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武汉大学人民医院感染预防与控制办公室 湖北 武汉 430060
Received:17 October 2023,
Published:25 April 2025
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曾红兰,叶青,何宇红.导管相关血流感染的监测与诊断进展[J].武汉大学学报(医学版),2025,46(04):547-553.
ZENG Honglan,YE Qing,HE Yuhong.Progress in surveillance and diagnosis of catheter‑related bloodstream infections[J].Medical Journal of Wuhan University,2025,46(04):547-553.
曾红兰,叶青,何宇红.导管相关血流感染的监测与诊断进展[J].武汉大学学报(医学版),2025,46(04):547-553. DOI: 10.14188/j.1671-8852.2023.0550.
ZENG Honglan,YE Qing,HE Yuhong.Progress in surveillance and diagnosis of catheter‑related bloodstream infections[J].Medical Journal of Wuhan University,2025,46(04):547-553. DOI: 10.14188/j.1671-8852.2023.0550.
血管内导管为患者提供了长期和稳定的血管通路,已被广泛应用于临床诊疗中。但置入血管内导管后会有发生不良事件的风险,包括从局部皮肤软组织感染到严重的导管相关血流感染。导管相关血流感染的发生会延长患者的住院时间,甚至增加患者的死亡风险。目前国内外关于监测血管导管的类型以及要求不完全一致,因此本文就国内外关于导管相关血流感染的监测要求以及诊断依据进行系统的总结,以期为医疗机构防控导管相关血流感染的发生提供参考依据。
Intravascular catheters provide long‑term and stable vascular access for patients and have been widely used in clinical diagnosis and treatment. However
there is a risk of adverse events after intravascular catheterization
ranging from local skin and soft tissue infections to severe catheter‑related bloodstream infections. The occurrence of catheter‑related bloodstream infections can prolong the length of hospital stay and even increase the risk of death. At present
the types and requirements of monitoring vascular catheters at home and abroad are not completely consistent. So this paper systematically summarizes the monitoring requirements and diagnostic basis of catheter‑related bloodstream infections
in order to provide a reference for medical institutions to prevent and control the occurrence of catheter‑related bloodstream infections.
SELBY L M , RUPP M E , CAWCUTT K A . Prevention of central‑line associated bloodstream infections: 2021 update [J ] . Infect Dis Clin North Am , 2021 , 35 ( 4 ): 841 ‑ 856 .
中国心胸血管麻醉学会围术期感染控制分会 . 麻醉科导管相关性血流感染预防专家共识 [J ] . 中华医学杂志 , 2023 , 103 ( 23 ): 1733 ‑ 1738 .
Perioperative Infection Control Branch of Chinese Society of Cardiothoracic and Vascular Anesthesia . Expert consensus on the prevention of catheter‑related bloodstream infection in the department of anesthesiology [J ] . Natl Med J China , 2023 , 103 ( 23 ): 1733 ‑ 1738 .
WOLCOTT R . Biofilm and catheter‑related bloodstream infections [J ] . Br J Nurs , 2021 , 30 ( 8 ): S4 ‑ S9 .
PANDIT P , SAHNI A K , GROVER N , et al . Catheter‑related blood stream infections: Prevalence, risk factors and antimicrobial resistance pattern [J ] . Med J Armed Forces India , 2021 , 77 ( 1 ): 38 ‑ 45 .
中华人民共和国国家卫生健康委员会 . 血管导管相关感染预防与控制指南(2021版) [J ] . 传染病信息 , 2021 , 34 ( 4 ): 289 ‑ 290 .
National Health Commission of the People's Republic of China . Guidelines for prevention and control of vascular catheter associated infection (2021 edition) [J ] . Infect Dis Inf , 2021 , 34 ( 4 ): 289 ‑ 290 .
