Nosocomial central venous catheter-related infections in intensive care units.
To examine the recent microbiology of catheter-related infections (CRIs) in the intensive care unit (ICU) setting and to determine the association between selected factors and mortality among ICU patients diagnosed with a CRI, a retrospective review of all ICU patients determined to have a CRI between January 1992 and December 1994 was undertaken. A total of 108 patients with 111 episodes of CRIs were identified. The most common isolate was coagulase negative staphylococcus (37.9%), followed by Staphylococcus aureus (20.9%). Methicillin resistance was common in both CNS (93%), and S aureus (42%) isolates. Factors predictive for death in a multivariate analysis were as follows: male sex (relative risk (RR) 2.43, 95% confidence interval (CI) 1.0, 6.07), hypotension (RR 6.90, 95% CI 1.56, 12.2), American Society of Anesthesiologist physical status score greater than 3 (RR 4.36, 95% CI 1.56, 12.2), and underlying medical condition (RR 3.50, 95% CI 1.17, 10.5). This study demonstrated the increasing proportion of CRIs due to methicillin-resistant organisms in the ICU. Functional status and degree of illness were the strongest predictors for survival in this population.
Tabak
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Dept of Medicine, Tulane University School of Medicine, New Orleans, USA.
Clark
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Lepre
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Beilke
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D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D016106:Methicillin Resistance; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012306:Risk; D013203:Staphylococcal Infections / Q000453:epidemiology