文献分析结果 http://www.gopubmed.org/web/gopubmed/1?WEB078pof5txk1flI3I1I00h001000j100200010 arterial catheters and central venous catheters and infection 243 documents semantically analyzed top author statistics 1 2 Top Years Publications 2008 20 2009 15 2007 14 2005 14 2006 13 2003 12 2001 11 2004 10 1998 10 2002 8 1996 8 1994 8 2010 7 1995 7 1992 7 1989 7 1985 7 1999 6 1993 6 1988 6 1 2 1 2 Top Countries Publications USA 70 Germany 13 France 12 Italy 11 Canada 11 Netherlands 11 Spain 10 Japan 8 United Kingdom 8 Australia 4 Turkey 4 Switzerland 4 Tunisia 4 China 3 Belgium 3 Taiwan 3 Israel 3 Austria 3 Iran 2 Singapore 2 1 2 1 2 3 ... 7 Top Cities Publications Boston 8 New York 4 Tunis 4 Utrecht 4 Santa Cruz de Tenerife 3 Seattle 3 Toronto 3 Wien 3 Marseilles 3 Charlottesville 3 Aurora 2 Istanbul 2 Indianapolis 2 Beijing 2 Geneva 2 Ankara 2 Amsterdam 2 Detroit 2 St. Louis 2 Turin 2 1 2 3 ... 7 1 2 3 ... 8 Top Journals Publications Crit Care Med 23 Intens Care Med 7 Pediatrics 5 Infect Control Hosp Epidemiol 4 J Vasc Surg 4 Cochrane Database Syst Rev 4 Infect Cont Hosp Ep 4 Ann Fr Anesth 4 Am J Kidney Dis 4 J Trauma 4 J Hosp Infect 3 Clin Infect Dis 3 Radiology 3 Am J Surg 3 Crit Care 2 Zhonghua Nei Ke Za Zhi 2 Shock 2 Pediatr Crit Care Med 2 J Invest Surg 2 N Engl J Med 2 1 2 3 ... 8 1 2 3 ... 71 Top Terms Publications Humans 225 Catheterization 215 Arteries 208 venous blood vessel morphogenesis 194 Patients 175 Catheterization, Central Venous 140 Middle Aged 107 Catheters, Indwelling 88 Adult 88 Sepsis 71 Aged 71 Prospective Studies 66 Thrombosis 59 Intensive Care 55 Incidence 55 Pulmonary Artery 55 Punctures 54 Intensive Care Units 53 Bacteremia 52 Hospitals 50 1 2 3 ... 71 1 2 3 ... 51 Top Authors Publications Maki D 5 Mora M 4 Damen J 4 Shah P 3 Lorente L 3 Martin M 3 Raad I 3 Walder B 2 Mermel L 2 Kakkos S 2 Haddad G 2 Reddy D 2 Nypaver T 2 Jimnez A 2 Cook D 2 Sheridan R 2 Crnich C 2 Fraser V 2 Elward A 2 Rahal K 2 1 2 3 ... 51 最新研究进展 Crit Care Med. 2010 Apr;38(4):1030-5. Infectious risk associated with arterial catheters compared with central venous catheters. Lucet JC , Bouadma L , Zahar JR , Schwebel C , Geffroy A , Pease S , Herault MC , Haouache H , Adrie C , Thuong M , Franais A , Garrouste-Orgeas M , Timsit JF . Head of Infection Control Unit, Bichat-Claude Bernard University Hospital, Assistance publique-hpitaux de Paris, Paris. jean-christophe.lucet@bch.aphp.fr Comment in: Crit Care Med. 2010 Apr;38(4):1208-9. Abstract BACKGROUND: Scheduled replacement of central venous catheters and, by extension, arterial catheters, is not recommended because the daily risk of catheter-related infection is considered constant over time after the first catheter days. Arterial catheters are considered at lower risk for catheter-related infection than central venous catheters in the absence of conclusive evidence. OBJECTIVES: To compare the daily risk and risk factors for colonization and catheter-related infection between arterial catheters and central venous catheters. METHODS: We used data from a trial of seven intensive care units evaluating different dressing change intervals and a chlorhexidine-impregnated sponge. We determined the daily hazard rate and identified risk factors for colonization using a marginal Cox model for clustered data. RESULTS: We included 3532 catheters and 27,541 catheter-days. Colonization rates did not differ between arterial catheters and central venous catheters (7.9% and 9.6% , respectively). Arterial catheter and central venous catheter catheter-related infection rates were 0.68% (1.0/1000 catheter-days) and 0.94% (1.09/1000 catheter-days), respectively. The daily hazard rate for colonization increased steadily over time for arterial catheters (p = .008) but remained stable for central venous catheters. Independent risk factors for arterial catheter colonization were respiratory failure and femoral insertion. Independent risk factors for central venous catheter colonization were trauma or absence of septic shock at intensive care unit admission, femoral or jugular insertion, and absence of antibiotic treatment at central venous catheter insertion. CONCLUSIONS: The risks of