined as CLABSI attributable to their hospital, while secondary CLABSI was defined as those not attributed to their hospital. Results: Fifty-nine incidences of CLABSI were identified in a total of 310 patients with CL and 1,413 CL days, giving a total of 42 CLABSI incidences per 1,000 CL days. Primary CLABSI was more common (n=36 [61%]) than secondary CLABSI (n=23 [39%]). Most of the patients recovered (53 [89.8%]); however, four (6.9%) patients expired. Most of the patients who recovered had permanent vascular access (n=32 [60.4%]), internal jugular placement (n=44 [83%]), and primary CLABSI (n=33 [62.3%]), although the p-values were non-significant. Conclusion: Strict implementation of CLABSI prevention bundles for line insertion and its maintenance and regular surveillance using laboratory confirmed cases is needed to reduce the rates of CLABSI.
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