Pathogen profile of central venous catheter-related blood stream infections in neurosurgical intensive care unit patients / 中国感染与化疗杂志

ABSTRACT

Objective To explore the distribution and antibiotic resistance of the pathogens in the patients with central venous catheter-related blood stream infection in neurosurgical intensive care unit (NSICU).Methods A total of 452 patients with central venous catheter were identified in NSICU from January 2014 to January 2017.Medical records were reviewed retrospectively to examine the incidence of central venous catheter-related blood stream infections,and the pathogen distribution and antibiotic resistance profile.Results The incidence of central venous catheter-related blood stream infection was 4.6％ (21/452).The incidence of such infection was significantly higher for the catheter in femoral vein (10.5％) than in internal jugular vein (4.0％) and subclavian vein (2.6％) (x2=9.755,P=0.008).Twenty-six strains of pathogen were isolated from the 21 patients,including 13 (50.0％) grampositive bacteria,11 (42.3％) gram-negative bacteria and 2 (7.7％) fungal strains (Candida albicans and Candida parapsilosis each).The most common gram-positive bacteria were Staphylococcus epidermidis(5) and Staphylococcus aureus(3).The most common gram-negative bacteria were Klebsiella pneumoniae(4) and Serratia marcescens(3).The most frequently isolated pathogen of central venous catheter-related blood stream infections was S.epidermidis (19.2％) and K.pneumoniae (15.4％).The antimicrobial susceptibility testing showed that gram-positive bacteria were highly resistant to penicillin,erythromycin,oxacillin and clindamycin.Gram-negative bacteria were highly resistant to cefazolin and piperacillin.The two fungal strain were highly sensitive to fluconazole,voriconazole,itraconazole and amphotericin B.Conclusions The predominant pathogens of central venous catheter-related blood stream infections in NSICU patients are gram-positive bacteria.S.epidermidis and K.pneumoniae are the major pathogens with high level of antibiotic resistance.Aseptic procedures and rational antibiotic therapy according to antimicrobial susceptibility test should be emphasized to control the resistant strains.