慢性血液透析患者隧道导管相关血流感染:频率、危险因素和结果——一项10年分析

IF 2.2 4区 医学 Q4 IMMUNOLOGY
Apmis Pub Date : 2025-03-13 DOI:10.1111/apm.70016
Mustafa Arslan, Ercan Kahraman, Elif Menekşe
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引用次数: 0

摘要

本研究旨在探讨慢性血液透析患者行隧道式血液透析导管治疗时导管相关性血流感染(CRBSI)的发生率、危险因素、致病微生物分布及治疗结果。回顾性分析2014年1月至2024年1月在我中心接受隧道导管血液透析治疗的所有患者的数据。共有171名患者参与了这项研究。45例患者有54次CRBSI发作。从置管到发生CRBSI的平均时间为127.4天,随着时间的延长,发生CRBSI的风险增加。在双变量logistic回归分析中,高龄(p = 0.03)、糖尿病(p = 0.005)、血液透析持续时间(p < 0.001)、失代偿性肝硬化(p = 0.02)和股静脉进入部位(p = 0.011)被确定为CRBSI的危险因素。在ROC分析中,确定糖尿病患者发生CRBSI的血红蛋白A1c阈值为9.350(敏感性69%,特异性87%,AUC = 0.755, p < 0.001)。我们认为,尽可能避免股静脉置管,加快由置管转向其他透析方式是预防CRBSI发生的重要措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tunneled Catheter-Related Bloodstream Infections in Chronic Hemodialysis Patients: Frequency, Risk Factors, and Outcomes—A 10-Year Analysis

The aim of this study is to investigate the rate, risk factors, causative microorganism distribution, and treatment outcomes of catheter-related bloodstream infection (CRBSI) in chronic hemodialysis patients undergoing treatment with a tunneled hemodialysis catheter. Data for all patients who underwent hemodialysis treatment with tunneled catheters at our center between January 2014 and January 2024 were retrospectively analyzed. A total of 171 patients were included in the study. Forty-five patients had 54 CRBSI episodes. The average time between catheter placement and the development of CRBSI was 127.4 days, and the risk of developing CRBSI increased as this duration extended. In the bivariate logistic regression analysis, advanced age (p = 0.03), diabetes (p = 0.005), duration of hemodialysis (p < 0.001), decompensated cirrhosis (p = 0.02), and the femoral vein being the entry site (p = 0.011) were identified as risk factors for CRBSI. In the ROC analysis, the hemoglobin A1c threshold value for the development of CRBSI in diabetic patients was determined to be 9.350 (69% sensitivity, 87% specificity, AUC = 0.755, p < 0.001). We believe that avoiding femoral vein catheterization as much as possible and expediting the transition from catheter to another method for dialysis are important measures to prevent the development of CRBSI.

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来源期刊
Apmis
Apmis 医学-病理学
CiteScore
5.20
自引率
0.00%
发文量
91
审稿时长
2 months
期刊介绍: APMIS, formerly Acta Pathologica, Microbiologica et Immunologica Scandinavica, has been published since 1924 by the Scandinavian Societies for Medical Microbiology and Pathology as a non-profit-making scientific journal.
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