Risk factors for catheter-related bloodstream infection: a prospective multicenter study in Brazilian intensive care units

Bicudo, Daniela; Batista, Ruth; Furtado, Guilherme Henrique; Sola, Angela; Medeiros, Eduardo Alexandrino Servolo de

doi:10.1016/S1413-8670(11)70200-8

The Brazilian Journal of Infectious Diseases

ISSN: 1413-8670

The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents.
The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor. Since its inception it has garnered a growing share of the publishing market.

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Central venous catheters (CVC) are devices of great importance in health care. The advantages gained from the use of catheters outweigh the complications that might result from their use, among which bloodstream infections (BSI). In spite of its importance, few national studies have addressed this issue.

Objective

The aim this study was to determine the incidence of BSI in patients with CVC, hospitalized in ICU, as well as the variables associated with this complication.

Methods

Multicentric cohort study carried out at ICUs of three hospitals at Universidade Federal de São Paulo complex.

Results

A total of 118 cases of BSI in 11.546 catheters day were observed: 10.22 BSI per 1,000 catheters day. On average, BSI was associated to seven additional days of hospital stay in our study (p<0.001), with a significant difference between types of catheters. Concerning the place of insertion, there was no statistical difference in BSI rates.

Conclusion

We concluded that a patient who uses a catheter for longer than 13 days presents a progressive risk for infection of approximately three times higher in relation to a patient who uses the catheter for less than 13 days (p<0.001). The median duration of catheter use was 14 days among patients with BSI and 9 days in patients without infection (p<0.001). There was higher prevalence of Gram-negative infections. The risk factors for BSI were utilization of multiple-lumen catheters, duration of catheterization and ICU length of stay.

Keywords:

intensive care units

catheter-related infections

catheterization, BSI

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