The evaluation of catheter-related bloodstream infections in neurology and neurosurgery intensive care units
Abstract number: R2229
Ataman Hatipoglu C., Ipekkan K., Oral B., Tuncer Ertem G., Yetkin M.A., Erdinc F.S., Kilic C., Inan L., Bulut C., Demiroz A.P.
Objectives: Catheter related bloodstream infections (CR-BSIs) are considered the most common serious complication associated with the use of central venous catheters (CVCs). We aimed in this study to determine the rate, epidemiological and microbiological characteristics, risk factors and outcomes of the CR-BSIs in patients hospitalised in Neurology and Neurosurgery Intensive Care Units (ICUs).
Methods: This prospective study was carried out between January 2007 and January 2008. All the patients hospitalised in Neurology and Neurosurgery ICUs with newly inserted central venous catheter were enrolled into the study. CR-BSI rate, risk factors for CR-BSIs and for mortality were studied.
Results: During the study period, 199 CVCs in 148 patients were followed. Eighty-two patients were female (55.4%), mean age was 58.7±21.8 years. Sixty-seven patients (45.3%) hospitalised in Neurology ICU and 81 (54.7%) in Neurosurgery ICU. Mean hospital stay in ICU was 15.6±15.3 days. Eighty-nine (60.1%) patients were died. Mean duration of catheterisation was 8.5±5.2 days. There were 32 episodes of CR-BSI in 29 patients. Total catheter days were 1703 days. CR-BSI rate was 20.3 per 1000 catheter days. In univariate analyses comparing patients with CR-BSI and without CR-BSI, we found that prior antibiotic therapy rate was higher (p = 0.02) and mean hospital stay in ICU was longer (p < 0.001) in patients with CR-BSI. In patients hospitalised in Neurology ICU, CR-BSI risk was 2.4 times higher than Neurosurgery ICU patients (p = 0.004). Catheters which kept in place for more than 7 days were increased the risk of CR-BSI 6.3 times (p < 0.001). In multivariate analyses, catheterisation day and hospital stay in ICU were found independent risk factors (p < 0.001). The mortality rate was higher in patients with CR-BSI (79.3%) than the patients without CR-BSI (55.5%) (p = 0.019). In univariate analyses comparing fatal patients with CR-BSI and non-fatal patients with CR-BSI for mortality risk factors, we found that mortality rate was higher in patients aged greater than 60 (p = 0.017), in patients hospitalised in Neurology ICU (p = 0.006) and in patients receiving TPN (p = 0.03). In multivariate analyses, being aged greater than 60 was found independant risk factor for mortality (p= 0.037).
Conclusion: Catheterisation day and hospital stay were found independent risk factors for catheter-associated blood-stream infections, and age greater than 60 years was found independent risk factor for mortality.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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