Incidence of central venous catheter-related infection in a community hospital
Abstract number: P1083
Delgado M., Yebenes J., Ballester L., Sauca G., Vidal E., Icart R., Capdevila J.
Introduction: Catheter-related infections (CRI) are a main cause of nosocomial bloodstream infections and are related to important morbidity and mortality. In the Spanish Nosocomial Infection Study (EPINE) the prevalence of catheter-related bloodstream infection (CRBI) is between 2.5 and 3.4 episodes per 1000 hospitalised patients.
Objective: To asses the incidence of central venous catheter related bloodstream infections (CRBI) in a community hospital.
Methods: Prospective daily follow-up of all central venous catheters (CVC) inserted in the Hospital de Mataro during a period of 9 months. Main patient's demographic data and catheters characteristics were recorded. All catheters were inserted using full sterile barrier methods. Hubs were closed with disinfectable needleless mechanical valve connectors. Catheters removed by suspicion of infection were semiquantitatively cultured using the roll plate method. Two blood cultures were also performed. According to clinical and microbiological criteria, catheters were classified as: not infection-related, entry-site infection, colonised catheter, and CRBI.
Results: During 9 months 597 catheters were placed in 480 patients, 282 males (58%). Total catheterisation days were 4886. Mean catheterisation days were 8.19 (158). Catheters were inserted in the emergency room in 35 cases (5.8%), 151 in surgical theater (25.2%), 45 in others units (7.23%) and 365 in ICU (61%) where a trained and specialised nurse team exists. The subclavian access were used in 194 catheters (32.49%), jugular in 124 (20.7%), brachial in 245 (41%) and femoral in 30 (5.02%). Catheters were removed by end of treatment in 419 cases (70.18%), dysfunction in 42 cases (7.03%), and by fever or suspicion of infection in 40 patients (6.7%). Seven episodes of CRBI were registered, all of them caused by S. epidermidis, which results in an incidence rate of 1.43 episodes/catheterisation days. No CRBI was observed during this period in the ICU, resulting in an incidence rate of 0 in ICU and 2.25 episodes/1000 catheterisation days in conventional hospitalisation units.
Conclusion: The incidence of CRBI in our institution is in the accepted normal range. We observe relevant differences in CRBI's rates between conventional hospitalisation units and ICU where a trained and specialised nurse team exists. This suggests the importance of catheter manipulation in the genesis and prevention of CRBI.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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