Comparison of bacterial colonization of central venous catheters introduced through two different routes - A prospective, randomized, observational study

Abstract

Background: Central venous catheterizations are commonly used in critically ill patients and may cause different complications including infections. Methods: This prospective, randomized observational study was conducted in 60 patients admitted to respiratory intensive care unit (RICU) in a tertiary care hospital to compare the incidence and character of bacterial colonization between internal jugular (IJV) and subclavian (SCV) catheterization after seven days of placing the central venous catheter. Results: The incidence of catheter tip colonization (CTC) was statically higher in IJV compared to SCV (p = 0.030) whereas, there was no significant difference in blood cultures (p = 0.671) between the groups. The incidence of CTC and growth on blood culture increased with increase in number of attempts. Common microorganism colonizing the central venous catheters (CVCs) was non fermenting Gram negative bacteria and Klebsiella spp. Two cases of catheter related blood stream infection (CRBSI) were reported in the SCV group. Microorganisms causing CRBSI were Pseudomonas spp and Staphylococcus aureus. Conclusions: Despite sterile precautions bacterial colonization of central venous catheter tip is seen, more in the IJV group but CRBSI was common in SCV group. Catheter tip culture positivity does not confirm infection. As the number of attempts increase there are more incidences of positive blood culture and CRBSI.

Keywords

• central venous catheter
• catheter tip colonization
• catheter related blood stream infection