Objective To investigate the risk factors of central venous catheters (CVC) colonization.Methods A retrospective study was performed on adult patients with CVCs placement in Renji Hospital,Shanghai Jiaotong University from January 2006 to March 2010.Clinical data,catheter-related information (including duration of catheter placement,position and purpose of catheterization,and whether or not out-of-ward catheterization),catheter culture results,and prevalence of catheter-related blood stream infection (CRBSI)was collected.Results A total of 651 patients aged 18 to 97 years (median:63 years) were enrolled in the study,in whom 762 CVC were placed.The median duration of catheter placement was 1 1 days (2 to 122 days)and the total duration of CVC placement was 10 725 days.The prevalence of catheter colonization was 16％(122/762),and 134 germs were cultured.Gram-positive cocci was the most common colonized bactera (52.2％,70/122),followed by gram-negative bacilli (33.6％,45/122) and fungi (14.2％,19/122).Overall 13 CRBSI were confirmed and the rate of CRBSI was 1.21/1000 catheter-days.Logistic regression analysis demonstrated that the risk factors for CVC colonization included mechanical ventilation [odds ratio (OR) =1.783,95％ confidence interval (Cl) =1.108 ～2.870],serum albumin concentration less than 25 g/L before catheterization (OR =1.783,95％ Cl =1.357 ～ 6.757),prolonged duration of catheter placement (OR =1.105,95％ Cl =1.009 ～ 1.111),and out-of-ward catheterization (OR =2.837,95％ Cl =1.010 ～7.969).Conclusion Patients with prolonged duration of catheter placement and out-of-ward catheterization are inclined to CVC colonization.%目的 了解中心静脉导管(CVC)微生物定植的相关危险因素.方法 对2006年1月至2010年3月在上海交通大学医学院附属仁济医院进行CVC置管的成年患者进行回顾性分析,采集患者病史资料、导管相关资料(置管时间、置管部位、置管目的、是否带管人院)、CVC微生物定植结果和导管相关性血流感染发生情况.结果 共651例患者纳入本研究,年龄中位数为63岁(18 ～97岁),累计置入CVC 762例次,置管时间中位数为11 d(2～122d),总置管时间为10 725 d.CVC微生物定植率为16％ (122/762),共培养出134株菌株,以革兰氏阳性球菌多见(52.2％,70/134),其次为革兰氏阴性杆菌(33.6％,45/134)和真菌(14.2％,19/134).13例发生导管相关性血流感染,发生率为1.21/千导管日(13/10 725).Logistic回归分析显示机械通气(OR=1.783,95％ Cl=1.108～2.870)、置管前血清白蛋白浓度≤25 g/L(OR=1.783,95％ Cl=1.357～6.757)、置管时间长(OR=1.105,95％ Cl=1.009～1.111)及带管人院(OR=2.837,95％ Cl=1.010 ～7.969)均为CVC微生物定植的危险因素.结论 置管时间延长及带管人院均易发生CVC微生物定植.
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