Influence of insertion site on central venous catheter colonization and bloodstream infection rates
File version
Author(s)
Robertson, Iain K
Parkes, Scott
Rickard, Claire M
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Dr. L Brochard (Editor-in-Chief)
Date
Size
269409 bytes
File type(s)
application/pdf
Location
License
Abstract
Objective To compare colonization and catheter-related bloodstream infection (CR-BSI) rates among three insertion sites (subclavian, internal jugular, femoral) used for central venous catheter (CVC) placement. Design Twenty-four-month prospective study, with relative effects analyzed by Cox proportional hazards regression. Setting Eight-bed intensive care unit. Patients Four hundred and ten critically ill patients requiring CVC placement. Measurements and results All short-term multi-lumen CVCs, including antimicrobial-coated devices, were studied with management standardized. Six hundred and five CVCs (4,040 catheter days) were analyzed. Colonization and CR-BSI incidence were, respectively, 15.1 (95% CI 13.5-21.0) and 1.8 (95% CI 1.2-4.2) per 1,000 catheter-days. Colonization was higher at the internal jugular (HR 3.64; 95% CI 1.32-10.00; p?=?0.01) and femoral (HR 5.15; 95% CI 1.82-14.51; p?=?0.004) sites than at the subclavian site. The femoral site carried a greater risk of being colonized by non-S. epidermidis species than the subclavian and internal jugular sites combined (HR 4.15; 95% CI 1.79-9.61; p?=?0.001). CVCs inserted in the Department of Emergency Medicine were more colonized than those inserted in the ICU or operating room (HR 2.66; 95% CI 1.27-5.56; p?=?0.01), and CVCs were less colonized in females than in males (HR 0.49; 95% CI 0.26-0.89; p?=?0.02). No difference in CR-BSI rates was noted between the three sites. Conclusions Colonization was lowest at the subclavian site. Regional differences exist with respect to type of pathogen isolated. Colonization was influenced by insertion location and gender. The incidence of CR-BSI was not different.
Journal Title
Intensive Care Medicine
Conference Title
Book Title
Edition
Volume
34
Issue
6
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
© 2008 Springer-Verlag. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. The original publication is available at www.springerlink.com
Item Access Status
Note
Access the data
Related item(s)
Subject
Clinical sciences