Central venous catheter-related blood stream infections: incidence, risk factors, outcome, and associated pathogens.
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.
Pawar
Mandakini
M
Department of Microbiology, Escorts Heart Institute and Research Centre, New Delhi, India.
Mehta
Yatin
Y
Kapoor
Pawan
P
Sharma
Jitendra
J
Gupta
Abhinav
A
Trehan
Naresh
N
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