Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care 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...
MGM Journal of Medical Sciences
Objectives: To describe central venous catheter (CVC) colonizations and catheter-related bloodstream infections (C-RBSIs) among patients admitted in the Intensive Care Unit (ICU) of a tertiary care teaching hospital. Materials and methods: This was a cross-sectional study conducted among critically ill patients admitted in ICU. The semi-quantitative method was used for catheter tip culture. The definitions of catheter infection and colonization were based on the Centre for Disease Control Blood Stream Infection Guidelines. Results: The study population comprised 75 ICU patients whose CVCs had been placed. The incidence of CVC-related colonizations and bloodstream infections was observed to be 42.7% (32/75) and 17.3% (13/75) respectively. Coagulase-negative staph was the most common organism found causing CVC colonization (50%) and C-RBSI (61.5%). Conclusion: Coagulase-negative staphylococci are the most frequent microorganisms which colonize the CVC. The findings of this study may help with implementation of educational and training programs on central line-associated bloodstream infections (CLABSIs) for health care personnel and enable better management of these devices with regard to the prevention, diagnosis, and treatment of CLABSIs.
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.
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...
International Journal of Medical Research and Review, 2016
Introduction: Central venous catheter (CVC) related blood stream infections are associated with serious infectious complications resulting in significant morbidity, increased duration of hospitalization and added medical cost. Aim: The study was done to determine the incidence of central venous catheter related infections, their antimicrobial sensitivity pattern, biofilm production and associated risk factors in hospitalized patients. Material and Method: Catheter tip culture & blood cultures of 143 patients with indwelling central venous catheters were processed. Result: Out of 143 specimens, catheter tip colonization was observed in 45 samples, while 14 were both catheter tip as well as blood culture positive hence included ascatheter related blood stream infections (CRBSI). CRBSI was found significantly associated with increased duration of catheterization, increased number of attempts and placement of CVC in internal jugular vein. Most common isolated organisms were Klebsiella pneumoniae followed by Coagulase negative Staphylococcus, Staphylococcus aureus and Pseudomonas aerguinosa in CRBSI as well as in CVC colonization. Majority of them were resistant to Gentamicin, Ciprofloxacin, Ceftiazidime and Ceftrixone. Biofilm production was determined by tissue culture plate method and was found to be maximum seen in Klebsiella spp. Conclusion: Incidence of CRBSI was 9.79% and of CVC colonization was 34.26%. Rate of CRBSI was 8.53 per 1000 CVC days. Klebsiella pneumoniae was most common isolate and predominant biofilm producer and was found to be multidrug resistant to Gentamicin, Ciprofloxacin, Ceftiazidime.
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.
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.
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....