Key words: Bacteremia, Catheter

Transcription

1 Key words: Bacteremia, Catheter

2 1. ID No.: 2. Name: 3. Date of Birth: 4. Ward: Table 1 Recordings Inspection Card on Central Venous Catheter [To be filled out by physicians] 5. Type of catheter A: central venous catheter B: Swan-Ganz catheter C: Dialysis catheter D: Pressure measurement line( ) 6. Puncture site The circumference of A: Clavicula, B: Groin, C: Radius 7. Reason for removal A: Exchange due to long-term catheterization B: Catheterization not yet necessary C: Fever D: Contamination of the inlet E: Death F: Others( ) 8. Diagnosis: ( ) 9. General condition A: Favorable B: Average C: Poor D: Very poor 10. Use of antibiotics A: Yes B: No [To be filled out by nurses] 11. Date of removal: ( ) 12. Date of introduction: ( ) 13. Duration of catheterization A: Less than 1 week B: Less than 2 weeks C: Less than 3 weeks D: Less than 4 weeks E: Less than 5 weeks F: Less than 6 weeks G: Less than 7 weeks H: Less than 8 weeks I: Less than 9 weeks J: Less than 10 weeks K: Less than 11 weeks L: Less than 12 weeks M: Less than 13 weeks N: Less than 14 weeks 0: Less than 15 weeks P: More than 15 weeks 14. Number of injections and blood collections from the removed catheters A: Less than twice B: 3-5 times C: 6-8 times D: 9-11 times E: times F: Over 15 times 15. Injection site A: Three-way tap B: Rubber tube C: Others( ) 16. Methods of maintenance A: Opsite+Isodine-gel B: Opsite C: Catheripad D: Gauge(daily exhanged) E: Primapore F: Others( ) 17. Change of delivery system A: Everyday B: 3-5 times/week C: 1-2 times/week 18. Use of filter A: Yes B: No 19. Blood culture A: Yes B: No [To be filled out at the bacterial room] 20. Blood culture: ( ) 21. Culture with catheter tip: ( )

3 Table 2 Colonization on the catheter tip by sex Table 3 Colonization on the catheter tip by age Table 4 Colonization on the catheter tip by ward

4 Table 5 Colonization on the catheter tip by catheter Table 6 Colonization on the catheter tip by puncture site Table 7 Colonization on the catheter tip by reason for removal (1) Exchange for long-term catheterization (2) Catheterization no yet necessary

5 Table 8 Colonization on the catheter tip by diagnosis Table 9 Colonization on the catheter tip by patient's condition Table 10 Colonization on the catheter tip by antibiotic Table 11 Colonization on the catheter tip by season

6 Table 12 Colonization on the catheter tip by duration Table 13 Colonization on the catheter tip by injection times Table 14 Colonization on the catheter tip by maintenance 1 Sterile esteril wound dressing; Opsite, Smith & Nephew Co. 2 Adhesive wound dressing; Catheripad, Nichiban Co, Ltd., Primapore, Smith & Nephew Co.

7 Table 15 Colonization on the catheter tip by change of delivery system Table 16 Colonization on the catheter tip by filter Table 17 Colonization on the catheter tip by blood culture Table 18 Colonization on the catheter tip by result of blood culture Citrobacter, Enterococcus, Staphylococcus epider- Candida, Eubacterium, Klebsiella (Table 20) Staphylococcus epidermidis

8 Table 19 Microorganisms cultured from blood and catheter tip Table 20 Microorganisms cultured from catheter tip

9 Surgery, 91: , ) Brenard, R. W., Starhl, W. M. & Chase, R. M. Jr.: Subclavin catheterizations: A prospective study. Infectious complications. Ann. Surg., 173: , ) Michel, L., McMichan, J. C. & Bachy, J. L.: Microbial colonization of indwelling central venous catheters: Stastical evaluation of potential contaminating factors. Am. J. Surg., 137: , ) Sanders, R. A. & Sheldon, G. F.: Septic ciomplications of total parenteral nutrition: A five year experience. Am. J. Surg., 132: , ) Band, J. D. & Maki, D. G.: Safety of changing intravenous delivery systems at longer than 24-hour intervals. Ann. Intern, Med., 91: 173 1) Colvin, M. P., Blogg, C. E., Savege, T. M. & Jarvis, J. D.: A safe long-term infusion tech- nique?. Lancet, 2: , ) Bozzeti, F., Terno, G., Camerini, E., Baticci, F., Scarpa, D. & Pupa, A.: Pathogenesis and predictability of central venous catheter sepsis.

10 A Bacteriologic Study of Infections Associated with Central Venous Catheters Kenji NAMIKI, Kenji NAKAZAWA, Akira UMEZONO & Iwao AOYAMA Committee of Hospital Infections, Saiseikai Utsumomiya Hospital From May 1985 to October 1986, We made a bacteriologic study of almost all the central venous catheters used in our hospital. The results obtained are as follows; 1) We got the positive results of 137 cases with microorganisms out of 940 catheters, and its ratio was 14.9%. The microorganisms were mainly normal skin flora, such as Staphylococcus aureus, Candida, Bacillus and so on. 2) There were 16 blood cultures positive, of which 13 also had microorganisms in the catheters. In 9 out of these 13, the same microorganisms were found both in the blood cultures and the catheter tips. 3) In cases with fever and contamination at the site of catheter insertion, the positive ratio was meaningfully higher than the others. 4) As the time of catheterization got longer, the positive ratio got meaningfully higher. 5) As the condition of the patient got worse, the positive ratio became meaningfully higher. 6) On the matter of maintenance, we got the better results on adhesive wound dressing when we compare with other mediums. 7) Sex, age, the puncture site, antibiotics, the injection times, the changing of the delivery systems and filters, could not be correlated with incidence of catheter contamination.