Sustained low incidence of central venous catheter-related infections over six years in a Swedish hospital with an active central venous catheter team.
BACKGROUND
There are limited data on the long-term effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors over a 6-year period in a hospital with an active CVC team.


METHODS
We conducted a continuous prospective study aiming to include all CVCs used at our hospital during the years 2004 to 2009, evaluating colonization, CRI, CRBSI, and possible risk factors.


RESULTS
A total of 2,772 CVCs was used during the study period. Data on culture results and catheterization time were available for 2,045 CVCs used in 1,674 patients. The incidences of colonization, CRI, and CRBSI were 7.0, 2.2, and 0.6 per 1,000 CVC-days, respectively. Analysis of quarterly incidences revealed 1 occasion with increasing infection rates. Catheterization time was a risk factor for CRI but not for CRBSI. Other risk factors for CRI were hemodialysis and CVC use in the internal jugular vein compared with the subclavian vein. Hemodialysis was the only risk factor for CRBSI.


CONCLUSIONS
We found that a CRI prevention program led by an active CVC team and adhered to by the entire staff at a county hospital is successful in keeping CVC infections at a low rate over a long period of time.
Department of Anesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden; Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linköping University, Linköping, Sweden. Electronic address: fredrik.hammarskjold@lj.se.
Fredrik
F
Hammarskjöld
Division of Cardiothoracic Anesthesia and Intensive Care, Department of Medical and Health Science, Faculty of Health Science, Linköping University, Linköping, Sweden.
Sören
S
Berg
Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linköping University, Linköping, Sweden.
Håkan
H
Hanberger
Department of Anesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
Knut
K
Taxbro
Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linköping University, Linköping, Sweden; Futurum the Academy for Health Care, Jönköping County Council, Jönköping, Sweden.
Bo-Eric
BE
Malmvall
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
Central venous catheter-related bloodstream infection; Intravascular catheter; Nosocomial infection; Statistical process control