Prevalence of primary bloodstream infections in representative German hospitals and their association with central and peripheral vascular catheters.
The prevalence of noncentral and central lines and the prevalence of nosocomial primary bloodstream infections was investigated in 72 representative German hospitals (NIDEP Study). Data from a total of 14,966 patients were documented. On the prevalence day, it amounted to 23.9% for noncentral and 5.1% for central lines. The total prevalence of nosocomial primary bloodstream infections was 0.3%, 8.3% of all nosocomial infections recorded were primary bloodstream infections. The device utilization rate of vascular catheters was retrospectively observed for both the prevalence day and another 6 days. The device utilization rate was 27.3% for peripheral and 6.1% for central catheters with higher rates in west Germany. The associated incidence density of primary nosocomial bloodstream infections per 1000 catheter-days was 0.3 for noncentral and 0.8 for central lines. In 61.4%, the primary bloodstream infections were microbiologically confirmed. In 52.6% of cases, Gram-positive bacteria were isolated (Staphylococcus aureus: 15.8%, other coagulase negative Staphylococcus species: 34.2%) and in 47.4%, Gram-negative ones (mostly: Escherichia coli: 13.2% and Klebsiella species: 10.5%). Prevention to reduce nosocomial bloodstream infections is possible by antimicrobial establishing specially trained infusion therapy teams, using antimicrobial or antiseptic impregnated bloodstream catheters and a strict review of the indication for a vascular catheter together with a minimization of catheter days.
Wischnewski
N
N
Institute for Hygiene, Environmental and Occupational Health Medicine, Free University of Berlin, Germany.
Kampf
G
G
Gastmeier
P
P
Schlingmann
J
J
Daschner
F
F
Schumacher
M
M
Rüden
H
H
D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D003428:Cross Infection / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification / Q000472:pathogenicity; D006094:Gram-Positive Bacteria / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D008297:Male; D015995:Prevalence; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity