Öz
Objective: Central venous catheter-related infections lead to an increase in widespread antibiotic use, prolonged hospital stays, increased costs, as well as morbidity and mortality. In this study, we aimed to evaluate the infections associated with central venous catheters used in our intensive care unit (ICU) and identify the possible contributing factors.
Methods: The hospital records of patients aged 18 and above who were admitted to ICU and had central venous catheters (femoral, jugular, and subclavian catheters) were retrospectively evaluated. Patients’ demographic data and also reason for admission, APACHE II score, duration of ICU stay, and 28-day mortality were recorded. Additionally, data on the time of catheter insertion, catheter site, catheter type, administration of blood and total parenteral nutrition (TPN) through the catheter, presence of catheter-related infection, identified pathogens, time of infection development after catheter insertion, and concurrent blood culture results were recorded.
Results: A total of 169 patients were included in the study, of whom 99 (58.6%) were male and 70 (41.4%) were female. The catheters were located in the femoral region in 56 (33.1%) cases, jugular region in 99 (58.6%) cases, and subclavian region in 14 (8.3%) cases. There was no significant difference in the development of catheter infection based on the site of application (p=0.929). The rates of infection were significantly higher in catheters used for TPN and blood transfusion (p=0.002 and p=0.005, respectively). The average duration of intensive care stay was significantly higher in patients who developed catheter infections.
Conclusion: Catheter-related bacteremia is an important risk factor for morbidity and mortality, especially in critically ill patients. In our study, no significant differences were found in the rates of catheter-related infection based on the application sites. We observed that the use of TPN, blood transfusion, and longer catheter duration posed risks for infection.
Anahtar Kelimeler
catheter-related bacteremia central venous catheter intensive care unit
Kaynakça
- Cantón-Bulnes ML, Garnacho-Montero J. Practical approach to the management of catheter-related bloodstream infection. Rev Esp Quimioter. 2019;32(2):38-41.
- Menteş Ö, Yiğit T, Harlak A, Şenocak R, Balkan M, Balkan A. Cerrahi yoğun bakım ünitesinde kateter kaynaklı enfeksiyonlar. Gülhane Askeri Tıp Dergisi, 2008;50:158-161.
- Polat F, Şahinoğlu AH, Dilek A, Köksal E, Üstün YB, Kaya C ve ark. Rehberlere Dayalı Önlem ve Bakım Paketlerinin Yoğun Bakım Ünitesinde Santral Venöz Kateter Enfeksiyonları Üzerine Etkisi. Türk Yogun Bakim Dernegi Dergisi 2014;12:86-93.
- Özkocaman V. Tünelli Santral Venöz Kateterle (Hickman Tipi) İlişkili Enfeksiyonların Tanımlanması ve Tedavisi, Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2002;28(3): 101-103.
- Rupp ME, Karnatak R. Intravascular Catheter-Related Bloodstream Infections. Infect Dis Clin North Am. 2018;32(4):765-787.
- Weber DJ, Rutala WA. Central line associated bloodstream infections: prevention and management. Infect Dis Clin North Am. 2011;25:77-102.
- Kıray S, Yıldırım D, Özçiftçi S, Korhan EA, Uyar M. Santral Venöz Kateter Bakımı ve Enfeksiyon: Bir Sistematik Derleme. Turkish Journal of Intensive Care. 2019; 17(2):60-74.
- Crawford AG, Fuhr JP, RAO B. Cost–Benefit Analysis of Chlorhexidine Gluconate Dressing in the Prevention of Catheter Related Bloodstream Infections. Infect Control Hosp Epidemiol. 2004;25(8): 668-674.
- Aydın M, Azak E, Bilgin H, Menekşe S, Asan A, Mert HT et al. Changes in antimicrobial resistance and outcomes of health care-associated infections. Eur J Clin Microbiol Infect Dis. 2021;40(8):1737-1742.
- Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001;286(6):700-707.
- Arvaniti K, Lathyris D, Blot S, Apostolidou-Kiouti F, Koulenti D, Haidich AB. Cumulative evidence of randomized controlled and observational studies on catheter-related infection risk of central venous catheter insertion site in ICU patients: a pairwise and network meta-analysis. Crit Care Med. 2017;45(4):437–448.
- Parienti JJ, Mongardon N, Megarbane B, Mira JP, Kalfon P, Gros A, et al. Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 2015;373(13):1220–1229.
- See I, Freifeld AG, Magill SS. Causative organisms and associated antimicrobial resistance in healthcare-associated central line-associated bloodstream infections from oncology settings, 2009–2012. Clin Infect Dis. 2016;62(10):1203–1209.
- Wright MO, Decker SG, Allen-Bridson K, Hebden JN, Leaptrot D. Healthcare-associated infections studies project: an American Journal of Infection Control and National Healthcare Safety Network data quality collaboration: location mapping. Am J Infect Control. 2018;46(5):577–578.
- Lin KY, Cheng A, Chang YC, Hung MC, Wang JT, Sheng WH, et al. Central line-associated bloodstream infections among critically-ill patients in the era of bundle care. J Microbiol Immunol Infect. 2017;50:339–348.
- Pitiriga V, Kanellopoulos P, Bakalis I, Kampos E, Sagris I, Saroglou G, et al. Central venous catheter-related bloodstream infection and colonization: the impact of insertion site and distribution of multidrug-resistant pathogens. Antimicrob Resist Infect Control. 2020;9(1):189.
- Moro ML, Vigano EF, Cozzi A. Risk factors for central venous catheter related infections in surgical and intensive care units. The Central Venous Catheter Related Infections Study Group. Infect Control Hosp Epidemiol 1994; 15: 253-264.
- Raad I, Hana HA, Award A, Alrahwan A, Bivins C, Khan A, et al. Optimal frequency of changing ıntravenous administrarion sets: İs it safe to prolong use beyond 72 hours. Infect Control Hosp Epidemiol. 2001;22(3):136-139
Öz
Kaynakça
- Cantón-Bulnes ML, Garnacho-Montero J. Practical approach to the management of catheter-related bloodstream infection. Rev Esp Quimioter. 2019;32(2):38-41.
- Menteş Ö, Yiğit T, Harlak A, Şenocak R, Balkan M, Balkan A. Cerrahi yoğun bakım ünitesinde kateter kaynaklı enfeksiyonlar. Gülhane Askeri Tıp Dergisi, 2008;50:158-161.
- Polat F, Şahinoğlu AH, Dilek A, Köksal E, Üstün YB, Kaya C ve ark. Rehberlere Dayalı Önlem ve Bakım Paketlerinin Yoğun Bakım Ünitesinde Santral Venöz Kateter Enfeksiyonları Üzerine Etkisi. Türk Yogun Bakim Dernegi Dergisi 2014;12:86-93.
- Özkocaman V. Tünelli Santral Venöz Kateterle (Hickman Tipi) İlişkili Enfeksiyonların Tanımlanması ve Tedavisi, Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2002;28(3): 101-103.
- Rupp ME, Karnatak R. Intravascular Catheter-Related Bloodstream Infections. Infect Dis Clin North Am. 2018;32(4):765-787.
- Weber DJ, Rutala WA. Central line associated bloodstream infections: prevention and management. Infect Dis Clin North Am. 2011;25:77-102.
- Kıray S, Yıldırım D, Özçiftçi S, Korhan EA, Uyar M. Santral Venöz Kateter Bakımı ve Enfeksiyon: Bir Sistematik Derleme. Turkish Journal of Intensive Care. 2019; 17(2):60-74.
- Crawford AG, Fuhr JP, RAO B. Cost–Benefit Analysis of Chlorhexidine Gluconate Dressing in the Prevention of Catheter Related Bloodstream Infections. Infect Control Hosp Epidemiol. 2004;25(8): 668-674.
- Aydın M, Azak E, Bilgin H, Menekşe S, Asan A, Mert HT et al. Changes in antimicrobial resistance and outcomes of health care-associated infections. Eur J Clin Microbiol Infect Dis. 2021;40(8):1737-1742.
- Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001;286(6):700-707.
- Arvaniti K, Lathyris D, Blot S, Apostolidou-Kiouti F, Koulenti D, Haidich AB. Cumulative evidence of randomized controlled and observational studies on catheter-related infection risk of central venous catheter insertion site in ICU patients: a pairwise and network meta-analysis. Crit Care Med. 2017;45(4):437–448.
- Parienti JJ, Mongardon N, Megarbane B, Mira JP, Kalfon P, Gros A, et al. Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 2015;373(13):1220–1229.
- See I, Freifeld AG, Magill SS. Causative organisms and associated antimicrobial resistance in healthcare-associated central line-associated bloodstream infections from oncology settings, 2009–2012. Clin Infect Dis. 2016;62(10):1203–1209.
- Wright MO, Decker SG, Allen-Bridson K, Hebden JN, Leaptrot D. Healthcare-associated infections studies project: an American Journal of Infection Control and National Healthcare Safety Network data quality collaboration: location mapping. Am J Infect Control. 2018;46(5):577–578.
- Lin KY, Cheng A, Chang YC, Hung MC, Wang JT, Sheng WH, et al. Central line-associated bloodstream infections among critically-ill patients in the era of bundle care. J Microbiol Immunol Infect. 2017;50:339–348.
- Pitiriga V, Kanellopoulos P, Bakalis I, Kampos E, Sagris I, Saroglou G, et al. Central venous catheter-related bloodstream infection and colonization: the impact of insertion site and distribution of multidrug-resistant pathogens. Antimicrob Resist Infect Control. 2020;9(1):189.
- Moro ML, Vigano EF, Cozzi A. Risk factors for central venous catheter related infections in surgical and intensive care units. The Central Venous Catheter Related Infections Study Group. Infect Control Hosp Epidemiol 1994; 15: 253-264.
- Raad I, Hana HA, Award A, Alrahwan A, Bivins C, Khan A, et al. Optimal frequency of changing ıntravenous administrarion sets: İs it safe to prolong use beyond 72 hours. Infect Control Hosp Epidemiol. 2001;22(3):136-139
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Anesteziyoloji |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 9 Sayı: 3 |
