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Central venous catheter associated blood stream infections (CVC-BSIs) in the non-intensive care settings: Epidemiology, microbiology and outcomes

journal contribution
posted on 2019-11-01, 00:00 authored by Z Aminzadeh, P Simpson, Eugene AthanEugene Athan
© 2019 Australasian College for Infection Prevention and Control Background: Most studies have examined central venous catheter associated blood stream infections (CVC-BSIs) in Intensive Care Units (ICUs) but information on CVC-BSIs in non-ICU settings is sparse. This study aimed to determine the burden, microbiologic patterns, and associations of CVC-BSIs in non-ICU settings in a tertiary regional centre, University Hospital Geelong (UHG), Victoria, Australia. Methods: A retrospective study was conducted in the UHG from October 2016 to April 2018. Based on the National Healthcare Safety Network definition, 23 CVC-BSIs occurred in non-ICU settings. Data analysed using SPSS-v25 with a P value < 0.05 was deemed as significant. Results: The incidence rate was 1.2 per 10,000 bed-days. The mean age of patients was 57.22 ± 18 years. 43.5% of patients had Charlson index score of ≥5 and 78% received appropriate empiric antibiotics. The 90-day mortality rate was zero. In total, 26 microorganisms were isolated. Gram-negative bacilli were more common than Gram-positive cocci. The mean catheter duration was 45.22 ± 8.99 days. Hickman lines contributed to 52.2% of BSIs. Within the first two weeks of line insertion, 53.84% of CVC-BSIs occurred with 76.92% of CVC-Gram-negative bacteraemia and 71.4% of BSIs were related to Hickman lines. Also, 69.2% of CVC-BSIs occurred within ≤4 weeks of line insertion including 84.6% of CVC-Gram-negative bacteraemia. Conclusion: CVC-BSIs constitute a significant burden on high risk patients in non-ICU settings, with Gram negative bacilli predominating. A prospective surveillance program for all patients with CVC in the non-ICU setting may improve CVC management processes and influence educational measures.

History

Journal

Infection, Disease and Health

Volume

24

Issue

4

Pagination

222 - 228

Publisher

Elsevier

Location

Amsterdam, The Netherlands

ISSN

2468-0451

eISSN

2468-0869

Language

eng

Publication classification

C1 Refereed article in a scholarly journal