Abstract
We intended to evaluate the risk factors for catheter-related bloodstream infection (CR-BSI) with central venous (CV) catheters. For the hub of the CV line, we used three-way stopcocks in the first year of the study and closed needleless connectors (NCs) in the second year. Background factors included the age and sex of patients; the ward; the specialty service; the CV catheter and its days of placement; and the staff compounding the intravenous infusion, i.e., either nurses, who disinfect hands-free, or pharmacists using clean benches. Outcome factors included positive culture from the blood-related samples and the body temperature estimate. Of a total of 29 221 device-days in 1073 patients, positive cultures showed an overall incidence of 2.26 per 1000 device-days. Multivariate analysis showed a higher odds ratio of positive cultures for the ICU (odds ratio [OR], 4.415; 95% confidence interval [CI], 2.054–9.490]) and for CV catheter placement for more than 30 days (OR, 7.529; 95% CI, 4.279–13.247), but no significance for male sex (OR, 1.752; 95% CI, 0.984–3.119) or for pharmacists’ compounding (OR, 2.150; 95% CI, 0.974–4.749). Univariate analysis showed no significance for the following factors: age more than 70 years (OR, 0.968; 95% CI 0.561–1.641), the surgery service (OR, 1.029; 95% CI, 0.582–1.818), double-lumen CV catheters (OR, 0.841; 95% CI, 0.465–1.521), or the NC (1.107; 95% CI, 0.673–1.821). We conclude that the theoretical benefit of the NC, the abolished dead space in the hub, contributed little to the outcomes of blood-related culture. The hands-free disinfection may have resulted in comparable odds ratios for the nurses and the pharmacists compounding the infusions.
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References
Bouza E, Munoz P, Lopez-Rodriguez J, Jesus Perez M, Rincon C, Martin Rabadan P, et al. A needleless closed system device (CLAVE) protects from intravascular catheter tip and luer colonization: a prospective randomized study. J Hosp Infect 2003;54:279–287.
Yebenes JC, Vidaur L, Serra-Prat M, Sirvent JM, Batlle J, Motje M, et al. Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: a randomized controlled trial. Am J Infect Control 2004;32:291–295.
Niel-Weise BS, Daha TJ, van den Broek PJ. Is there evidence for recommending needleless closed catheter access systems in guidelines? A systematic review of randomized controlled trials. J Hosp Infect 2006;62:406–413.
Centers for Diseases Control and Prevention. Appendix A Examples of clinical definitions for catheter-related infections. MMWR 2002;5:127–128.
McDonald LC, Banerjee SN, Jarvis WR. Line-associated bloodstream infections in pediatric intensive-care-unit patients associated with a needleless device and intermittent intravenous therapy. Infect Control Hosp Epidemiol 1998;19:772–777.
Cookson ST, Ihrig M, O’Mara EM, Denny M, Volk H, Banerjee SN, et al. Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol 1998;19:23–27.
Maragakis LL, Bradley KL, Song X, Beers C, Miller MR, Cosgrove SE, et al. Increased catheter-related bloodstream infection rates after the introduction of a new mechanical valve intravenous access port. Infect Control Hosp Epidemiol 2006;27:67–70.
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Yoshida, J., Ishimaru, T., Fujimoto, M. et al. Risk factors for central venous catheter-related bloodstream infection: a 1073-patient study. J Infect Chemother 14, 399–403 (2008). https://doi.org/10.1007/s10156-008-0637-9
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DOI: https://doi.org/10.1007/s10156-008-0637-9