A Study of Central Venous Catheter Colonizations and Catheter-related Bloodstream Infections among Patients admitted in the Intensive Care Unit of a Tertiary Care Teaching Hospital (original) (raw)
Related papers
2020
Central Venous Catheters (CVCs) are indispensable in current intensive care treatment; also pose a greater risk of device related infections in comparison to any other type of medical device and are major cause of morbidity, mortality and increased expense. A cross sectional prospective study of one year duration was conducted in the tertiary care University Hospital ICU located in the rural region of Haryana, India, to determine the incidence of the central venous catheter related bloodstream infection (CRBSI), rate of catheter colonization and to identify the associated risk factors and the microbial spectrum of CRBSI along with the antimicrobial sensitivity pattern of microbial isolates. Sixty patients with central venous catheter inserted and admitted under ICU having signs and symptoms of septicaemia post 48 hours of central venous catheter insertion were included. The rate of CRBSI was assessed by paired quantitative blood culture method in the CVC and peripheral vein. The CRB...
Sri Lankan Journal of Infectious Diseases, 2022
Introduction: Central venous catheters (CVC) are frequently used in modern health care systems. However, CVCs are likely to get colonised with microorganisms, resulting in catheterrelated blood stream infections (CRBSI). This study investigated microorganisms causing CRBSI and CVC colonisation, their antibiotic resistance, and factors associated with CRBSI in patients in the intensive care units (ICU) at the Colombo North Teaching Hospital (CNTH) and Apeksha hospital, Sri Lanka. Methods: The study included 300 adult patients in ICUs with a CVC in-situ for >48 hours. Blood taken through the CVC, peripheral blood and CVC tips were cultured. Microorganisms were identified and tested for antibiotic susceptibility. Demographic factors were recorded. Results: Seventeen patients (13.1%) developed CRBSI. The CRBSI rate was 13.3 per 1,000 catheter days in CNTH while it was 10 (5.9%) cases and 5.2 per 1,000 catheter days in Apeksha hospital. In CNTH, CVC colonisation was detected in 35 (26.9%). Coagulase negative staphylococci (CoNS) were the leading cause of both CRBSI (41%) and colonisation (58%). In Apeksha hospital, Klebsiella sp. (5/10) were the predominant pathogens that caused CRBSI. Eighty-nine CVCs (52.3%) were colonised by CoNS (58%). In CNTH, CRBSI was detected more in males (14/17) (p<0.05). The majority of microorganisms that caused CRBSI and CVC colonisation in both hospitals showed resistance to commonly used antibiotics. Conclusion: The CRBSI rates and the incidences were higher in CNTH. CoNS was the most common cause of CRBSI in CNTH and Gram negative bacteria in Apeksha hospital. CVC colonisation with CoNS was common in both hospitals. Antibiotic resistance was high among bacteria causing CRBSI and colonisation.
Catheter related blood stream infections in ICU: A study from North India
International Journal of Infection Control, 2013
Central venous catheter (CVC) insertion is common in ICU practices; this can be a source of dangerous bacteremia, sepsis, multi organ failure and sometimes even death. We conducted this study to find out the rate of Catheter colonization, Catheter related blood stream infections (CRBSI), their association and microbial spectrum of CRBSI in critical care unit over 1 year period. Patients admitted in critical care units requiring central venous catheterization and presenting with signs of septicemia during catheterization period were investigated for catheter related blood stream infections. tip of Central venous catheter (CVC) as well as peripheral blood for culture were obtained simultaneously and processed according to pre determined protocol. Antimicrobial susceptibility testing was done for the isolated organisms. CRBSI rate of 10/1000 catheter days was observed, with Staphylococcus spp. as the most common organism. Since central venous catheters are increasingly being used in the critical care, regular surveillance for infections associated with them is essential.
Infection Control and Hospital Epidemiology, 2007
Objective. To determine the incidence of central venous catheter (CVC)-associated bloodstream infection (CA-BSI) among patients admitted to general medical wards outside the intensive care unit (ICU). Design. Prospective cohort study performed over a 13-month period, from April 1, 2002, through April 30, 2003. Setting. Four selected general medical wards at Barnes-Jewish Hospital, a 1,250-bed teaching hospital in Saint Louis, Missouri. Patients. All patients admitted to 4 general medical wards. Results. A total of 7,337 catheter-days were observed during 33,174 patient-days. The device utilization ratio (defined as the number of catheter-days divided by the number of patient-days) was 0.22 overall and was similar among the 4 wards (0.21, 0.25, 0.19, and 0.24). Forty-two episodes of CA-BSI were identified (rate, 5.7 infections per 1,000 catheter-days). Twenty-four (57%) of the 42 cases of CA-BSI were caused by gram-positive bacteria: 10 isolates (24%) were coagulase-negative staphylo...
