Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

2003 ◽  
Vol 24 (7) ◽  
pp. 501-505 ◽  
Author(s):  
Irina Zuschneid ◽  
Frank Schwab ◽  
Christine Geffers ◽  
Henning Rüden ◽  
Petra Gastmeier
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Relative Reduction ◽  
Central Venous ◽  
Infection Surveillance

AbstractBackground And Objective:The German Nosocomial Infection Surveillance System (KISS) began in 1997 as a nationwide surveillance project for voluntary registration of nosocomial infections in intensive care units (ICUs). This study investigates trends in the rates of central venous catheter (CVC)–associated primary bloodstream infections (BSIs) in ICUs since participation in KISS.Methods:Eighty-four ICUs that had participated in KISS for at least 24 months were considered for more detailed analysis. Monthly rates of primary BSI for the 84 ICUs were pooled for the 24 months. The best model for describing the curve of reduction was sought. Additionally, incidence densities were compared using the z test.Results:For the 212 ICUs participating, a relative 25.7% decrease (from 2.1 to 1.6 primary BSIs per 1,000 CVC-days) was observed from January 1997 to June 2001. The 84 ICUs that participated in KISS for a minimum of 24 months accumulated 552,359 patient-days and 404,897 CVC-days during their 24 months. A linear regression model was selected to explain the curve of primary BSI reduction in the 84 ICUs. It showed a decrease from 2.1 to 1.5 primary BSIs per 1,000 CVC-days, meaning an overall relative reduction of 28.6% during the 2-year observation period. These results were significant (Student's t test for the monthly reduction coefficient; P = .04). The reduction of primary BSIs was shown for both clinical sepsis and laboratory-confirmed, CVC-associated primary BSIs.Conclusion:Performing surveillance with KISS was associated with a reduction of the rates of CVC-associated primary BSIs in ICU patients (Infect Control Hosp Epidemiol 2003;24:501-505).

Reproducibility of the Surveillance Effect to Decrease Nosocomial Infection Rates

2009 ◽  
Vol 30 (10) ◽  
pp. 993-999 ◽  
Author(s):  
P. Gastmeier ◽  
F. Schwab ◽  
D. Sohr ◽  
M. Behnke ◽  
C. Geffers
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Knee Prosthesis ◽  
Venous Catheter ◽  
Infection Rates ◽  
Relative Risks ◽  
Infection Surveillance ◽  
Reduction Effect

Objective.To investigate whether the reduction effect due to participation in a nosocomial infection surveillance system for laboratory-confirmed central venous catheter (CVC)-associated primary bloodstream infection (BSI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI) is reproducible for different time periods, independent of confounding factors that might occur during a specific time period.Methods.Data from the German national nosocomial infection surveillance system from the period January 1997 through June 2008 were used. CVC-associated BSI data and SSI data were analyzed for 3 starting periods, and VAP data were analyzed for 2 starting periods. Monthly infection rates were calculated for the following 36 months, and relative risks comparing the first and third surveillance years of each period were calculated.Results.A total of 2,399 CVC-associated BSI cases from 267 intensive care units, 3,637 VAP cases from 150 intensive care units, and 829 SSIs following 3 different procedures from 113 departments were analyzed. A significant reduction in VAP was shown for both starting periods investigated (overall relative risk [RR], 0.80 [95% CI, 0.74-0.86]). A significant reduction in CVC-associated BSI was demonstrated for 2 of 3 starting periods (overall RR, 0.83 [95% CI, 0.75-0.91]). A significant reduction in SSI was found for 2 starting periods for knee prosthesis insertion (overall RR, 0.56 [95% CI, 0.38-0.82]), for all of the 3 starting periods for cesarean delivery (overall RR, 0.75 [95% CI, 0.61-0.93]), and for none of the 3 starting periods for endoscopically performed cholecystectomy (overall RR, 0.89 [95% CI, 0.62-1.27]).Conclusions.The surveillance effect, manifest as a significant reduction of nosocomial infection rates between the first and third years of participation in a surveillance system, was observed independently from the calendar year in which the surveillance activities started.

