Assessment of CRBSI rates using catheter or hospital days

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Intravenous literature: Delgado-Capel, M., Capdevila-Morell, J.A., Sauca-Subias, G., Ballester-Joya, L., Vidal-Diez, E. and YÃbenes-Reyes, J.C. (2012) Incidence of catheter-related bloodstream infection

in a general hospital using two different detection methods. Enfermedades Infecciosas y Microbiolog ­a Clínica. Mar 23. [Epub ahead of print].

Abstract:

INTRODUCTION: The aim of this study was to determine the incidence of central venous catheter-related bloodstream infection (CRBSI) in a general hospital, using two different assessment methods.

METHODS: Method A: One observer prospectively followed up all patients with central venous catheters (CVCs) placed in our hospital over a period of 1 year, recording all CRBSI episodes. Incidence was calculated in two ways, in relation to the total number of catheter days, and in relation to the total number of hospital days of all patients hospitalized during this period. Method B: Another observer recorded all CRBSI episodes diagnosed during the same time period using microbiology data in which blood culture and catheter culture were positive for the same microorganism. Incidence was calculated in relation to the total number of hospital days of all hospitalized patients. The patient’s demographic characteristics and the catheter-related variables were recorded and analysed. Based on clinical and microbiological criteria, catheters were classified as uninfected, colonized, or CRBSI.

RESULTS: Over the study period, 878 central venous catheters were placed in 704 patients. The total number of catheter days was 7357, and the mean duration of catheter use was 8.15 days (1-86). The total number of hospital stays in this period was 92,167. Method A: 15 episodes of CRBSI were detected, yielding an overall incidence of 2.03 episodes/1000 catheter days or 0.16 episodes/1000 hospital days. Method B: 11 episodes of CRBSI, with an incidence of 0.12 episodes/1000 hospital days.

CONCLUSION: The two methods studied yielded different CRBSI rates, with a higher incidence reported by prospective follow-up (Method A). In addition, this method enabled a better assessment to be made of CRBSI risk as the calculation could be performed in relation to the days patients were catheterized.

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