The catheter site influences in the micro-organism responsible of arterial catheter-related infection

Excerpt

Sir: Although arterial catheter-related infection (AC-RI) has been amply reported [1, 2], we have found no study reporting the micro-organisms responsible according to femoral and radial access. We therefore analyzed this as a part of our recently published study [3], such as we have lately done with central venous catheter-related infection [4]. An initial analysis of 1,231 arterial catheters inserted during 18 months revealed no significant differences in the incidence of arterial catheter-related bloodstream infections (AC-RBSI) and of arterial catheter-related local infections (AC-RLI) according to catheter site [5]. In a second analysis of 2,949 arterial catheters inserted over 3 years, however, we found that the incidence of each was higher in femoral than in radial access [3]. This analysis included patients admitted to our medical-surgical intensive care unit from 1 May 2000 to 30 April 2003 who developed AC-RI, either AC-RBSI or AC-RLI. AC-RBSI was defined 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 arterial catheter-tip colonization (defined as a growth of more than 15 cfu) with the same micro-organism as in the blood culture. AC-RLI was defined as any sign of local infection (induration, erythema, heat, pain, purulent drainage) and arterial catheter-tip colonization. Continuous variables are expressed as mean and standard deviation, and comparisons used Kruskall-Wallis's test. Categorical variables are expressed as percentages which were compared by χ² test. A logistic regression analysis was carried out to compare the effect of insertion site on type of micro-organism responsible for AC-RI. This effect is expressed as odds ratio and 95% confidence interval. A p value less than 0.05 was considered statistically significant. …