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文献詳細

雑誌文献

臨床泌尿器科78巻12号

2024年11月発行

特集 泌尿器科医が知っておくべき感染症ベストコレクション

カテーテル関連血流感染症

著者: 河瀨京太郎1 荒岡秀樹1

所属機関: 1虎の門病院 臨床感染症科

ページ範囲:P.962 - P.967

文献概要

▶ポイント

・カテーテル関連血流感染症(CRBSI)は血管内留置カテーテル挿入中のすべての患者で生じ得る感染症であり,診断には血液培養の提出が必須となる.

・CRBSIでは原則として治療のために,感染したカテーテルの抜去が必要である.

・初療時からCRBSIを強く疑う場合は抗MRSA薬を含む経験的抗菌薬を使用し,治療経過が思わしくなければ,血液培養再検や播種病変の検索を行う.

参考文献

1) Magil SS, et al : Changes in Prevalence of Health Care ― Associated Infections in U.S. Hospitals. N Engl J Med 379 : 1732-1744, 2018
2) Raad I, et al : Intravascular catheter-related infections : advances in diagnosis, prevention, and management. Lancet Infect Dis 7 : 645-657, 2007
3) Pronovost PJ, et al : Sustaining Reductions in Central Line-Associated Bloodstream Infections in Michigan Intensive Care Units : A 10-Year Analysis. Am J Med Qual 31 : 197-202, 2016
4) JANIS : 集中治療室 (ICU) 部門におけるサーベイランスの概要と目的, 2023 https://janis.mhlw.go.jp/report/open_report/2022/3/3/ICU_Open_Report_202200.pdf (2024年7月13日閲覧)
5) O'Grady NP : Prevention of Central Line-Associated Bloodstream Infections. N Engl J Med 389 : 1121-1131, 2023
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12) Palavecino E, et al : Laboratory approaches to determining blood culture contamination rates : an ASM Laboratory Practices Subcommittee report. J Clin Microbiol 62 : e0102823, 2024
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14) Safdar N, et al : Inflammation at the insertion site is not predictive of catheter-related bloodstream infection with short-term, noncuffed central venous catheters. Crit Care Med 30 : 2632-2635, 2002
15) Buetti N, et al : Local signs at insertion site and catheter-related bloodstream infections : an observational post hoc analysis using individual data of four RCTs. Crit Care Med 24 : 694, 2020
16) Aslam S, et al : Systematic review and meta-analysis on management of hemodialysis catheter-related bacteremia. J Am Soc Nephrol 25 : 2927-2941, 2014
17) Ruiz-Ruigomez M, et al : Impact of duration of antibiotic therapy in central venous catheter-related bloodstream infection due to Gram-negative bacilli. J Antimicrob Chemother 75 : 3049-3055, 2020
18) Muff S, et al : Short-Course Versus Long-Course Systemic Antibiotic Treatment for Uncomplicated Intravascular Catheter-Related Bloodstream Infections due to Gram-Negative Bacteria, Enterococci or Coagulase-Negative Staphylococci : A Systematic Review. Infect Dis Ther 10 : 1591-1605, 2021
19) Ekkelenkamp MB, et al : Bacteremic complications of intravascular catheters colonized with Staphylococcus aureus. Clin Infect Dis 46 : 114-118, 2008
20) Lee YM, et al : Clinical impact of early reinsertion of a central venous catheter after catheter removal in patients with catheter-related bloodstream infections. Infect Control Hosp Epidemiol 42 : 162-168, 2021

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1332

印刷版ISSN:0385-2393

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