Intravascular Catheter Colonization and Related Bloodstream Infection in Critically III Neonates

1990 ◽  
Vol 11 (6) ◽  
pp. 301-308 ◽  
Author(s):  
Wendy A. Cronin ◽  
Teresa P. Germanson ◽  
Leigh G. Donowitz
Keyword(s):  
Bloodstream Infection ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Coagulase Negative Staphylococcus ◽  
Intravascular Catheter ◽  
Catheter Colonization ◽  
Catheter Tip ◽  
Critically Ill Neonates ◽  
Peripheral Arterial ◽  
Intravenous Catheters

AbstractIntravascular catheter tip colonization was prospectively evaluated in critically ill neonates to determine its relationship to the type of device used, duration of catheterization, insertion site and nosocomial bloodstream infection. Sixty-one percent (376 of 621) of all intravascular catheter tips were retrieved from 91 infants. Thirteen percent (41 of 310) of peripheral intravenous, 14% (6 of 42) of umbilical, 21% (3 of 11) of central venous, 36% (4 of 11) of peripheral arterial and 100% (2 of 2) of femoral catheters were colonized. Duration of catheterization was significantly longer for colonized lines (p < .001). Eight of 26 (30.8%) peripheral intravenous catheters remaining in place for more than three days were colonized, compared with 33 of 284 (11.6%) at three days or less (p= 0.012). Coagulase-negative staphylococcus was the organism most frequently isolated from catheter tips and bloodstream infections. Catheter colonization rates in this population were higher than those found in adults. Heavily manipulated devices and those in place for longer periods of time were the most frequently colonized.

scholarly journals Clinical Outcomes and Risk Factors for Tunneled Hemodialysis Catheter-Related Bloodstream Infections

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Kylie Martin ◽  
Yves S Poy Lorenzo ◽  
Po Yee Mia Leung ◽  
Sheri Chung ◽  
Emmet O’flaherty ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Jugular Vein ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Left Internal Jugular Vein ◽  
Hemodialysis Catheter ◽  
Increased Risk ◽  
Catheter Related Bloodstream Infection ◽  
Reduced Risk

Abstract Diabetes and left internal jugular vein insertion site were significantly associated with increased risk of a catheter-related bloodstream infection from a tunneled hemodialysis catheter. Ex-smoker status was significantly associated with reduced risk.

scholarly journals The Epidemiology of Bloodstream Infections and Antimicrobial Susceptibility Patterns: A Nine-Year Retrospective Study at St. Dominic Hospital, Akwatia, Ghana

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
John Gameli Deku ◽  
Mavis Puopelle Dakorah ◽  
Sylvester Yao Lokpo ◽  
Verner N. Orish ◽  
Francis Abeku Ussher ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Bloodstream Infection ◽  
Antimicrobial Susceptibility ◽  
Bloodstream Infections ◽  
Sub Saharan Africa ◽  
Coagulase Negative Staphylococcus ◽  
Eastern Region ◽  
Sensitivity Testing ◽  
Antimicrobial Susceptibility Pattern

Background. Bloodstream infections are among the top causes of morbidity and mortality in people of all ages, especially in immunocompromised patients in sub-Saharan Africa. This study aimed at describing the epidemiology of bloodstream infections and antimicrobial susceptibility pattern over a nine-year period at St. Dominic Hospital, Akwatia, in the Eastern Region of Ghana. Method. This study retrospectively analysed data from 4,489 patients who were referred to the Laboratory Department for blood culture and sensitivity testing from January 2009 to December 2017. Sociodemographic data included age, gender, and patients’ department. Blood culture results were retrieved from archival records in the laboratory. The authorities of St. Dominic Hospital granted approval for the study. Results. The incidence of bloodstream infection over the 9 years was 51.4 positive cultures per 100,000 hospital attendance. Staphylococcus aureus was the leading causative agent of bacteraemia for the first two scalar years (2009–2011 (38.9%) and 2012–2014 (42.2%)) while coagulase-negative staphylococcus (CoNS) (50.5%) was predominant for the last scalar year (2015–2017), followed by Staphylococcus aureus (169/587 (28.8%)). The highest incidence of bloodstream infections was recorded in the wet seasons (months of May (8.9 per 10,000 persons) and October (10.1 per 10,000 persons)). The bacterial isolates demonstrated high resistance to tetracyclines (390/531 (73.4%)), penicillins (1282/1669 (76.8%)), and sulphonamides (450/499 (90.2%)). Conclusion. Bloodstream infection and antimicrobial resistance are high in patients seeking healthcare in Akwatia. This therefore calls for concerted efforts aimed at reducing the incidence in the study area.

