title: Central venous catheter-related blood stream infections: incidence, risk factors, outcome, and associated pathogens.
abstract: OBJECTIVE
  To determine the incidence, risk factors, outcome, and pathogens of central venous catheter-related bloodstream infections (CVC-BSIs).
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Escorts Heart Institute and Research Centre, New Delhi, India.
  
  
  METHODS
  One thousand three hundred fourteen consecutive patients undergoing cardiac operations who were admitted to the intensive care unit with CVC.
  
  
  METHODS
  All patients were assigned into CVC-BSI (n = 35) and non-CVC-BSI (n = 1,279) groups.
  
  
  RESULTS
  Of the 1,314 patients in the study, 35 (2.6%) had CVC-BSI. On univariate analysis, significant risk factors were use of multilumen catheters, coexistent infections, intra-aortic balloon counterpulsation (IABC), total ventilation hours, emergency surgery, acute physiology, age, chronic health evaluation score (APACHE II), and steroids. On multivariate analysis, duration of catheterization (24.5 +/- 10.9 v 6.1 +/- 3.2; p < 0.001), coexistent infections (57.11% v 2.61%; p < 0.001), IABC (77.1% v 4.1%; p = 0.005), and temperature (38.2 +/- 0.6 v 37.4 +/- 0.3; p < 0.001) were independent predictors of CVC-BSI. Pathogens isolated were Escherichia coli (47%), Acinetobacter species (11.7%), Enterobacter species (5.8%), Proteus species (5.8%), methicillin-resistant Staphylococcus species (11.7%), coagulase-negative Staphylococcus species (5.8%), and Candida (11.7%). The mortality rate in CVC-BSI was 22.9% as compared with 0.2% in non-CVC-BSI cases (p < 0.001).
  
  
  CONCLUSIONS
  By univariate analysis, the risk factors for CVC-BSI were use of multilumen catheters, duration of catheterization, total ventilation hours, IABC, emergency surgery, APACHE II score, coexistent infections, and steroids. On multivariate analysis, duration of catheterization, IABC, coexistent infections, and temperature were independent predictors of CVC-BSI. The mortality was increased with CVC-BSI.
authors.affiliation: Department of Microbiology, Escorts Heart Institute and Research Centre, New Delhi, India.
authors.forename: Mandakini
authors.initials: M
authors.lastname: Pawar
authors.forename: Yatin
authors.initials: Y
authors.lastname: Mehta
authors.forename: Pawan
authors.initials: P
authors.lastname: Kapoor
authors.forename: Jitendra
authors.initials: J
authors.lastname: Sharma
authors.forename: Abhinav
authors.initials: A
authors.lastname: Gupta
authors.forename: Naresh
authors.initials: N
authors.lastname: Trehan
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D006348:Cardiac Surgical Procedures; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012307:Risk Factors