title: Timing of central venous catheter exchange and frequency of bacteremia in burn patients.
abstract: We evaluated the impact of increasing the interval between routine central venous catheter exchanges from every 3 days to every 4 days on the rate of catheter infections and catheter-related bacteremia. Computer records of catheter tip and blood culture results in burn patients were reviewed. The change to every 4 day catheter exchange occurred in November 2000 and data were collected until June 2001. One hundred and ninety-six guidewire exchanges were performed in the every 3 day (q3day) group, and 164 guidewire exchanges were performed in the every 4 day (q4day) group. The rate of catheter infections (>15 colony forming units) was 11% in the q3day group and 28% in the q4day group. Catheter-related blood stream infection occurred in 4% of patients in q3day group and 12% of patients in q4day group. A prospective review of this change in practice revealed that there was a significantly greater risk of infections in the q4day group. The increase in infected central venous catheter segments was associated with an increase in blood stream infections.
authors.affiliation: The DeWitt Daughtry Family Department of Surgery, Divisions of Burn, Trauma and Surgical Critical Care, Leonard M. Miller School of Medicine of the University of Miami, Miami, Florida 33101, USA.
authors.forename: Booker
authors.initials: B
authors.lastname: King
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
authors.forename: Antonio
authors.initials: A
authors.lastname: Pepe
authors.forename: Peter
authors.initials: P
authors.lastname: Pappas
authors.forename: Robin
authors.initials: R
authors.lastname: Varas
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control*; D002056:Burns / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D011446:Prospective Studies; D013997:Time Factors