title: Risk factors for catheter-related bloodstream infections in adult hospitalized patients - multicenter cohort study.
abstract: BACKGROUND
  Risk factors for catheter-related bloodstream infections (CRBSIs) may change over time with progress in infection control. This study was undertaken to explore the current risk factors for CRBSIs in hospitalized patients.
  
  
  METHODS
  Adult patients with non-tunneled central venous catheters (CVCs) in 12 Japanese referral hospitals were prospectively enrolled between December 2009 and January 2012. Patients were monitored for CRBSIs for up to 8 weeks from CVC insertion; data were collected regarding patient characteristics, the purpose of CVC insertion, insertion methods, mechanical complications during insertion, and post-insertion catheter care.
  
  
  RESULTS
  A total of 892 patients were enrolled in this study. The overall incidence of CRBSIs was 0.40 infections per 1000 catheter-days. Univariate analysis using the Fisher's exact test identified one of the participating hospitals (hospital A; p < 0.001), internal jugular vein catheterization (IJVC) (p = 0.0013), not using maximal sterile barrier precautions (p = 0.030), and the Seldinger technique for catheter insertion (p = 0.025) as significant risk factors for CRBSI. After excluding data from hospital A, only IJVC remained a significant risk factor for CRBSI (p = 0.025). The cumulative probability of remaining without CRBSI was significantly lower in patients with IJVCs than in patients with other catheter routes (p < 0.001; log-rank test). Similarly, the cumulative probability of remaining without catheter removal due to a suspected infection was significantly lower in patients with IJVCs (p = 0.034; log-rank test).
  
  
  CONCLUSIONS
  The current study suggests that IJVC might be a risk factor for CRBSI under current infection control conditions.
authors.affiliation: From the 1 National Hospital Organization (NHO) Kumamoto Medical Center , Kumamoto.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Haga
authors.forename: Nobutomo
authors.initials: N
authors.lastname: Miyanari
authors.forename: Tadateru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Koike
authors.forename: Ryozo
authors.initials: R
authors.lastname: Kobayashi
authors.forename: Hiroya
authors.initials: H
authors.lastname: Mizusawa
authors.forename: Chikaaki
authors.initials: C
authors.lastname: Nakamichi
authors.forename: Mataro
authors.initials: M
authors.lastname: Goto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002404:Catheterization / Q000009:adverse effects* / Q000379:methods*; D062905:Central Venous Catheters / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*