[Prospective analysis of central venous catheter colonization and related factors].
OBJECTIVE
To evaluate the incidence of central venous catheter (CVC) colonization in inpatient units of the Institut de Malalties Digestives i Metabòliques (IMDiM) of Hospital Clinic (Barcelona, Spain) with a view to reducing the risk of infection.


METHODS
A 4-month descriptive, prospective and longitudinal study was performed. A total of 230 patients admitted to the IMDiM with CVC were included during the study period. At catheter removal, the tip was cultured and, if the patient had fever, two blood cultures were also obtained. A database was created. Data were analyzed using SPSS v.11.0. Variables were compared with the Chi-square and Student's t-tests and a multivariate analysis was performed using Cox logistic regression. A value of P<0.05 was considered significant.


RESULTS
Catheter tip culture was positive in 45.2%. The rate of catheter-related bloodstream infections was 2.9 per thousand catheter-days, which was clinically significant. The probability of catheter tip contamination 10 days after placement was 25%. Multivariate analysis revealed that the independent variables associated with a higher risk of infection were catheter type, changes of dressing, and infected bacterial stopcocks.


CONCLUSIONS
These results suggest that: 1) the protocol for catheter insertion and care should be reviewed and updated, 2) catheter removal should be considered after the 10th day, 3) the appropriate type of catheter should be selected, the catheter with the lowest number of lumens should be used, and changes of catheter dressing should be reduced.
Pérez Castro
Immaculada
I
Institut de Malalties Digestives i Metabóliques, Hospital Clínic de Barcelona, Barcelona, España. iperez@clinic.ub.es
Iborra Obiols
M Isabel
MI
Comas Munar
M Dolors
MD
Yrurzun Andreu
Rosa
R
Sanz Moncusí
Miquel
M
Lahoz Simón
Consuelo
C
Gómez Montoya
M Isabel
MI
Comallonga Bartomeu
Teresa
T
Navasa Anadón
Miquel
M
D001419:Bacteria / Q000302:isolation & purification*; D002405:Catheterization, Central Venous; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies