Highlights
- •CVC-BSIs constitute a burden to high risk patients in non-ICU settings in UHG.
- •Outcome; no mortality.
- •Tunnelled line-BSIs are dominant CVC-BSIs.
- •Gram negative bacilli are predominating isolates.
- •First 2 weeks after line insertion a high risk of developing BSI.
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.
Keywords
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Article info
Publication history
Published online: August 07, 2019
Accepted:
July 7,
2019
Received in revised form:
July 4,
2019
Received:
May 6,
2019
Identification
Copyright
© 2019 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.
