PDF(Pubmed)
Abstract：
The predominant use of intravenous catheters as primary access type in the pediatric hemodialysis population is associated with an increased risk of catheter related blood stream infections. While strict adherence to catheter placement and long-term care guidelines have helped to decrease the incidence of these infections, blood stream infections remain an infection burden in pediatric patients with long term hemodialysis catheters. The formation of biofilms on the surfaces of these catheters has been shown to be a source of microbes causing blood stream infections. One of the strategies for preventing bacterial colonization, inhibiting microbial multiplication, and suppressing the seeding of these microbes from biofilms upon maturation, has been the use of antibiotic-based lock solutions in-between dialysis treatments. Although clinical guidelines for the use of antibiotic lock solutions are yet to be developed, available evidence suggests a beneficial role of antibiotic lock solutions in the management of catheter related blood stream infections. Additionally, a clear understanding of how biofilms are formed and their role in the pathogenesis of catheter related bloodstream infection will facilitate the development of solutions that can prevent biofilm formation and inhibit their multiplication, maturation and seeding into the bloodstream.
摘要：
在儿科血液透析人群中，静脉导管作为主要通路类型的主要使用与导管相关血流感染的风险增加有关。虽然严格遵守导管放置和长期护理指南有助于降低这些感染的发生率，在长期使用血液透析导管的儿科患者中，血流感染仍然是感染负担。在这些导管表面上形成的生物膜已被证明是引起血流感染的微生物源。预防细菌定植的策略之一，抑制微生物繁殖，并在成熟时抑制这些微生物从生物膜中播种，在透析治疗之间一直使用基于抗生素的锁定解决方案。尽管使用抗生素锁定溶液的临床指南尚未制定，现有证据表明抗生素锁定溶液在导管相关血流感染的治疗中具有有益作用.此外,清楚了解生物膜是如何形成的，以及它们在导管相关血流感染发病机理中的作用，将有助于开发能够防止生物膜形成和抑制其增殖的解决方案，成熟并播种到血液中。