Clinical usefulness of catheter-drawn blood samples and catheter-tip cultures for the diagnosis of catheter-related bloodstream infections in neonates

2020 ◽  
Vol 41 (7) ◽  
pp. 854-856
Author(s):  
Janita Ferreira ◽  
Paulo Augusto Moreira Camargos ◽  
Viviane Rosado ◽  
Leni Márcia Anchieta ◽  
Roberta Maia de Castro Romanelli
Keyword(s):  
Adverse Events ◽  
Bloodstream Infection ◽  
Efficient Method ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Blood Sampling ◽  
Central Venous ◽  
Blood Samples ◽  
Catheter Tip ◽  
Catheter Related Bloodstream Infection

AbstractCatheter-drawn blood sampling is an efficient method of diagnosing catheter-related bloodstream infection (CRBSI) in neonates; it has greater sensitivity and accuracy than methods using catheter-tip cultures. No association was detected between catheter-drawn blood sampling and the occurrence of adverse events with central venous catheters.

scholarly journals Practices and intravascular catheter infection during on- and off-hours in critically ill patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Niccolò Buetti ◽  
Stéphane Ruckly ◽  
Jean-Christophe Lucet ◽  
Arthur Mageau ◽  
Claire Dupuis ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Intravascular Catheter ◽  
Central Venous ◽  
Night Time ◽  
Cox Models ◽  
Catheter Infection ◽  
Peripheral Arterial ◽  
Catheter Infections ◽  
Similar Risk

Abstract Background The potential relationship between intravascular catheter infections with their insertion during weekend or night-time (i.e., off-hours or not regular business hours) remains an open issue. Our primary aim was to describe differences between patients and catheters inserted during on- versus off-hours. Our secondary aim was to investigate whether insertions during off-hours influenced the intravascular catheter infectious risks. Methods We performed a post hoc analysis using the databases from four large randomized-controlled trials. Adult patients were recruited in French ICUs as soon as they required central venous catheters or peripheral arterial (AC) catheter insertion. Off-hours started at 6 P.M. until 8:30 A.M. during the week; at weekend, we defined off-hours from 1 P.M. on Saturday to 8.30 A.M. on Monday. We performed multivariable marginal Cox models to estimate the effect of off-hours (versus on-hours) on major catheter-related infections (MCRI) and catheter-related bloodstream infections (CRBSIs). Results We included 7241 patients in 25 different ICUs, and 15,208 catheters, including 7226 and 7982 catheters inserted during off- and on-hours, respectively. Catheters inserted during off-hours were removed after 4 days (IQR 2, 9) in median, whereas catheters inserted during on-hours remained in place for 6 days (IQR 3,10; p < 0.01) in median. Femoral insertion was more frequent during off-hours. Among central venous catheters and after adjusting for well-known risk factors for intravascular catheter infection, we found a similar risk between off- and on-hours for MCRI (HR 0.91, 95% CI 0.61–1.37, p = 0.65) and CRBSI (HR 1.05, 95% CI 0.65–1.68, p = 0.85). Among central venous catheters with a dwell-time > 4 or > 6 days, we found a similar risk for MCRI and CRBSI between off- and on-hours. Similar results were observed for ACs. Conclusions Off-hours did not increase the risk of intravascular catheter infections compared to on-hours. Off-hours insertion is not a sufficient reason for early catheter removal, even if femoral route has been selected.

A Multicenter Intervention to Prevent Catheter-Associated Bloodstream Infections

2006 ◽  
Vol 27 (7) ◽  
pp. 662-669 ◽  
Author(s):  
David K. Warren ◽  
Sara E. Cosgrove ◽  
Daniel J. Diekema ◽  
Gianna Zuccotti ◽  
Michael W. Climo ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Relative Rate ◽  
Femoral Vein ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Evidence Based ◽  
Process Of Care ◽  
Standard Data ◽  
Relative Ratio

Background.Education-based interventions can reduce the incidence of catheter-associated bloodstream infection. The generalizability of findings from single-center studies is limited.Objective.To assess the effect of a multicenter intervention to prevent catheter-associated bloodstream infections.Design.An observational study with a planned intervention.Setting.Twelve intensive care units and 1 bone marrow transplantation unit at 6 academic medical centers.Patients.Patients admitted during the study period.Intervention.Updates of written policies, distribution of a 9-page self-study module with accompanying pretest and posttest, didactic lectures, and incorporation into practice of evidence-based guidelines regarding central venous catheter (CVC) insertion and care.Measurements.Standard data collection tools and definitions were used to measure the process of care (ie, the proportion of non-tunneled catheters inserted into the femoral vein and the condition of the CVC insertion site dressing for both tunneled and nontunneled catheters) and the incidence of catheter-associated bloodstream infection.Results.Between the preintervention period and the postintervention period, the percentage of CVCs inserted into the femoral vein decreased from 12.9% to 9.4% (relative ratio, 0.73; 95% confidence interval [CI], 0.61-0.88); the total proportion of catheter insertion site dressings properly dated increased from 26.6% to 34.4% (relative ratio, 1.29; 95% CI, 1.17-1.42), and the overall rate of catheter-associated bloodstream infections decreased from 11.2 to 8.9 infections per 1,000 catheter-days (relative rate, 0.79; 95% CI, 0.67-0.93). The effect of the intervention varied among individual units.Conclusions.An education-based intervention that uses evidence-based practices can be successfully implemented in a diverse group of medical and surgical units and reduce catheter-associated bloodstream infection rates.

