title: Catheter-related infection in Irish intensive care units diagnosed with HELICS criteria: a multi-centre surveillance study.
abstract: BACKGROUND
  Catheter-related infection (CRI) surveillance is advocated as a healthcare quality indicator. However, there is no national CRI surveillance programme or standardized CRI definitions in Irish intensive care units (ICUs).
  
  
  OBJECTIVE
  To examine the feasibility of multi-centre CRI surveillance in nine Irish ICUs, using Hospitals in Europe Link for Infection Control through Surveillance (HELICS) definitions (CRI 1, CRI 2 and CRI 3).
  
  
  METHODS
  All non-tunnelled central venous catheters (CVCs) inserted in patients aged >18 years with an ICU stay ≥48 h were included over a three-month study period.
  
  
  RESULTS
  Feasibility was demonstrated by the 99.5% return rate for study forms. Data on 1209 CVCs in 614 patients over 7587 CVC-days showed 17 episodes of CRI, representing a national rate of 2.2 per 1000 CVC-days [95% confidence interval (CI) 1.2-3.3]. Rates of CRI 1, CRI 2 and CRI 3 were 0.13 (95% CI 0.00-0.39), 0.79 (95% CI 0.16-1.42) and 1.39 (95% CI 0.60-2.17) per 1000 CVC-days, respectively. CRI was associated with length of ICU stay (P < 0.001), number of CVCs inserted (P < 0.001) and total number of CVC-days per patient (P < 0.001). CRI was higher in CVCs inserted in operating theatres (incident rate ratio 3.9, 95% CI 1.3-11.5; P = 0.02) compared with CVCs inserted in ICUs. Participant feedback reported minimal difficulty with surveillance implementation, and data collection required approximately 1 h per patient per week.
  
  
  CONCLUSIONS
  The study demonstrated that multi-centre ICU surveillance using HELICS CRI definitions was practical, feasible and provided clinically relevant information. CRI surveillance in ICUs, although labour intensive, is recommended to reduce CRI and allow ongoing evaluation of processes aimed at CRI reduction.
authors: Department of Critical Care Medicine, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland. iancm25@hotmail.com
authors: I
authors: I
authors: Conrick-Martin
authors: M
authors: M
authors: Foley
authors: F M
authors: FM
authors: Roche
authors: M H
authors: MH
authors: Fraher
authors: K M
authors: KM
authors: Burns
authors: P
authors: P
authors: Morrison
authors: M
authors: M
authors: Healy
authors: M W
authors: MW
authors: Power
authors: F
authors: F
authors: Fitzpatrick
authors: D
authors: D
authors: Phelan
authors: C M
authors: CM
authors: Walshe
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000175:diagnosis* / Q000453:epidemiology*; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence