The micro-organism responsible for central venous catheter related bloodstream infection depends on catheter site

Excerpt

Sir: Although the micro-organism responsible for central venous catheter related bloodstream infection (CVC-RBSI) have been amply reported [1, 2, 3], we have found no study reporting the micro-organism responsible according to the three catheter sites (femoral, jugular, and subclavian). We therefore analyzed this issue as a part of our recently published study [4]. In a first analysis of 1,277 CVC inserted over 18 months we found no significant differences in CVC-RBSI incidence between sites [5]. In a second analysis of 2,595 CVC inserted over 3 years we found that the incidence was higher in femoral than jugular and subclavian accesses and in jugular than subclavian access [4]. Our study was carried out in a medical-surgical intensive care unit between 1 May 2000 and 30 April 2003. We defined CVC-CRBSI according to the following criteria: a positive blood culture obtained from a peripheral vein and signs of systemic infection (fever, chills, and/or hypotension), with no apparent source of bacteremia except the catheter, and catheter-tip colonization (defined as a growth > 15 colony-forming units) with the same micro-organism than in the blood culture. Continuous variables are expressed as means with standard deviations which were compared by the Kruskall-Wallis test. Categorical variables are expressed as percentages and compared using the χ² test. A logistic regression analysis was carried out to compare the effect of insertion site on type of micro-organism responsible for bacteremias. This effect is expressed as odds ratio and 95% confidence interval. A p value less than 0.05 was considered statistically significant. …