[Risk factors for the appearance of central venous catheters colonisation].
OBJECTIVE
Intravascular device placement (IVD) is a part of everyday medical practice, however, its application is associated with a high risk of onset of nosocomial infections (NI) and increased mortality and morbidity. Nosocomial blood infections (NBIs) account for 10% of all the registered NI. NBIs are more frequent in patients with a placed IVD and it present an important risk factor for the onset of NBI, i.e. catheter-associated NBIs (CANBIs). Pathogenesis of CANBIs is complex and conditioned by the presence of different characteristics related to a catheter, patient and a specific causative organism. The most common CRBSI causes include coagulase-negative staphylococcus, S. aureus, Enterobacter spp, Candida spp, Klebsiella spp, Pseudomonas spp. and Enterococcus spp.


METHODS
All the patients hospitalized at the Intensive Care Department of the Clinic of Digestive Diseases over the period January 1, 2004-September 1, 2004 were retrospectively analyzed. The study included 107 patients in whom central venous catheter (CVC) was placed for more than 48 h. All the causes isolated from a CVC segment were recorded. Culture, isolation and identification of the causative organisms were performed using standard microbiological methods in the Bacteriological Laboratory within the Emergency Center, Clinical Center of Serbia. Catheter segment samples (tip of the CVC 3-5 cm long) were analyzed. Based on the insight into medical documentation, patients' examination and medical staff interview, catheter and patient-related characteristics were recorded.


RESULTS
A total of 107 CVCs were analyzed, out of which 56 (52%) were sterile while 51 (48%) were colonized. The results of our study evidenced that total parenteral nutrition (TPN) (p < 0.05), number of catheterization days (p < 0.05), and central venous pressure measurement (p < 0.05) were significantly associated with CVC colonization. In this study, no statistically significant difference in catheter colonization was found with respect to sex, age, anatomical insertion site and CVC placement site.


CONCLUSIONS
According to the results of our study, TPN, the number of catheterization days and measurement of central venous pressure play major roles in colonization of CVC. Understanding risk factors associated with CVC colonization and onset of CANBIs is a prerequisite for quality preventive work of health professionals.
Klinicki centar Srbije, Sluzba za bolnicku epidemiologiju, socijalnu medicinu i higijenu, Beograd, Srbija. hosp_epi@yahoo.com
Vesna
V
Mioljević
Vesna
V
Suljagić
Biljana
B
Jovanović
Jelena
J
Gligorijević
Snezana
S
Jovanović
Natasa
N
Mazić
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000635:transmission*; D001419:Bacteria / Q000302:isolation & purification*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000635:transmission*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D012307:Risk Factors