title: Arterial catheter-related infection of 2,949 catheters.
abstract: BACKGROUND
  Which particular arterial catheter site is associated with a higher risk of infection remains controversial. The Centers for Disease Control and Prevention guidelines of 1996 and the latest guidelines of 2002 make no recommendation about which site or sites minimize the risk of catheter-related infection. The objective of the present study was to analyze the incidence of catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) of arterial catheters according to different access sites.
  
  
  METHODS
  We performed a prospective observational study of all consecutive patients admitted to the 24 bed medical and surgical intensive care unit of a 650 bed university hospital during three years (1 May 2000 to 30 April 2003).
  
  
  RESULTS
  A total of 2,018 patients was admitted to the intensive care unit during the study period. The number of arterial catheters, the number of days of arterial catheterization, the number of CRLIs and the number of CRBSIs were as follows: total, 2,949, 17,057, 20 and 10; radial, 2,088, 12,007, 9 and 3; brachial, 112, 649, 0 and 0; dorsalis pedis, 131, 754, 0 and 0; and femoral, 618, 3,647, 11 and 7. The CRLI incidence was significantly higher for femoral access (3.02/1,000 catheter-days) than for radial access (0.75/1,000 catheter-days) (odds ratio, 1.5; 95% confidence interval, 1.10-2.13; P = 0.01). The CRBSI incidence was significantly higher for femoral access (1.92/1,000 catheter-days) than for radial access (0.25/1,000 catheter-days) (odds ratio, 1.9; 95% confidence interval, 1.15-3.41; P = 0.009).
  
  
  CONCLUSIONS
  Our results suggest that a femoral site increases the risk of arterial catheter-related infection.
authors.affiliation: Department of Intensive Care, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. lorentemartin@msn.com
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lorente
authors.forename: Ruth
authors.initials: R
authors.lastname: Santacreu
authors.forename: María M
authors.initials: MM
authors.lastname: Martín
authors.forename: Alejandro
authors.initials: A
authors.lastname: Jiménez
authors.forename: María L
authors.initials: ML
authors.lastname: Mora
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000382:microbiology; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D003428:Cross Infection / Q000209:etiology / Q000382:microbiology* / Q000517:prevention & control; D004866:Equipment Contamination / Q000517:prevention & control; D005260:Female; D005263:Femoral Artery / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies