Catheter-related bloodstream infections among VINCat hospitals: the impact outside the ICU
Abstract number: P1443
Bella F., Freixas N., Almirante B., Pujol M., Limón E., Vallés J., Barcenilla F., Matas L., Gudiol F.
Background: Catheter-related bloodstream infections (CR-BSI) continue to be a cause of high morbidity and mortality rates despite they are the most preventable health-care associated infections. Surveillance of CR-BSI is useful for quality improvement, however, while there is a huge amount of information based on Intensive Care Units (ICU), only few data concerning non-ICU patients are available.
Objective: to determine the comparative frequency of CR-BSI in ICU and non-ICU patients admitted to VINCat hospitals during 2008.
Methods: VINCat is a nosocomial infection surveillance program in Catalonia, (6.5 million population), in Spain. Beginning 2007, 39 hospitals perform laboratory based prospective standardized surveillance for CR-BSI using CDC definitions. Rates of central venous catheter (CVC) BSI and short and midline peripheral venous catheter (PVC) BSI were expressed by 1.000 patient-days according to area of hospitalization.
Results: From January to December 2008, 608 episodes of CVC-BSI (0.20 ep/1.000 patient-days) and 117 episodes of PVC-BSI (0.04 ep/1.000 patient-days) were recorded. Among patients with CVC-BSI, 232 episodes were acquired in the ICU, 199 in medical wards and 177 in surgical wards. While the crude number of CR-BSI were higher in non-ICU areas, adjusted rates for ICU patients were: 1.9 ep/1.000 patient-days, for medical patients: 0.12/ep/1.000 patient-days and for surgical patients: 0.14/ep/1.000 patient-days. Among patients with PVC-BSI, 18 episodes (0.15 ep/1.000 patient-days) were observed in ICU patients, 30 (0.02 ep/1.000 patient-days) in surgical patients and 69 (0.05 ep/1.000 patient-days) in medical patients. Among patients with CVC-BSI, coagulase-negative staphylococci (CNS) were the causative microorganisms in 50% of cases, followed by Staphylococcus aureus (14%) and Pseudomonas aeruginosa (7%). In contrast, patients with PVC-BSI had more frequently S. aureus (53%) followed by CNS (30%).
Conclusions: The VINCat surveillance program has allowed us to determine that CR-BSI among non-ICU patients remains largely underestimated and are frequently caused by S. aureus. Targeted interventions in specific areas are needed to reduce this serious complication.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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