Central-Line–Associated Bloodstream Infections in Québec Intensive Care Units: Results from the Provincial Healthcare-Associated Infections Surveillance Program (SPIN)

2016 ◽  
Vol 37 (10) ◽  
pp. 1186-1194 ◽  
Author(s):  
Lynne Li ◽  
Elise Fortin ◽  
Claude Tremblay ◽  
Muleka Ngenda-Muadi ◽  
Caroline Quach ◽  
...  
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Incidence Rates ◽  
Surveillance Program ◽  
Central Venous ◽  
Healthcare Associated

BACKGROUNDFollowing implementation of bundled practices in 2009 in Quebec and Canadian intensive care units (ICUs), we describe CLABSI epidemiology during the last 8 years in the province of Québec (Canada) and compare rates with Canadian and American benchmarks.METHODSCLABSI incidence rates (IRs) and central venous catheter utilization ratios (CVCURs) by year and ICU type were calculated using 2007–2014 data from the Surveillance Provinciale des Infections Nosocomiales (SPIN) program. Using American and Canadian surveillance data, we compared SPIN IRs to rates in other jurisdictions using standardized incidence ratios (SIRs).RESULTSIn total, 1,355 lab-confirmed CLABSIs over 911,205 central venous catheter days (CVC days) were recorded. The overall pooled incidence rate (IR) was 1.49 cases per 1,000 CVC days. IRs for adult teaching ICUs, nonteaching ICUs, neonatal ICUs (NICUs), and pediatric ICUs (PICUs) were 1.04, 0.91, 4.20, and 2.15 cases per 1,000 CVC days, respectively. Using fixed SPIN 2007–2009 benchmarks, CLABSI rates had decreased significantly in all ICUs except for PICUs by 2014. Rates declined by 55% in adult teaching ICUs, 52% in adult nonteaching ICUs, and 38% in NICUs. Using dynamic American and Canadian CLABSI rates as benchmarks, SPIN adult teaching ICU rates were significantly lower and adult nonteaching ICUs had lower or comparable rates, whereas NICU and PICU rates were higher.CONCLUSIONQuébec ICU CLABSI surveillance shows declining CLABSI rates in adult ICUs. The absence of a decrease in CLABSI rate in NICUs and PICUs highlights the need for continued surveillance and analysis of factors contributing to higher rates in these populations.Infect Control Hosp Epidemiol 2016;1–9

scholarly journals Incidence of Central Venous Catheter-Related Bloodstream Infections: Evaluation of Bundle Prevention in Two Intensive Care Units in Central Brazil

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Thais Yoshida ◽  
Ana Elisa Bauer de Camargo Silva ◽  
Luciana Leite Pineli Simões ◽  
Rafael Alves Guimarães
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Incidence Density ◽  
P Value ◽  
Central Venous ◽  
Central Brazil ◽  
Before And After

Background. Central venous catheter-associated bloodstream infections (CVC-BSIs) have been associated with increased length of hospital stay, mortality, and healthcare costs, especially in intensive care units (ICUs). The aim of this study was to evaluate the incidence density of CVC-BSIs before and after implementation of the bundle in a hospital of infectious and dermatological diseases in Central Brazil. Methods. A retrospective cohort study was conducted in two ICUs (adult and pediatric) between 2012 and 2015. Two periods were compared to assess the effect of the intervention in incidence density of CVC-BSIs: before and after intervention, related to the stages before and after the implementation of the bundle, respectively. Results. No significant reduction was observed in the incidence density of CVC-BSIs in adult ICU (incidence rate ratio [IRR]: 0.754; 95.0% CI: 0.349 to 1.621; p-value = 0.469), despite the high bundle application rate in the postintervention period. Similarly, significant reduction in the incidence density in pediatric ICU has not been verified after implementation of the bundle (IRR: 1.148; 95.0% CI: 0.314 to 4.193; p-value = 0.834). Conclusion. Not significant reduction in the incidence density of CVC-BSIs was observed after bundle implementation in ICUs, suggesting the need to review the use of process, as well as continuing education for staffs in compliance and correct application of the bundle. Further studies are needed to evaluate the effect of bundle in the reduction of incidence density of CVC-BSIs in Brazil.

scholarly journals Central venous catheter-related bloodstream infections in the intensive care unit

2011 ◽  
Vol 15 (4) ◽  
pp. 213-223 ◽  
Author(s):  
Virendra C. Patil ◽  
Harsha V. Patil ◽  
M. N. Ramteerthkar ◽  
R. D. Kulkarni
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous
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