8例外周静脉导管相关性血流感染的启示
Inspiration from 8 Cases of Peripheral Intravenous Catheter-Related Bloodstream Infection

目的：分析外周静脉导管相关性血流感染(Peripheral intravenous catheter-related bloodstream infection, PIVC-BSI)的病例，探讨其原因及预防措施。方法：对怀疑PIVC-BSI的患者留取血液标本并从物体表面、环境及工作人员的手取样做细菌培养，分析患者临床资料、环境卫生学指标及实验室检查结果并跟踪患者结局。结果：8例患者于静脉输液封管后0.5~3.5 h内出现寒颤，体温最高达41℃。4例患者的血标本检出洋葱伯克霍尔德菌感染，2例导管尖端洗脱液检出的细菌与血标本培养出的细菌相同。治疗准备间空气湿度为60%~80%。患者经抗生素治疗后好转出院，经温湿度控制及输液工具全部更换后，再无患者输液后寒颤发热。结论：8例PIVC-BSI为洋葱伯克霍尔德菌感染引起，空气湿度高为最可能的因素，需根据地区气候特点加强环境温湿度控制及物品的管理。
Object: Cases of peripheral intravenous catheter-related bloodstream infection (PIVC-BSI) were analyzed to explore the causes of PIVC-BSI and to propose preventive measures. Method: Peripheral blood samples were taken from patients suspected of PIVC-BSI and samples were taken from the surface of the relevant objects, the environment and the hands of staff for bacterial culture. The clinical data, environmental hygiene indicators and laboratory findings of PIVC-BSI patients were analyzed and the patient's treatment outcomes were followed. Result: All the 8 patients had chills within 0.5~3.5 hours after intravenous infusion, and the highest body temperature reached 41？C. The peripheral blood samples of 4 patients were cultured as Burkholderia cepacia infection, and the eluate from the catheter tip of 2 patients cultured the same bacteria as the blood culture. The air is humid during treatment preparation, and the humidity is 60%~80%. All the patients were discharged after being treated with antibiotics. After the temperature and humidity were controlled and all the infusion devices were replaced, there was no chill and fever after the patient was infused. Conclusion: These 8 patients were PIVC-BSI caused by Burkholderia cepacia infection, and the high air humidity was the most likely factor. It is necessary to strengthen the control of environmental temperature and humidity and the management of items according to the regional climate characteristics.