The influence of puncture site on the occurrence of vascular catheter-related infections in intensive care unit patients and its pathogenicanalysis

XUE Ri; WANG Yan; ZHAO Meng

doi:10.3969/j.issn.1007-8134.2023.06.011

Abstract：Objective To investigate the differences in the incidence of vascular catheter-related infections in critically ill patients admitted to the intensive care unit with central venous catheters inserted at different puncture sites,and to identify the distribution of pathogenic microorganisms and drug resistance of infections.Methods Retrospective analysis of the clinical data of patients who underwent central venous catheterization in the Department of Intensive Care Units from January 1,2016 to December 31,2021 in our hospital.Based on different puncture sites,they were divided into the subclavian group,internal jugular vein group,and femoral vein group.The incidence and pathogenic characteristics of vascular catheter-related infections in the 3 groups of patients were analyzed.Results The incidence of catheter-related infections in the femoral vein group was statistically significant compared to the subclavian and internal jugular vein groups(P＜0.05).The main pathogens of infection are multidrug-resistant Gram-negative bacteria,including Acinetobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa.They are highly resistant to common antibiotics such as ceftriaxone and ciprofloxacin,and are highly sensitive to antibiotics such as tigecycline,polymyxin,and carbapenems.Conclusions The central venous catheterization using the femoral vein as the puncture site has the highest risk of vascular catheter-related infections,and the pathogenic microorganisms leading to infection are mostly multidrug-resistant Gram-negative bacteria;In clinical practice,appropriate puncture sites should be selected based on the patient's treatment needs,and the selection of antibiotics should be adjusted in a timely manner based on drug sensitivity results.