colonization and catheter-related infection did not differ between arterial catheters and central venous catheters, indicating that arterial catheter use should receive the same precautions as central venous catheter use. The daily risk was constant over time for central venous catheter after the fifth catheter day but increased significantly over time after the seventh day for arterial catheters. Randomized studies are needed to investigate the impact of scheduled arterial catheter replacement. PMID: 20154601 Publication Types, MeSH Terms, Substances Publication Types: Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't MeSH Terms: Aged Anti-Infective Agents, Local/therapeutic use Bandages Catheter-Related Infections/etiology* Catheterization, Central Venous/adverse effects* Catheterization, Central Venous/methods Catheterization, Peripheral/adverse effects* Catheterization, Peripheral/methods Chlorhexidine/therapeutic use Cross Infection/etiology* Cross Infection/microbiology Female Humans Intensive Care Units Male Middle Aged Proportional Hazards Models Risk Factors Substances: Anti-Infective Agents, Local Chlorhexidine LinkOut - more resources Full Text Sources: Lippincott Williams Wilkins MD Consult Ovid Technologies, Inc. Swets Information Services Other Literature Sources: COS Scholar Universe Evaluations and comments from leading researchers and clinicians - Faculty of 1000 Medicine Libraries: LinkOut Holdings Related citations 相关文献 Prospective, randomized trial of two antiseptic solutions for prevention of central venous or arterial catheter colonization and infection in intensive care unit patients. Prospective, randomized trial of two antiseptic solutions for prevention of central venous or arterial catheter colonization and infection in intensive care unit patients. Mimoz O, Pieroni L, Lawrence C, Edouard A, Costa Y, Samii K, Brun-Buisson C. Crit Care Med. 1996 Nov; 24(11):1818-23. Prospective study of peripheral arterial catheter infection and comparison with concurrently sited central venous catheters. Prospective study of peripheral arterial catheter infection and comparison with concurrently sited central venous catheters. Koh DB, Gowardman JR, Rickard CM, Robertson IK, Brown A. Crit Care Med. 2008 Feb; 36(2):397-402. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Maki DG, Stolz SM, Wheeler S, Mermel LA. Ann Intern Med. 1997 Aug 15; 127(4):257-66. Review A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, noncuffed central venous catheters: implications for preventive strategies. Review A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, noncuffed central venous catheters: implications for preventive strategies. Safdar N, Kluger DM, Maki DG. Medicine (Baltimore). 2002 Nov; 81(6):466-79. Review The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Review The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Maki DG, Kluger DM, Crnich CJ. Mayo Clin Proc. 2006 Sep; 81(9):1159-71. See reviews... See all
DKFZ第35A条新闻稿2009年8月5日 一个重要的受体蛋白的功能得到阐释/海德堡大学医院和德国癌症研究中心的研究人员把成果发表在《免疫学杂志》上 细菌病原体的带状基因或者说短链寡核苷酸(DNA,标为红色)通过T型受体9(TLR9,白色)传感器在2个结合位点(标为蓝色)上接起来,免疫细胞由此可以上报危险信号并增强疫苗的免疫效果。据猜测在信号识别中可能是由两个TLR分子(白色和灰色)协同发挥的作用。 免疫细胞是怎样识别引起感染的病原体的呢?海德堡大学的研究人员通过与德国癌症研究中心的合作澄清了一个重要的细菌性感染的受体机制:通过一个所谓的T型受体9(TLR9),免疫细胞可以识别细菌性和病毒性的病原体,并触发链式生化反应,启动防御机制。海德堡科学家的这项发现有助于开发新的抗感染药剂和疫苗。 两个接触点识别病原体 由海德堡大学医院卫生研究所亚历山大.达尔普克( Alexander Dalpke )教授领导的团队研究了“先天免疫系统之眼”:附在免疫细胞的表面的微小蛋白质结构-Toll样受体(TLR)。一旦出现感染,受体就能识别病原体基因中在进化长河中保留下来的某些结构模式,然后激发防御反应。 那么这些模式是如何被识别的呢?海德堡德国癌症研究中心(DKFZ)亚历山大.韦伯博士所率的青年研究小组对此进行了研究。这位青年科学家建成了一个TLR9受体的三维计算机模型,这也是两个研究小组联合科研的出发点。这个模型基于现有公开实验数据而推测的受体基本组成单元。借助这个三维模型可以推衍出某些受体,而对采用基因工程修饰后的不同受体测试表明,在要想绑定细菌的基因,受体上存在两个接触点致关重要。 可以改善疫苗 根据这个新的研究结果可以创建一个更准确的受体模式。其中一个应用在于药理学。在实验室可以人工合成模仿细菌基因组的核酸,它们可以通过T细胞受体激活先天免疫系统。这种活性物质可以用作疫苗的成分,非特异性地中其作用。通过这项认识,人们还可以制造准确得多的核苷酸。 海德堡科学家的这项有关病原体和免疫系统之间信号对答的基础研究仍将继续深入:下一步是要把该项发现应用到另一种受体类型上。与TLR9不同,TLR7不能识别细菌性而只能识别病毒性基因。研究人员希望,通过这种把三维结构预测与实验测量相结合的办法能够澄清过去无法解释的那些识别机制。 参考文献: M. E. Peter, A. V. Kubarenko, A. N. R. Weber, A. H. Dalpke, Identification of an N-terminal recognition site in TLR9 that contributes to CpG-DNA mediated receptor activation, The Journal of Immunology, 2009, 182, 7690-7697