Incidence, risk factors, and microbiology of central venous catheterization-associated bloodstream infections at a surgical tertiary intensive care unit

Abstract

Background: Central venous catheters (CVCs) can act as a portal for bloodstream infections, which increases the morbidity and mortality in intensive care units (ICUs). Objective: The primary aim of this study was to find out the incidence, to ascertain risk factors of bloodstream infections related to CVC, and to know the microbiological profile of organisms causing catheter-related bloodstream infection (CRBSI) in an ICU of a tertiary level hospital. Methodology: All patients who had CVC insertion in the operation theater before the procedure and were later transferred to ICU, and those patients who were directly admitted to the ICU and had CVC inserted were included in the study. On suspicion of an insertion-site infection, site swabs were sent for microbiological analysis. If catheter tip colonization/infection or CRBSI was suspected, the CVC was removed, and the tip of the catheter along with two sets of blood (peripheral and central) was sent for culture analysis. A semi-quantitative culture analysis was done to confirm CRBSI. Results: On review of data, 150 patients with cumulative 1056 catheter surveillance days revealed an incidence of 24.66% for CVC-related infections, which included exit site infections (5.33%), catheter tip infections (13.33%), and CRBSI (6%). The rate of CRBSI associated with CVCs placed in the surgical ICU was 35.3 per 1000 catheter surveillance days. Staphylococcus aureus was the most common organism causing CRBSI and CONS (coagulase-negative staphylococcus) was the most common organism causing catheter tip and exit site infections.

Keywords

• catheter
• catheter-related bloodstream infection
• central venous catheterization
• infection
• staphylococcus aureus
• the intensive care unit