犬隻使用中央靜脈導管相關感染之評估

中央途徑的血管通路如中央靜脈導管(central venous catheter, CVC)可用以輸液治療與多次採血，但由於可能出現的導管相關感染(catheter-related infection, CRI)往往限制這類導管的使用並導致血管通路的喪失。本實驗的目的在於評估犬隻頸靜脈短期放置CVC所可能引起之感染率與感染主要菌叢相，作為中央血管通路預防感染的參考依據。將CVC放置於8隻已節育健康犬隻之頸靜脈內，進行6天的實驗期，期間由導管周圍皮膚、導管開口與護帽連接處(hub)內外圍、導管於皮下與導管尖端等處分別進行採樣，並採集血液進行微生物培養。其結果顯示，CVC的埋置並無發現相關感染的現象，不過在導管放置後第三天及第六天，由導管周圍皮膚與導管外圍所分離到的8菌株中，以革蘭氏陽性菌為主(87.5%, 7/8)，包括3株sp.、2株與2株，且這些菌株對多數抗生素皆具敏感性，以cefazolin、chloramphenicol與enrofloxacin等抗生素敏感性較佳。由本研究可知，CVC未來可安全應用於犬隻，以作為長期輸液與採血途徑，並進行中央靜脈壓的監控。

關鍵字

犬；中央靜脈導管；導管相關感染

並列摘要

Vascular access of central line such as central venous catheter (CVC) allows for reliable fluid therapy, the key in treating acute renal failure and frequent blood sampling. However, catheter-related infection (CRI) significantly limits the use of catheters and causes vascular access loss. The purpose of this study was to evaluate the CRI induced by using CVC in dogs. The application of CVC was performed to eight healthy neutrolized mature dogs in a period of 6-day-experment. Skin of insertion site, internal site and external surface of catheter hub, and submucosa site were cultured for bacteriological examinations. Blood cultures were also obtained through the distal part of catheter before catheter removal. The results indicated that CRI was not found during the 6 days of experiment. However, gram-positive bacteria (87.5%, 7/8) were mostly isolated from skin of insertion site and external surface of catheter hub on the 3rd and 6th day after CVC insertion, including Bacillus spp. (37.5%), Staphylococcus epidermidis (25.0%), and Micrococcus luteus (25.0%), which were all susceptible to cefazolin, chloramphenicol and enrofloxacin. It is suggested that the application of CVC in dogs would be safe for a long-term fluid therapy and central venous pressure monitoring.

並列關鍵字

catheter-related infection ； central venous catheter ； dog

國際替代計量

犬隻使用中央靜脈導管相關感染之評估

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