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目的探讨静脉导管相关性栖稻黄单胞菌脓毒症的临床特点。方法临床怀疑导管相关性脓毒症时,即采外周血和导管内血液行细菌培养,拔除静脉导管时送导管内容物及导管尖端行细菌培养。结果15例患者导管入口处均无红肿、疼痛、分泌物,临床表现为突然不规则发热、寒战,体温37.8～40℃,11例(73.3%)超过38.5℃,2例伴(13.3%)咳嗽、咳黏液脓性痰;栖稻黄单胞菌在15例患者外周血、导管内血液培养中均为优势生长菌,7例导管尖端培养阳性;15株栖稻黄单胞菌均对哌拉西林、替卡西林/克拉维酸、阿米卡星、头孢他啶、头孢哌酮/舒巴坦、亚胺培南/西司他丁、氧氟沙星敏感,均对头孢西丁、头孢呋辛钠、头孢唑林、氨曲南耐药,3株对阿莫西林耐药,2株对头孢噻吩、头孢曲松耐药。15例患者中,12例痊愈,3例死亡。结论导管相关性栖稻黄单胞菌脓毒症多发生于患有各种基础疾病、免疫功能低下者,对I代、Ⅱ代头孢霉素、氨曲南耐药性高。
Objective To investigate the clinical features of intravenous catheter-related X. aeruginosa sepsis. Methods Clinical suspicion of catheter-related sepsis, that is, taking peripheral blood and ductal blood bacterial culture, removal of the catheter when the contents of the catheter and catheter tip bacterial culture. Results Fifteen patients had no inflamed, painful and exudate at the entrance of the catheter. The clinical manifestations were sudden irregular fever and chills. The body temperature ranged from 37.8 ℃ to 40 ℃. Eleven patients (73.3%) over 38.5 ℃. Two patients (13.3%) had cough , Cough mucoid purulent sputum; Xanthomonas prophylaxis in all 15 cases of peripheral blood, intraductal blood culture are dominant growth bacteria, 7 cases of catheter tip culture positive; Ceftazidime, cefuroxime, ceftazidime, cefoperazone / sulbactam, imipenem / cilastatin, ofloxacin were sensitive to cefoxitin, cefuroxime, Sodium, cefazolin, aztreonam, 3 strains resistant to amoxicillin, 2 strains resistant to cefalotin and ceftriaxone. Of the 15 patients, 12 were cured and 3 died. Conclusions Catheter-associated Xanthomonas parahaemolyticus sepsis occurs mostly in patients with various underlying diseases and immunocompromised patients. It has high resistance to generation I, generation II cephalosporins and aztreonam.