title: Catheter-related bloodstream infections: a prospective observational study of central venous and arterial catheters.
abstract: BACKGROUND
  Catheter-related bloodstream infections (CRBSIs) can lead to increased morbidity and length of stay (LOS) in the intensive care unit (ICU). The purpose of this study was to analyse the incidence of catheter-related bloodstream infection associated with central venous catheters (CVCs) and arterial catheters (ACs) and to identify risk factors for CRBSIs in our ICU.
  
  
  METHODS
  This was a prospective observational study in a 17-bed medical-surgical ICU of a 715-bed university hospital. Patients admitted to the ICU for ≥ 24 h between 1 September 2007 and 30 April 2008, who received a CVC or AC, were included in the study.
  
  
  RESULTS
  A total of 219 patients with 258 CVCs and 336 ACs were included in the study and observed for a combined total of 3172 catheter-days. The CRBSI incidence density was 1.2 per 1000 catheter-days for CVCs and 2.1 per 1000 catheter-days for ACs. The mean LOS (p = 0.003), the number of days a catheter remained in situ (p = 0.001), and the length of pre-ICU in-hospital stay (p = 0.031) were significantly higher in the CRBSI group. Risk factor analysis was not reliable due to the low number of CRBSIs.
  
  
  CONCLUSIONS
  The incidence of AC- and CVC-related CRBSIs was comparable to the incidence reported in the literature. However, the incidence for ACs was higher than for CVCs. In addition to CVCs, ACs should be considered a possible cause of catheter-related infections and both should be replaced when CRBSI is suspected.
authors.affiliation: From the Julius Centre of Health Sciences and Primary Care, University Medical Centre Utrecht , Utrecht.
authors.forename: Bastiaan H
authors.initials: BH
authors.lastname: Wittekamp
authors.forename: Myriam
authors.initials: M
authors.lastname: Chalabi
authors.forename: Walther N K A
authors.initials: WN
authors.lastname: van Mook
authors.forename: Bjorn
authors.initials: B
authors.lastname: Winkens
authors.forename: Annelies
authors.initials: A
authors.lastname: Verbon
authors.forename: Dennis C J J
authors.initials: DC
authors.lastname: Bergmans
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*