scholarly journals Influence of insertion site on central venous catheter colonization and bloodstream infection rates

2008 ◽  
Vol 34 (6) ◽  
pp. 1038-1045 ◽  
Author(s):  
John R. Gowardman ◽  
Iain K. Robertson ◽  
Scott Parkes ◽  
Claire M. Rickard
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Insertion Site ◽  
Venous Catheter ◽  
Infection Rates ◽  
Catheter Colonization ◽  
Central Venous

Catheter-related Bloodstream Infections: A Root Cause Analysis in a Series of Simultaneous Ochrobactrum anthropi Infections

2019 ◽  
Vol 20 (8) ◽  
pp. 609-614 ◽  
Author(s):  
Benedetto Caroleo ◽  
Pasquale Malandrino ◽  
Aldo Liberto ◽  
Dario Condorelli ◽  
Federico Patanè ◽  
...  
Keyword(s):  
Clinical Audit ◽  
Control Strategies ◽  
Insertion Site ◽  
Primary Source ◽  
Bloodstream Infections ◽  
Root Cause Analysis ◽  
Ochrobactrum Anthropi ◽  
Cause Analysis ◽  
Root Cause ◽  
Catheter Tip

Objective:Catheter-related bloodstream infections (CRBSIs) pathogenesis is complex and multifactorial mostly due to cutaneous microorganisms migration through the catheter insertion site and catheter tip colonization. Ochrobactrum anthropi is a gram-negative bacterium belonging to the Brucellaceae and related infections are especially observed in immunocompromised patients.Methods:Therefore, O. anthropi infection prevention and surveillance are relevant issues for healthcare system and risk management, in order to improve healthcare quality and patient safety. Four cases of anthropi-related CRBSIs occurring in immunodepressed patients under chemotherapy treatment are reported and the possible prevention and surveillance strategies are analyzed.Results:In the reported cases, all infections occurred almost simultaneously in the Oncology Unit, leading to hypothesize an identical infection source. Subsequently, a clinical audit was performed in order to investigate infection origin and implement prevention and control strategies. Clinical audit allowed to identify the hand hygiene defects as the primary source of the infections, responsible for catheter flushing solution contamination.Conclusion:The aim of this study is to reveal how through correct root cause analysis and clinical audit, several measures could be undertaken in order to promote the prevention of the CRBSIs risk

Safety of Peripheral Intravenous Catheters in Children

1999 ◽  
Vol 20 (11) ◽  
pp. 736-740 ◽  
Author(s):  
Ruth B. Shimandle ◽  
Daniel Johnson ◽  
Mark Baker ◽  
Naomi Stotland ◽  
Theodore Karrison ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Insertion Site ◽  
Intravenous Therapy ◽  
Catheter Colonization ◽  
Colony Forming Units ◽  
Catheter Sepsis ◽  
Catheter Complications ◽  
Current Guidelines ◽  
Intravenous Catheters ◽  
Catheter Replacement

AbstractObjectives:To determine the overall and per-day risk of complications of short peripheral intravenous (PIV) catheters placed for indefinite periods.Design:During 5 months, general pediatric patients receiving intravenous therapy through short PIV catheters were monitored. Patient and catheter characteristics were recorded, complications were noted, and rolled semiquantitative cultures of removed catheters were performed. Major endpoints were infection and phlebitis. Per-day risk of complications and catheter colonization (>15 colony-forming units) were calculated.Setting:University children's hospital.Patients:General pediatric ward inpatients with PIV.Results:We studied 642 Teflon catheters in place >24 hours (mean, 3.7 days) in 525 patients. There were no cases of catheter sepsis (0%; 95% confidence interval [CI95], 0%-0.6%), one possible insertion-site infection (0.2%; CI95, 0.004%-0.9%), and seven cases of phlebitis (1.1%; CI95, 0.4%-2.3%). Catheter colonization occurred in 92 (26%) of 348 catheters cultured. Neither the per-day risk of phlebitis nor of catheter colonization increased significantly with placement >3 days.Conclusion:Current guidelines recommend replacement of PIV catheters in adults within 2 to 3 days; no recommendations are made for children. Our findings and those of others indicate that the overall risk of PIV catheter complications in children is extremely low and would not be reduced substantially by routine catheter replacement.

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