This study aimed to determine the burden, microbiologic patterns, and associations of CVC-BSIs in non-ICU settings in a tertiary regional centre, University Hospital Geelong (UHG), Victoria, Australia” Aminzadeh et al (2019).
Abstract:
BACKGROUND: Most studies have examined central venous catheter associated blood stream infections (CVC-BSIs) in Intensive Care Units (ICUs) but information on CVC-BSIs in non-ICU settings is sparse. This study aimed to determine the burden, microbiologic patterns, and associations of CVC-BSIs in non-ICU settings in a tertiary regional centre, University Hospital Geelong (UHG), Victoria, Australia.
METHODS: A retrospective study was conducted in the UHG from October 2016 to April 2018. Based on the National Healthcare Safety Network definition, 23 CVC-BSIs occurred in non-ICU settings. Data analysed using SPSS-v25 with a P value < 0.05 was deemed as significant. RESULTS: The incidence rate was 1.2 per 10,000 bed-days. The mean age of patients was 57.22 ± 18 years. 43.5% of patients had Charlson index score of ≥5 and 78% received appropriate empiric antibiotics. The 90-day mortality rate was zero. In total, 26 microorganisms were isolated. Gram-negative bacilli were more common than Gram-positive cocci. The mean catheter duration was 45.22 ± 8.99 days. Hickman lines contributed to 52.2% of BSIs. Within the first two weeks of line insertion, 53.84% of CVC-BSIs occurred with 76.92% of CVC-Gram-negative bacteraemia and 71.4% of BSIs were related to Hickman lines. Also, 69.2% of CVC-BSIs occurred within ≤4 weeks of line insertion including 84.6% of CVC-Gram-negative bacteraemia. CONCLUSION: CVC-BSIs constitute a significant burden on high risk patients in non-ICU settings, with Gram negative bacilli predominating. A prospective surveillance program for all patients with CVC in the non-ICU setting may improve CVC management processes and influence educational measures.
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Reference:
Aminzadeh, Z., Simpson, P. and Athan, E. (2019) Central venous catheter associated blood stream infections (CVC-BSIs) in the non-intensive care settings: Epidemiology, microbiology and outcomes. Infection, Disease & Health. August 7th. doi: 10.1016/j.idh.2019.07.003. [Epub ahead of print].