Indian journal of medical microbiology
Central venous catheters (CVCs) though indispensable in current medical and intensive care treatment, also puts patients at risk of catheter related infection (CRI) resulting in increased morbidity and mortality. We analysed the incidence, risk factors, bacteriological profile and antimicrobial susceptibility pattern of the isolates in central venous catheter associated bloodstream infection (CVC-BSI) in the intensive care unit (ICU) patients and studied the formation of biofilm in CVCs. The following case control study included 115 patients with CVC in situ. Quantitative blood cultures (QBC) and catheter tip cultures were performed for the diagnoses. Direct catheter staining was done for an early diagnosis by acridine orange (AO) and Gram staining methods. Biofilm production in catheters was detected by 'tissue culture plate' (TCP) method. The results were analysed using the computer-based program statistical package for the social sciences (SPSS). In 25/115 patients, defin...
Central venous catheter-related bloodstream infections in the intensivecare unit
2012
Context: Central venous catheter-related bloodstream infection (CRBSI) is associated with high rates of morbidity and mortality in critically ill patients. Aims: This study was conducted to determine the incidence of central venous catheter-related infections (CRIs) and to identify the factors influencing it. So far, there are very few studies that have been conducted on CRBSI in the intensive care unit in India. Settings and Design: This was a prospective, observational study carried out in the medical intensive care unit (MICU) over a period of 1 year from January to December 2004. Materials and Methods: A total of 54 patients with indwelling central venous catheters of age group between 20 and 75 years were included. The catheters were cultured using the standard semiquantitative culture (SQC) method. Statistical analysis used SPSS-10 version statistical software. Results: A total of 54 CVC catheters with 319 catheter days were included in this study. Of 54 patients with CVCs stu...
Catheter Related Blood Stream Infections In Patients Of The Intensive Care Unit
International Archives of Medicine, 2017
Objective: To identify the prevalence of bloodstream infection associated with the Catheter related Blood stream infections in patients of the Intensive Care Unit, and the characteristics of its use and handling. Methods: Descriptive and transversal study with a sample of 88 participants. Data were collected through the observational method and the records in the medical records. The absolute and relative frequencies were used for data analysis. Results: 73.86% of the patients had central venous access in the subclavian vein, 100% used double lumen Catheter related Blood stream infections, 0.5% chlorhexidine solution for skin antisepsis, dressing coverage is performed mostly with Sterile gauze and tape, with a daily exchange. The rate of infection related to the use of the Catheter related Blood stream infections was (6.81%). The most infused pharmacological drugs were antimicrobials (69.32%). Conclusion: The study showed that care with central venous accesses is performed according to recommendations for prevention of bloodstream infection related to the use of these devices. The infection rate is close to the standards found in the literature.
Prevalence of Central Venous Catheter-Related Infections in Catheterized ICUS' Patients
Medical devices are used extensively in many practice. This include devices used on a temporary, intermittent and long term basis. Transient or permanently implanted plastic devices are frequently the starting point of infection. A total number of 117 clinical isolates were recovered from 83 contaminated CVCs from ICUs hospitalized infants and adult patients of age up to 90 years. The majority of the isolates (about 92%) were Gram-negative rods, in addition to Gram-positive cocci and Yeast (4% each). The most prevalent contaminants were Acinetobacter baumannii (23%) followed by Pseudomonas aeruginosa (18%), Klebsiella pneumoniae (15%) and Enterobacter species (13%). Less common isolates were Acinetobacter lowffii (5%), Yeasts (4%), Providencia, Stenotrophomonas, Achromobacter, Proteus and Staphylococci (3% each), Pseudomonas fluorescens, Pseudomonas putida, and Micrococcus (1% each). Positive slime production was observed with about 72% of the Gram-negative isolates and one Candida tropicalis strain. Strong slime production was detected in 11 out of 23 Pseudomonas strains, 10 out of 33 Acinetobacter and 2 out of 18 Klebsiella strains. Among 32 antibiotics tested, the susceptibility pattern revealed that the most effective antibiotics were levofloxacin, imipenem and meropenem; 68, 67 and 67%, of Gram-negative isolates were affected, respectively. Among the affected isolates there were Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae strains; highly resistant to other antibiotics. Minimum inhibitory concentration (MIC) to fluconazole was found to be 2 µg/ml. The absence or presence of adherent growth and biofilm formation on the catheter surface, to any degree, was confirmed by scanning electron microscopy; where heavy growth showed cottony like appearance. More basic research at the level of pathogenesis with in-vitro model for prevention and elimination of microbial colonization of CVC and modification of catheter materials is needed to design novel strategies.
Critical care (London, England), 2005
Central venous catheterization is commonly used in critically ill patients and may cause different complications, including infection. Although there are many studies about CVC-related infection, very few have analyzed it in detail. The objective of this study was to analyze the incidence of catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) with central venous catheters (CVCs) according to different access sites. This is a prospective and observational study, conducted in a 24-bed medical surgical intensive care unit of a 650-bed university hospital. All consecutive patients admitted to the ICU during 3 years (1 May 2000 and 30 April 2003) were included. The study included 2,018 patients. The number of CVCs and days of catheterization duration were: global, 2,595 and 18,999; subclavian, 917 and 8,239; jugular, 1,390 and 8,361; femoral, 288 and 2,399. CRLI incidence density was statistically higher for femoral than for jugular (15.83 versus 7....