DIMICK JB, SWOBODA SM, PELZ RK, HENDRIX CW, LIPSETT PA; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 429.
Johns Hopkins Sch. of Med, Baltimore, MD
BACKGROUND: The objective of this study was to determine patient and catheter characteristics associated with increased risk for catheter-related blood stream infection (CRBSI) in high-risk critically ill surgical patients.METHODS: Prospective observational study of critically ill patients (N=260) with projected intensive care unit length of stay greater than 3 days. The setting was a surgical intensive care unit at a large tertiary care center. Catheters were cultured only for clinical suspicion of infection. Time to event (CRBSI) analysis using Kaplan-Meier methods and the Cox proportional hazards model were used for patient and catheter risk factors.RESULTS: A total of 854 catheters were observed for 4,712 catheter days. There were 89 colonized catheters and 17 episodes of CRBSI (incidence = 3.6 episodes per 1000 catheter days [95%CI, 2.1-5.8]). Microbiol. isolates were gram positive in 75%, gram negative in 20%, and yeast in 5%. Duration of catheterization was a significant risk factor for CRBSI (P=0.002). After 5 days the risk of CRBSI increased almost 4-fold (OR, 3.7; 95%CI, 1.4-10.1; P=0.009). Univariate risk factors for CRBSI also included 3 lumen catheters (HR, 5.9; 95%CI, 2.3-15.3), multifunctional catheters (fluid/medication/blood products) (HR, 3.0; 95%CI, 1.1-8.4), and non-white race (HR, 1.8;95%CI, 1.1-2.9). In the multivariate analysis, 3 lumens (HR, 4.5; 95%CI, 1.5-13.2) and non-white race (HR, 1.8; 95%CI, 1.1-3.0) were independently associated with an increased risk of CRBSI.CONCLUSIONS: Catheters in place > 5 days and are triple lumen in design have the highest risk of blood stream infection. These catheters should be targeted for quality improvement efforts.KEYWORDS: Catheter; Infection; Risk factors
Publication Types:
Keywords:
- Catheterization
- Critical Illness
- Humans
- Incidence
- Infection
- Infection Control
- Intensive Care Units
- Prospective Studies
- Risk Factors
- blood supply
Other ID:
UI: 102248764
From Meeting Abstracts