[Cathether related blood stream infection in ICU patients with prolonged central venous catheterisation--cause and prevention].
Colonization of the tip of the intravenous catheter is often observed in the ICU practice and can be the source of dangerous bacteriemia (CRBSI--catheter related bloodstream bacteraemia) and sepsis with multiorgan failure. There are many cases conected with bacterial colonization of the tip of the catheter in the ICU practice, which could be the source of dangerous bacteriemia--CRBSI (catheter related bloodstream bacteriemia) and sepsis with organs failure.


METHODS
105 patients with sepsis were examined, which clinical state pointed, that CVC was the source of infection. We removed the CVC in this patient, and its tip and patient's blood were examined microbiologically. In the case of positive result, the antibiogram was made.


OBJECTIVE
Evaluation of colonisation and infections of central venous catheters and catheter related blood stream infections (CRBSI) in general ICU patients' and with identification of most frequent microorganisms and their antibiotic sensibility. Results. After examining of 105 samples in 37 (35, 24%) cases we did not culture bacteria. From the rest of 68 (64, 76%) samples we cultured 110 bacterial colonies. 8 of them were admitted to be contaminated samples. 60 tips of the catheter were used to proper analysis from which we isolated 102 bacterial colonies: 44 (43.1%) Gram positive cocci, 32 (31.5%) Enterobacteriaceae, 23 (22.5%) glucose non-fermentative gram-negative rods rods Gram negative non glucose fermentation and 3 (2.9%) fungi (C. albicans). We analized 60 blood samples that derived from patients with confirmed catheter colonisation. It was found that 8 blood samples indicated bacteriemia, but only in 2 cases isolated bacteria came from the CVC. Conclusions. (1) The majority of central venous catheters on ICU are colonized by pathogenic microorganisms. (2) Aerobic Gram positive and Gram negative bacteria are responsible for CVCs' infection. (3) Bacterial colonization of CVCs' is not very often the reason of CRBSI. (4) Prolonged use of central venous catheters needs careful prophylactic standards of an microbiological monitoring.
Karpel
Ewa
E
Katedra i Klinika Anestezjologii i Intensywnej Terapii, Slaska Akademia Medyczna w Katowicach. kait@csk.katowice.pl
Kunsdorf-Wnuk
Anna
A
Musioł
Ewa
E
Skorupa
Anna
A
Arct-Danielak
Danuta
D
Jarosz
Urszula
U
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology* / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002710:Chlorhexidine / Q000627:therapeutic use; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology* / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D013997:Time Factors
D000900:Anti-Bacterial Agents; D002710:Chlorhexidine