Centers for Disease Control and Prevention . 2021 NHSN Patient Safety Component Manual [EB/OL ] .( 2021 / 1 )[ 2023 / 09 / 21 ] . https://www.cdc.gov/nhsn/pdfs/validation/2021/pcsmanual_2021-508.pdf https://www.cdc.gov/nhsn/pdfs/validation/2021/pcsmanual_2021-508.pdf .
HIGGINS M , ZHANG L , FORD R , et al . The microbial biofilm composition on peripherally inserted central catheters: A comparison of polyurethane and hydrophobic catheters collected from paediatric patients [J ] . J Vasc Access , 2021 , 22 ( 3 ): 388 ‑ 393 .
陈琪 , 唐非 . 医院常见致病菌生物膜形成能力的研究进展 [J ] . 中国消毒学杂志 , 2022 , 39 ( 3 ): 226 ‑ 229 .
CHEN Q , TANG F . Research progress on biofilm formation ability of common pathogenic bacteria in hospitals [J ] . Chin J Disinfect , 2022 , 39 ( 3 ): 226 ‑ 229 .
王芳 , 余锋 , 姚豪杰 , 等 . 导管相关性真菌血流感染病原菌生物膜形成及预后影响因素 [J ] . 中华医院感染学杂志 , 2022 , 32 ( 3 ): 408 ‑ 411 .
WANG F , YU F , YAO H J , et al . Biofilm formation of pathogenic bacteria and the prognosis in patients with catheter‑related fungal bloodstream infection [J ] . Chin J Nosocomiology , 2022 , 32 ( 3 ): 408 ‑ 411 .
ROY R , TIWARI M , DONELLI G , et al . Strategies for combating bacterial biofilms: A focus on anti‑biofilm agents and their mechanisms of action [J ] . Virulence , 2018 , 9 ( 1 ): 522 ‑ 554 .
O'GRADY N P . Prevention of central line‑associated bloodstream infections [J ] . N Engl J Med , 2023 , 389 ( 12 ): 1121 ‑ 1131 .
BUETTI N , TIMSIT J F . Management and prevention of central venous catheter‑related infections in the ICU [J ] . Semin Respir Crit Care Med , 2019 , 40 ( 4 ): 508 ‑ 523 .
BUETTI N , LO PRIORE E , ATKINSON A , et al . Catheter‑related infections: Does the spectrum of microbial causes change over time? A nationwide surveillance study [J ] . BMJ Open , 2018 , 8 ( 12 ): e023824 .
O'GRADY N P , ALEXANDER M , BURNS L A , et al . Guidelines for the prevention of intravascular catheter‑related infections [J ] . Clin Infect Dis , 2011 , 52 ( 9 ): e162 ‑ e193 .
RUIZ‑RUIGÓMEZ M , AGUADO J M . Duration of antibiotic therapy in central venous catheter‑related bloodstream infection due to Gram‑negative bacilli [J ] . Curr Opin Infect Dis , 2021 , 34 ( 6 ): 681 ‑ 685 .
RUIZ‑RUIGÓMEZ M , FERNÁNDEZ‑RUIZ M , SAN‑JUAN R , et al . Impact of duration of antibiotic therapy in central venous catheter‑related bloodstream infection due to Gram‑negative bacilli [J ] . J Antimicrob Chemother , 2020 , 75 ( 10 ): 3049 ‑ 3055 .
LENDAK D , PUERTA‑ALCALDE P , MORENO‑GARCÍA E , et al . Changing epidemiology of catheter‑related bloodstream infections in neutropenic oncohematological patients [J ] . PLoS One , 2021 , 16 ( 4 ): e0251010 .
MARCOS M , SORIANO A , IÑURRIETA A , et al . Changing epidemiology of central venous catheter‑related bloodstream infections: Increasing prevalence of Gram‑negative pathogens [J ] . J Antimicrob Chemother , 2011 , 66 ( 9 ): 2119 ‑ 2125 .
ZENG C , WU A H , LI L Y , et al . Multi‑center prospective study on central line‑associated bloodstream infections in 79 ICUs of China [J ] . BMC Infect Dis , 2021 , 21 ( 1 ): 1208 .
AL‑SHUKRI R N , AL‑RAWAJFAH O M , AL‑DAKEN L , et al . ICU‑acquired central line‑associated bloodstream infection and its associated factors in Oman [J ] . Am J Infect Control , 2022 , 50 ( 9 ): 1026 ‑ 1031 .
LI L , FORTIN E , TREMBLAY C , et al . Central‑line‑associated bloodstream infections in québec intensive care units: Results from the provincial healthcare‑associated infections surveillance program (SPIN) [J ] . Infect Control Hosp Epidemiol , 2016 , 37 ( 10 ): 1186 ‑ 1194 .
ROSENTHAL V D , JIN Z L , VALDERRAMA‑BELTRAN S L , et al . Multinational prospective cohort study of incidence and risk factors for central line‑associated bloodstream infections in ICUs of 8 Latin American countries [J ] . Am J Infect Control , 2023 , 51 ( 10 ): 1114 ‑ 1119 .
SHAH H , BOSCH W , THOMPSON K M , et al . Intravascular catheter‑related bloodstream infection [J ] . Neurohospitalist , 2013 , 3 ( 3 ): 144 ‑ 151 .
STEVENS V , GEIGER K , CONCANNON C , et al . Inpatient costs, mortality and 30‑day re‑admission in patients with central‑line‑associated bloodstream infections [J ] . Clin Microbiol Infect , 2014 , 20 ( 5 ): O318‑O324.
武迎宏 , 曹煜隆 , 周春莲 , 等 . 中央导管相关血流感染经济损失的病例对照研究 [J ] . 中华医院感染学杂志 , 2018 , 28 ( 17 ): 2615 ‑ 2617 .
WU Y H , CAO Y L , ZHOU C L , et al . Economic burden of central line‑associated bloodstream infections: A case‑control study [J ] . Chin J Nosocomiology , 2018 , 28 ( 17 ): 2615 ‑ 2617 .
王新晴 . 某三级医院中央导管相关血流感染现状与直接经济负担研究 [D ] . 滨州 : 滨州医学院 , 2020 .
WANG X Q . Study on the current situation and direct economic burden of central catheter‑related bloodstream infection in a tertiary hospital [D ] . Binzhou : Binzhou Medical University , 2020 .
BUETTI N , MARSCHALL J , DREES M , et al . Strategies to prevent central line‑associated bloodstream infections in acute‑care hospitals: 2022 Update [J ] . Infect Control Hosp Epidemiol , 2022 , 43 ( 5 ): 553 ‑ 569 .
中华人民共和国卫生部 . 医院感染管理办法 [J ] . 中国护理管理 , 2006 , 6 ( 7 ): 5 ‑ 7 .
Ministry of Health of the People's Republic of China . Measures for the administration of nosocomial infection [J ] . Chin Nurs Manag , 2006 , 6 ( 7 ): 5 ‑ 7 .
中华人民共和国卫生部 . WS/T312‑2009 医院感染监测规范 [S ] . 北京 : 中华人民共和国卫生部 , 2009 .
Ministry of Health of the People's Republic of China . WS/T312‑2009 Standard for surveillance of nosocomial infection [S ] . Beijing : Ministry of Health of the People's Republic of China , 2009 .
戴凡 , 吴传芳 , 谭创 , 等 . 血管导管相关血流感染预防与控制最佳证据实施现状调查 [J ] . 中国感染控制杂志 , 2022 , 21 ( 8 ): 774 ‑ 780 .
DAI F , WU C F , TAN C , et al . Implementation situation of best evidence practice for prevention and control of vascular catheter‑related bloodstream infection [J ] . Chin J Infect Contr , 2022 , 21 ( 8 ): 774 ‑ 780 .
