Background and importance Central venous catheters (CVC) are devices used to draw blood and give treatments, including intravenous fluids and parenteral nutrition (PN). Among the side effects, bloodstream infections (BSIs) are considered to be the most severe complications, with a significant increase in morbidity and mortality.
Aim and objectives To determine the rate of catheter related bacteraemia (CRB) in hospitalised patients receiving central parenteral nutrition (CPN) and to determine the relationship to type of canalised route.
Material and methods A prospective study was conducted in a third level hospital from 1 January 2016 to 30 June 2019. All admitted patients who received CPN were included. Data registered were hospitalisation unit, type of canalised route, days with CVC and isolated microorganisms in case of infections. The infection rate used was CRB/1000 days of CVC.
Results During the study period, 525 CVC were analysed in 428 patients: 76.6% were inserted in the operation room, 18.3% in the intensive care unit (ICU) and 5.1% in the hospitalisation room. The most common access was the jugular vein (57.3%) followed by the subclavian vein (34.5%), peripherally inserted central catheter (PICC, 7.6%) and femoral vein (0.6%). A total of 143 CVC (27.2%) were removed for suspected BSIs, of which 50.3% were negative. There were 13 colonisations (2.5% of the total), 38 CRB (7.2%) and 20 positive results for central blood cultures without peripheral blood cultures (3.8%), so it was not possible to determine whether it was colonisation or CRB. Regarding location, 54.9% of the infected CVC were jugular, 35.2% subclavian and 9.9% PICC. The overall CRB rate was 6.8. Results by services were: 4.7 in surgery services, 8.2 in the ICU and 11.0 in medical services. Staphylococcus was the most common isolate (80.6%) followed by Escherichia coli and other gram negative bacteria (9.7%). There were two infections caused by Acinetobacter (2.8%) and three caused by Candida (4.2%).
Conclusion and relevance Most of CVC had been inserted in the operation room and the most common access was the jugular vein. Half of the removed CVC for suspected BSIs were negative. The CRB rate in our centre could be underestimated because peripheral blood cultures were not extracted in a high number of cases. The microorganisms isolated in this study were similar to those found in the existing literature.
References and/or acknowledgements 1. Seisdedos Elcuaz R, Conde García MC, et al. Infecciones relacionadas con el CVC en pacientes con NPT. Nutr Hosp2012 June (citado 2019 Sep 08);27:775–780.
No conflict of interest.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.