title: Arterial catheter-related bloodstream infections: results of an 8-year survey in a surgical intensive care unit.
abstract: OBJECTIVE
  To determine whether a policy based on provisional replacement of catheters every 5 days had an impact on the incidence of arterial catheter-related bloodstream infections in a population of adult surgical intensive care unit patients.
  
  
  METHODS
  Prepost study in which all patients with an arterial catheter who were admitted between 1997 and 2004 were observed. Scheduled replacement of arterial catheters every 5 days during period A (before 2000) was compared to nonscheduled replacement during period B (after 2000).
  
  
  METHODS
  A 20-bed surgical intensive care unit at a French university hospital.
  
  
  METHODS
  All intensive care unit patients requiring an arterial catheter.
  
  
  METHODS
  Modification to the catheter maintenance policies between period A and period B.
  
  
  RESULTS
  A total of 1,672 consecutive patients were included, and 3,247 arterial catheters were analyzed, yielding an average number of 1.9 (sd, 1.7) arterial catheters per patient. The rate of colonization (14.2% before 2000 vs. 16.4% after 2000; p = .10) and the incidence density of arterial catheter colonization (31.32 [95% confidence interval] 27.07-36.25 per 1,000 catheter-days before 2000 vs. 29.79 [95% confidence interval, 26.72-33.21] per 1,000 catheter-days after 2000; p = .11) did not differ significantly between the two periods. However, the rate of arterial catheter-related bloodstream infections (1.4% before 2000 vs. 0.6% after 2000; p = .01) and the arterial catheter-related bloodstream infections incidence density (3.13 [95% confidence interval, 1.97-4.97] before 2000 vs. 1.01 [95% confidence interval, 0.56-1.82] per 1,000 catheter-days after 2000; p < .0001) was significantly higher before 2000.
  
  
  CONCLUSIONS
  Discontinuation of scheduled replacement of arterial catheters every 5 days did not increase the risk of colonization but decreased the risk of bloodstream infections.
authors.affiliation: Department of Anesthesiology, Critical Care and SAMU, APHP Lariboisière Hospital, Paris, France. romainpirracchio@yahoo.fr
authors.forename: Romain
authors.initials: R
authors.lastname: Pirracchio
authors.forename: Matthieu
authors.initials: M
authors.lastname: Legrand
authors.forename: Mathieu Resche
authors.initials: MR
authors.lastname: Rigon
authors.forename: Joaquim
authors.initials: J
authors.lastname: Mateo
authors.forename: Anne Claire
authors.initials: AC
authors.lastname: Lukaszewicz
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
authors.forename: Laurent
authors.initials: L
authors.lastname: Raskine
authors.forename: Marie José Sanson
authors.initials: MJ
authors.lastname: Le Pors
authors.forename: Didier
authors.initials: D
authors.lastname: Payen
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002985:Clinical Protocols; D015331:Cohort Studies; D003422:Critical Care; D020878:Device Removal; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies