title: Catheter related bloodstream infection (CR-BSI) in ICU patients: making the decision to remove or not to remove the central venous catheter.
abstract: BACKGROUND
  Approximately 150 million central venous catheters (CVC) are used each year in the United States. Catheter-related bloodstream infections (CR-BSI) are one of the most important complications of the central venous catheters (CVCs). Our objective was to compare the in-hospital mortality when the catheter is removed or not removed in patients with CR-BSI.
  
  
  METHODS
  We reviewed all episodes of CR-BSI that occurred in our intensive care unit (ICU) from January 2000 to December 2008. The standard method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and a positive semi quantitative (>15 CFU) culture of a catheter segment from where the same organism was isolated. The conservative method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and one of the following: (1) differential time period of CVC culture versus peripheral culture positivity of more than 2 hours, or (2) simultaneous quantitative blood culture with ≥ 5:1 ratio (CVC versus peripheral).
  
  
  RESULTS
  53 CR-BSI (37 diagnosed by the standard method and 16 by the conservative method) were diagnosed during the study period. There was a no statistically significant difference in the in-hospital mortality for the standard versus the conservative method (57% vs. 75%, p = 0.208) in ICU patients.
  
  
  CONCLUSIONS
  In our study there was a no statistically significant difference between the standard and conservative methods in-hospital mortality.
authors.affiliation: Critical Care Unit, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. rodrigo.deliberato@einstein.br
authors.forename: Rodrigo Octávio
authors.initials: RO
authors.lastname: Deliberato
authors.forename: Alexandre R
authors.initials: AR
authors.lastname: Marra
authors.forename: Thiago Domingos
authors.initials: TD
authors.lastname: Corrêa
authors.forename: Marinês Dalla Vale
authors.initials: MD
authors.lastname: Martino
authors.forename: Luci
authors.initials: L
authors.lastname: Correa
authors.forename: Oscar Fernando Pavão
authors.initials: OF
authors.lastname: Dos Santos
authors.forename: Michael B
authors.initials: MB
authors.lastname: Edmond
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000401:mortality*; D055499:Catheter-Related Infections / Q000401:mortality*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003657:Decision Making; D005260:Female; D016469:Fungemia / Q000401:mortality*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies