Author/Editor		Mueller-Premru, M; Dragaš, AZ; Gubina, M; Derganc, M; Grosek, Š; Pokrajac, T
Title		Vloga osrednjih venskih katetrov pri nastanku sepse nedonošenčkov
Translated title		The role of central venous catheters in sepsis of premature newborns
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. Suppl 3
Publication year		1995
Volume		str. III-55-7
Language		slo
Abstract		Background. Central venous catheter infections are common in premature and other newborns treated in intensive care units. They are caused with coagulase-negative staphylococci and other bacteria. Bacteria can colonize catheters from skin via external catheter surface or from hub and other parts of catheter system via internal catheter surfate and cause bacteremia and sepsis. Methods. In a three year prospective study frequency and sites of catheter infection and their role in sepsis were evaluated. External catheter surfaces of 61 catheters in 54 patients with clinical signs of sepsis were studied with semiquantitative method. Internal catheter surfaces, catheter hubs, parenteral fluid in use and skin swabs were studied with quantitative method. Bacteria from catheters were compared with blood culture isolates. Results. Twenty four of 61 (40 percent) catheters were infected with 32 different bacterial strains. Bacteria were found on external and internal catheter surface, in catheter hub, in parenteral fluid and also on skin. In 25 of 54 (46 percent) patients with clinical signs of sepsis bacteria were isolated from blood. In 14 patients sepsis was probably catheter related. Conclusions. Bacteria colonize internal and external catheter surfaces. Sepsis was more common in patients with central venous catheter and hub infection. Bacteria in blood were commonly of the same species as found on catheter, on skin and in the hub. To confirm catheter sepsis and to evaluate it's origin it is necessary to type bacteria.
Summary		Izhodišča. Okužbe osrednjih venskih katetrov so pogoste pri nedonošenčkih in drugih novorojenčkih, ki se zdravijo v intenzivnih enotah. Povzročajo jih glede koagulaze negativni stafilokoki in druge bakterije. Bakterije se lahko naselijo na katetre s kožo po zunanji površini ali s petelička in drugih delov katetrskega sistema po notranji površini in povzročajo okužbo katetrov, lahko pa tudi bakteriemijo in sepso. Metode. V triletni prospektivni študiji smo ugotavljali pogostnost in mesta naselitve bakterij na osrednjih venskih katetrih ter njihov vpliv na nastanek sepse. Zunanjo površino 61 katetrov pri 54 bolnikih s kliničnimi znaki sepse smo proučevali s semikvantitativno metodo. Notranjo površino katetrov, petelinčke, parenteralno raztopino, ki so jo dobivali bolniki in brise kože ob katetru smo proučevali s kvantitativno metodo. Bakterije na katetrih smo primerjali z bakterijami iz krvi bolnikov. Rezultati. Na 24 od 61 (40 odst.) katetrov smo našli 32 različnih bakterijskih sevov. Pogosto smo našli bakterije na zunanji in notranji površini katetra, na peteličku, v parenteralni raztopini in na koži. Pri 25 od 54 bolnikov (46 odst.) s kliničnimi znaki sepse smo osamili bakterije iz krvi. Pri 14 bolnikih so sepso verjetno povzročili okuženi katetri. Zaključki. Bakterije se lahko naselijo na zunanji in notranji površini osrednjih venskih katetrov. Bolniki z okuženimi katetri in petelički so imeli sepso pogosteje kot bolniki z neokuženimi katetri in petelinčki. V krvi bolnikov smo pogosto našli bakterije iste vrste kot na katetru, na koži in na petelinčku. Da bi potrdili, da je bila sepsa katetrska in ugotovili, ali so bakterije vstopile s kožo ali s petelička, jih bo treba tipizirati.
Descriptors		INTENSIVE CARE UNITS, NEONATAL CATHETERIZATION, CENTRAL VENOUS SEPSIS INFANT, PREMATURE INFANT, NEWBORN