title: Central venous catheter related bloodstream infections in medical intensive care unit patients in a tertiary referral centre.
abstract: OBJECTIVE
  To determine the incidence of central line associated bloodstream infections (CLABSIs) in the medical intensive care unit (ICU) and ward setting at All India Institute of Medical Sciences (AIIMS), New Delhi.
  
  
  METHODS
  The study was conducted in the medical ICU, a 9-bedded ICU at the AIIMS, a tertiary care teaching hospital. The study design was a prospective observational study.
  
  
  METHODS
  One hundred patients admitted to medical ICU and the ward at AIIMS with an indwelling, non-tunnelled central venous catheter (CVC) in place at admission and those with a hospital stay with indwelling CVC for more than 48 hours were monitored. These patients were followed daily for the development of new onset sepsis 48 hours after insertion of CVC, in which case three sets of blood samples for culture were drawn over a span of 24 hours.
  
  
  METHODS
  Incidence of CLABSIs was measured per 1000 central line days.
  
  
  RESULTS
  One hundred patients hospitalised for an aggregate 1119 days acquired 29 hospital-acquired infections (HAIs), a rate of 38.8% or 31.2 HAIs per 1000 hospital days. The incidence of bloodstream infections (BSIs) in this group was 6.8%. No case of laboratory confirmed CLABSIs could be demonstrated. Incidence of clinical sepsis was 27.6% or 8.2 per 1000 CVC days. There were 9 cases out of the 29 patients (39.7%) who had evidence of HAIs with no apparent focus of infection. Only one of these cases had evidence of BSI with isolation of Staphylococcus aureus in both CVC tip culture and the simultaneous blood culture; however the antibiograms were different.
  
  
  CONCLUSIONS
  The low rate of BSIs in the present study and the absence of occurrence of a laboratory confirmed CLABSI should be interpreted in the light of the small sample size of the study and the multitude of antibiotics received before the development of HAI.
authors.lastname: Deepti
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sinha
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Sharma
authors.forename: Praveen
authors.initials: P
authors.lastname: Aggarwal
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Biswas
authors.forename: Seema
authors.initials: S
authors.lastname: Sood
authors.forename: P
authors.initials: P
authors.lastname: Ragunandan
authors.forename: Meera
authors.initials: M
authors.lastname: Ekka
authors.forename: Immaculata
authors.initials: I
authors.lastname: Xess
authors.forename: V
authors.initials: V
authors.lastname: Sreenivas
mesh_terms: D000328:Adult; D000368:Aged; D062905:Central Venous Catheters / Q000009:adverse effects*; D016638:Critical Illness; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology*; D062606:Tertiary Care Centers; D055815:Young Adult