Prevention of central venous catheter-related bloodstream infections using non-technologic strategies.
OBJECTIVE
To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them.


METHODS
This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from April 1997 to December 2001.


METHODS
The medical-surgical ICU of a tertiary-care, university-affiliated hospital in Argentina.


METHODS
We studied all patients admitted to the ICU using non-impregnated CVCs. Maximal sterile barrier precautions (ie, use of cap, mask, sterile gown, sterile gloves, and large sterile drape), strict handwashing, preparation of the patients' skin with antiseptic solutions, insertion and management of catheters by trained personnel, and continuing quality improvement programs aimed at appropriate insertion and maintenance of catheters were employed.


RESULTS
During the study period, 2,525 patients were admitted to the ICU. Eight hundred sixty-eight patients had 1,037 CVCs inserted. The number of CVC-related bloodstream infections (BSIs), acquired in the ICU, was 2.7 per 1,000 CVC-days (13 nosocomial CVC-related BSIs during 4,770 days of CVC use). Microorganisms isolated included methicillin-susceptible Staphylococcus aureus (n = 6), methicillin-resistant S. aureus (n = 2), coagulase-negative methicillin-resistant Staphylococcus (n = 2), Escherichia coli (n = 1), Klebsiella pneumoniae (n = 1), and Enterobacter cloacae (n = 1).


CONCLUSIONS
A low rate of catheter-related BSI was achieved without antimicrobial-impregnated catheters. The incidence of CVC-associated bacteremias corresponded to the 10th to 20th percentile range of the National Nosocomial Infections Surveillance System hospitals for the same type of ICU.
Gnass
Silvia Acosta
SA
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina.
Barboza
Luisa
L
Bilicich
Dafne
D
Angeloro
Pablo
P
Treiyer
Walter
W
Grenóvero
Silvia
S
Basualdo
Juan
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology* / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000706:statistics & numerical data*; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies