1例心脏瓣膜修补术后导管相关血流感染病例的调查与控制

Investigation and control of 1 case of catheter-related bloodstream infection following cardiac valve repair surgery

  • 摘要: 案例分析2024年7月1例心脏瓣膜修补术后患者发生导管相关血流感染(CRBSI)的原因,总结诊疗过程中的问题,并提出系统性防控改进措施,以降低今后类似感染的发生率。案例回顾了该例患者的临床资料,包括病史、实验室检查、导管使用与更换情况、抗菌药物使用记录等。结合指南和共识,对病例进行临床诊断、病原学诊断和感染危险因素分析,制定并实施了一系列感染防控改进措施。通过及时拔除导管、更换抗菌药物及对症支持治疗,患者感染得到控制,血培养转阴,感染指标及体温均恢复正常,最终康复出院。通过规范置管操作、日常维护、环境管理、抗菌药物合理使用等多环节系统干预,科室留置中心静脉导管(CVC)患者总例次数(7月:280例次;8月:79例次;9月:88例次)、留置CVC平均天数(7月:15.2 d;8月:9.7 d;9月:8.1 d)均显著下降,截至2025年10月科室未再发生导管相关的感染病例。

     

    Abstract: This case study analyzes the causes of catheter-related bloodstream infection (CRBSI) in a cardiac valve repair patient in July, 2024, summarized issues in diagnosis and treatment, and proposed systematic prevention and improvement measures to reduce the incidence of similar infections in the future. The clinical data of the patient were reviewed, including medical history, laboratory tests, records of catheter usage and replacement and use of antibacterial agents. Based on guidelines and consensus, clinical and etiological diagnoses were made, and infection risk factors were analyzed. A series of infection prevention and control improvement measures were formulated and implemented. Through timely catheter removal, antibacterial agent adjustment and symptomatic supportive treatment, the infection was controlled. Blood culture turned negative, infection indicators and body temperature returned to normal. The patient was finally discharged after recovery. By standardizing catheter insertion, daily maintenance, environmental management and rational use of antibacterial drugs through systematic multi-faceted interventions, the total number of patients with central venous catheter (CVC) (280 case-times in July, 79 case-times in August, 88 case-times in September) and the average CVC indwelling days (15.2 days in July, 9.7 days in August, 8.1 days in September) in the department significantly decreased. By October, 2025, no further catheter-related infections have occurred in the department.

     

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