[The impact of closed system and 7 days intravascular administration set replacement on catheter related infections in a general intensive care unit: a before-after study].
BACKGROUND
The incidence of catheter related Bloodstream infections (BSI) is high in intensive care units (ICU).


OBJECTIVE
To evaluate the BSI rate in a population of patients admitted to a General ICU before and after the implementation of the 2011 CDC guidelines.


METHODS
Retrospective observational study on patients admitted from January 2009 to December 2013. The infusion and monitoring lines were changed every 96 hours for the first 30 months, and every 7 days for the next 30. In all patients a closed infusion line with needle-free connectors pressure was used (Microclave). The following catheters were considered in the study: central venous catheter (CVC), arterial cannula (ART) and Swan Ganz catheter (SG).


RESULTS
During the period with change every 96 hours 15 BSI were observed over 13395 catheters/days (C/D), 1.12 per 1000 C/D, while when lines where changed every 7 days 11 BSI were observed over 13120 C/D, 0.83 per 1000 C/D. A statistically significant reduction of BSI was observed in SG catheters (4.17 vs. no BSI p = 0.02), while the CVCS (1.12 vs 1.45 - p = 0.37) and ART (0.35 vs 0.36 - p = 0.61) infection rates remained unchanged.


CONCLUSIONS
The replacement of infusion lines every 7 days in our sample did not increase the BSI, helping to reduce the costs.
Dipartimento di emergenza e urgenza, Terapia intensiva generale, AO San Gerardo, Monza, Università di Milano-Bicocca.
Alberto
A
Lucchini
Dipartimento emergenza urgenza, UO Pronto soccorso, AUSL Piacenza.
Simone
S
Angelini
Terapia intensiva generale e unità coronarica. Istituto Clinico Città Studi, Milano.
Luigi
L
Losurdo
Dipartimento di emergenza e urgenza, Terapia intensiva generale, AO San Gerardo, Monza, Università di Milano-Bicocca.
Angela
A
Giuffrida
Dipartimento di emergenza e urgenza, Terapia intensiva generale, AO San Gerardo, Monza, Università di Milano-Bicocca.
Stefania
S
Vanini
Dipartimento di emergenza e urgenza, Terapia intensiva generale, AO San Gerardo, Monza, Università di Milano-Bicocca.
Stefano
S
Elli
Dipartimento di emergenza e urgenza, Terapia intensiva generale, AO San Gerardo, Monza, Università di Milano-Bicocca.
Luigi
L
Cannizzo
Dipartimento di emergenza e urgenza, Terapia intensiva generale, AO San Gerardo, Monza, Università di Milano-Bicocca.
Roberto
R
Gariboldi
Terapia Intensiva d'emergenza e del Trauma, DAI DEA AOU Careggi, Firenze; Dottorando Scienze Infermieristiche, Università di Firenze.
Stefano
S
Bambi
AO Cà Granda Niguarda, Dipartimento di Scienze della Salute, Università di Milano Bicocca.
Roberto
R
Fumagalli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000191:economics / Q000453:epidemiology / Q000382:microbiology / Q000451:nursing*; D055499:Catheter-Related Infections / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000451:nursing*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000451:nursing*; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000451:nursing*; D062905:Central Venous Catheters / Q000009:adverse effects / Q000191:economics; D065187:Controlled Before-After Studies; D017408:Guidelines as Topic; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies