Open AccessCentral venous-catheter related bacteremia: incidence and risk factors in a hospital in western Mexico
Author(s) -
Juan Carlos Lona-Reyes,
Brenda López-Barragán,
Alfredo De Rosa,
J. Jesús Pérez-Molina,
Elba Patricia Ascencio-Esparza
Publication year - 2016
Publication title -
boletín médico del hospital infantil de méxico
Language(s) - English
Resource type - Journals
ISSN - 2444-3409
DOI - 10.1016/s2444-3409(16)30006-1
Subject(s) - medicine , bacteremia , central venous catheter , incidence (geometry) , catheter , prospective cohort study , antibiotics , surgery , internal jugular vein , microbiology and biotechnology , physics , optics , biology
BackgroundCentral venous catheters (CVC) are needed for monitoring and treatment of critically ill patients; however, their use increases the risk of bacteremia. The aim of the study was to quantify the incidence of central venous catheter-related bacteremia (CVCRB) and to identify factors associated with this infection.MethodsA prospective cohort study was conducted in a concentration hospital of western Mexico. The association of CVCRB and study variables was investigated using multivariate Cox regression analysis.ResultsTwo hundred and four patients with CVC were studied. The mean age was 4.6 years; 66.2% were male. Insertion sites of the catheters were subclavian vein 72.5% (n = 148), jugular vein 20.1% (n = 41) and femoral vein 7.4% (n = 15). CVCRB incidence was 6.5 events/1,000 catheter-days; microorganisms identified were gram-positive cocci 37.5% (n = 6), gram-negative bacilli 37.5% (n = 6) and Candida albicans 25% (n = 4). It was observed that the increase in catheter manipulations per day was associated with bacteremia (HR 1.14, 95% CI 1.06–1.23), whereas the use of intravenous antibiotics showed a protective effect (HR 0.84, 95% CI 0.76–0.92).ConclusionsIn addition to the strategies of maximum caution when placing or manipulating the catheter, we recommend decreasing, as much as possible, disconnects between the CVC and the infusion line. Antibiotics showed a protective effect, but the outcome is uncertain and the promotion of antimicrobial resistance should be considered