血液透析患者血培养结果的评价

S. Görgün, M. Usanmaz
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引用次数: 0

摘要

目的:血液透析是一种挽救慢性肾功能衰竭(CRF)患者生命的侵入性手术。然而,在这一过程中,由于导管的应用,感染可能会导致患者死亡。这些感染是通过监测患者的血液和/或导管培养来检测的。本研究对接受血液透析的CRF患者的血培养结果进行了分析,以便为流行病学资料提供帮助。方法:回顾性分析SBU三星培训研究医院血液透析科2017 - 2020年疑似导管感染患者的培养结果。送至实验室的血培养物分别为铜绿假单胞菌(5.4%)、粪肠球菌(3.6%)、大肠杆菌、阴沟肠杆菌复群(3.6%)和肺炎克雷伯菌(1.8%)。凝固酶阴性葡萄球菌中,17株(70.8%)对青霉素耐药,18株(75.0)对甲氧西林耐药。金黄色葡萄球菌菌株中,3株(50.0%)对青霉素耐药,3株(50.0%)对甲氧西林耐药。血培养CNS与金黄色葡萄球菌生长差异有统计学意义(p<0.05)。结论:我院血液透析患者血培养细菌分离率高。这一结果使得有必要提请注意血液透析过程中的无菌条件。血液和导管培养的监测、病原体的检测和抗生素谱结果的评估将在血液透析患者预防感染和采取必要的预防措施中发挥关键作用。
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Evaluation of Blood Culture Results in Hemodialysis Patients
Objective: Hemodialysis is a life-saving invasive procedure in patients with chronic renal failure (CRF). However, in this procedure, infections, which often cause patient deaths, may develop due to catheter application. These infections are detected by monitoring the blood and/or catheter cultures of the patients. In the study, an analysis of the blood culture results of patients with CRF undergoing hemodialysis was performed in order to contribute to the epidemiological data. Methods: In this study, the culture results of patients who were thought to have catheter infection in the Hemodialysis Unit of SBU Samsun Training and Research Hospital between 2017 and 2020 were evaluated retrospectively. Blood cultures sent to the laboratory were incubated in the hemoculture organisms isolated from blood cultures were Pseudomonas aeruginosa (5.4%), Enterococcus faecalis (3.6%), E. coli , Enterobacter cloacae complex (3.6%), and Klebsiella pneumoniae (1.8%). Of the coagulase-negative staphylococci, 17 (70.8%) were resistant to penicillin and 18 (75.0) to methicillin. Of the S. aureus strains, 3 (50.0%) were found to be resistant to penicillin and 3 (50.0%) to methicillin. A statistically significant difference was found between CNS and S. aureus growth in blood cultures (p<0.05). Conclusion: High rates of bacteria were isolated from blood cultures of hemodialysis patients in our hospital. This result makes it necessary to draw attention to aseptic conditions in the hemodialysis process. Monitoring of blood and catheter cultures, detection of causative agents and evaluation of antibiogram results will play a key role in preventing infections and taking necessary precautions in hemodialysis patients.
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