Risk factors of nosocomial bacteremia associated with pulmonary artery catheters in a critical care unit.
An epidemiologic investigation at a community teaching hospital identified 17 cases of endemic primary nosocomial bacteremias associated with the use of pulmonary artery catheters (PACs). A matched-case control study was undertaken to identify risk factors associated with these bacteremias. Factors significantly associated with bacteremia were length of hospitalization; length of stay in the critical care unit; length of time the PAC introducer was left in place and used as an intravenous (IV) access device after PAC withdrawal; respiratory compromise; PAC site infection; prior infections at other sites; concomitant hyperalimentation; and number of IV piggyback administrations per day prior to onset of bacteremia. Pathogens isolated included coagulase-negative Staphylococcus species (55.6%), Staphylococcus aureus (22.2%), Candida albicans (14.8%), and enterococci (7.4%). These pathogens were generally resistant to antibiotics given before the development of bacteremia. Bacteremia was associated with significant mortality, a prolonged hospital stay, and increased hospital charges. This study identifies important risk factors to consider in formulating guidelines to prevent and control PAC-associated nosocomial infections.
Section of Infectious Diseases, Olympia Fields Osteopathic Medical Center, Ill.
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M
Glowacki
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Quraishi
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Zakhireh
D000368:Aged; D002176:Candida albicans / Q000302:isolation & purification; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D003428:Cross Infection / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D011651:Pulmonary Artery; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology* / Q000401:mortality; D013211:Staphylococcus aureus / Q000302:isolation & purification