title: Prevalence of primary bloodstream infections in representative German hospitals and their association with central and peripheral vascular catheters.
abstract: 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.
authors.affiliation: Institute for Hygiene, Environmental and Occupational Health Medicine, Free University of Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Wischnewski
authors.forename: G
authors.initials: G
authors.lastname: Kampf
authors.forename: P
authors.initials: P
authors.lastname: Gastmeier
authors.forename: J
authors.initials: J
authors.lastname: Schlingmann
authors.forename: F
authors.initials: F
authors.lastname: Daschner
authors.forename: M
authors.initials: M
authors.lastname: Schumacher
authors.forename: H
authors.initials: H
authors.lastname: Rüden
mesh_terms: 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