Tuesday, May 19, 2009

Prospective analysis of central venous catheter colonization and related factors

Prospective analysis of central venous catheter colonization and related factors
Enferm Clin. 2009 May 14

Pérez Castro I, Iborra Obiols MI, Comas Munar MD, Yrurzun Andreu R, Sanz Moncusí M, Lahoz Simón C, Gómez Montoya MI, Comallonga Bartomeu T, Navasa Anadón M.
Institut de Malalties Digestives i Metabóliques, Hospital Clínic de Barcelona, Barcelona, España.

OBJECTIVE: To evaluate the incidence of central venous catheter (CVC) colonization in inpatient units of the Institut de Malalties Digestives i Metabòliques (IMDiM) of Hospital Clinic (Barcelona, Spain) with a view to reducing the risk of infection.

METHOD: A 4-month descriptive, prospective and longitudinal study was performed. A total of 230 patients admitted to the IMDiM with CVC were included during the study period. At catheter removal, the tip was cultured and, if the patient had fever, two blood cultures were also obtained. A database was created. Data were analyzed using SPSS v.11.0. Variables were compared with the Chi-square and Student's t-tests and a multivariate analysis was performed using Cox logistic regression. A value of P 0.05

RESULTS: Catheter tip culture was positive in 45.2%. The rate of catheter-related bloodstream infections was 2.9 per thousand catheter-days, which was clinically significant. The probability of catheter tip contamination 10 days after placement was 25%. Multivariate analysis revealed that the independent variables associated with a higher risk of infection were catheter type, changes of dressing, and infected bacterial stopcocks.

CONCLUSIONS: These results suggest that: 1) the protocol for catheter insertion and care should be reviewed and updated, 2) catheter removal should be considered after the 10th day, 3) the appropriate type of catheter should be selected, the catheter with the lowest number of lumens should be used, and changes of catheter dressing should be reduced.

PMID: 19447058 [PubMed - as supplied by publisher]