中华人民共和国国家卫生健康委员会 . 医院感染监测标准WS/T312‑2023 [J ] . 中国感染控制杂志 , 2023 , 22 ( 9 ): 1129 ‑ 1142 .
National Health Commission of the People's Republic of China . Standard for healthcare associated infection surveillance WS/T 312‑2023 [J ] . Chin J Infect Contr , 2023 , 22 ( 9 ): 1129 ‑ 1142 .
DUANE T M , RAMANATHAN R , LEAVELL P , et al . CAUTIs and CLABSIs: Do physicians REALLY know what they are? [J ] . Surg Infect , 2016 , 17 ( 1 ): 13 ‑ 16 .
PANEPINTO R , HARRIS J , WELLETTE J . A review of best practices related to intravenous line management for nurses [J ] . Nurs Clin North Am , 2021 , 56 ( 3 ): 389 ‑ 399 .
WRIGHT M O , ALLEN‑BRIDSON K , HEBDEN J N . Assessment of the accuracy and consistency in the application of standardized surveillance definitions: A summary of the American Journal of Infection Control and National Healthcare Safety Network case studies, 2010‑2016 [J ] . Am J Infect Control , 2017 , 45 ( 6 ): 607 ‑ 611 .
LARSEN E N , GAVIN N , MARSH N , et al . A systematic review of central‑line‑associated bloodstream infection (CLABSI) diagnostic reliability and error [J ] . Infect Control Hosp Epidemiol , 2019 , 40 ( 10 ): 1100 ‑ 1106 .
SEXTON D J , CHEN L F , MOEHRING R , et al . Casablanca redux: We are shocked that public reporting of rates of central line‑associated bloodstream infections are inaccurate [J ] . Infect Control Hosp Epidemiol , 2012 , 33 ( 9 ): 932 ‑ 935 .
MERMEL L A , ALLON M , BOUZA E , et al . Clinical practice guidelines for the diagnosis and management of intravascular catheter‑related infection: 2009 Update by the Infectious Diseases Society of America [J ] . Clin Infect Dis , 2009 , 49 ( 1 ): 1 ‑ 45 .
ULRICH P , LEPAK A J , CHEN D J . Diagnostic and therapeutic utility of positive intravascular catheter tip cultures [J ] . Microbiol Spectr , 2022 , 10 ( 6 ): e0402222 .
DHALIWAL M , DANEMAN N . Utility of differential time to positivity in diagnosing central line‑associated bloodstream infections:A systematic review and meta‑analysis [J ] . Clin Infect Dis , 2023 , 77 ( 3 ): 428 ‑ 437 .
BOUZIDI H , EMIRIAN A , MARTY A , et al . Differential time to positivity of central and peripheral blood cultures is inaccurate for the diagnosis of Staphylococcus aureus long‑term catheter‑related sepsis [J ] . J Hosp Infect , 2018 , 99 ( 2 ): 192 ‑ 199 .
FUX C A , COSTERTON J W , STEWART P S , et al . Survival strategies of infectious biofilms [J ] . Trends Microbiol , 2005 , 13 ( 1 ): 34 ‑ 40 .
DE SIO C , VENAFRO M , FOCCILLO G , et al . Bedside ultrasound as a screening test for the diagnosis of catheter‑related bloodstream infection (CRBI) [J ] . J Ultrasound , 2022 , 25 ( 1 ): 1 ‑ 7 .
陈冬容 , 赵晋 , 袁玉华 . 中美中央静脉导管相关血流感染监测体系的比较 [J ] . 中华临床感染病杂志 , 2023 , 16 ( 4 ): 306 ‑ 309 .
CHEN D R , ZHAO J , YUAN Y H . Comparison of monitoring systems for central line‑associated blood stream infections (CLABSI) between China and the United States [J ] . Chin J Clin Infect Dis , 2023 , 16 ( 4 ): 306 ‑ 309 .
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