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Prevention of Central Venous Catheter–Related Bloodstream Infections Using Non-Technologic Strategies

Published online by Cambridge University Press:  02 January 2015

Silvia Acosta Gnass ,
Luisa Barboza ,
Dafne Bilicich ,
Pablo Angeloro ,
Walter Treiyer ,
Silvia Grenóvero  and
Juan Basualdo
Silvia Acosta Gnass*
Affiliation:
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina
Luisa Barboza
Affiliation:
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina
Dafne Bilicich
Affiliation:
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina
Pablo Angeloro
Affiliation:
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina
Walter Treiyer
Affiliation:
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina
Silvia Grenóvero
Affiliation:
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina
Juan Basualdo
Affiliation:
Sanatorio Adventista del Plata and Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin, Entre Rios, Argentina
*
Sanatorio Adventista del Plata, Control de Infecciones, 25 de Mayo 255, 3103 Libertador San Martin, Entre Rios, Argentina
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Abstract

Objective:

To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them.

Design:

This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from April 1997 to December 2001.

Setting:

The medical–surgical ICU of a tertiary-care, university-affiliated hospital in Argentina.

Methods:

We studied all patients admitted to the ICU using non-impregnated CVCs. Maximal sterile barrier precautions (ie, use of cap, mask, sterile gown, sterile gloves, and large sterile drape), strict handwashing, preparation of the patients' skin with antiseptic solutions, insertion and management of catheters by trained personnel, and continuing quality improvement programs aimed at appropriate insertion and maintenance of catheters were employed.

Results:

During the study period, 2,525 patients were admitted to the ICU. Eight hundred sixty-eight patients had 1,037 CVCs inserted. The number of CVC-related bloodstream infections (BSIs), acquired in the ICU, was 2.7 per 1,000 CVC-days (13 nosocomial CVC-related BSIs during 4,770 days of CVC use). Microorganisms isolated included methicillin-susceptible Staphylococcus aureus (n = 6), methicillin-resistant S. aureus (n = 2), coagulase-negative methicillin-resistant Staphylococcus (n = 2), Escherichia coli (n = 1), Klebsiella pneumoniae (n = 1), and Enterobacter cloacae (n = 1).

Conclusions:

A low rate of catheter-related BSI was achieved without antimicrobial-impregnated catheters. The incidence of CVC-associated bacteremias corresponded to the 10th to 20th percentile range of the National Nosocomial Infections Surveillance System hospitals for the same type of ICU.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 8 , August 2004 , pp. 675 - 677
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1.Smith, RL, Meixter, SM, Simberkoff, MS. Excess mortality in critically ill patients with nosocomial bloodstream infections. Chest 1991;100:164–167.CrossRefGoogle ScholarPubMed
2.Martín, MA, Pfaller, MA, Wenzel, RP. Coagulase-negative staphylococcal bacteremia: mortality and hospital stay. Ann Intern Med 1989;110:9–16.Google Scholar
3.Haley, RW, Schaberg, DR, Von Allmen, SD, McGowan, JE JrEstimating the extra charges and prolongation of hospitalization due to nosocomial infections: a comparison of methods. J Infect Dis 1980;141:248–257.Google Scholar
4.Pittet, D, Tarara, D, Wenzel, RP. Nosocomial bloodstream infection in critically ill patients: excess length of stay, extra costs, and attributable mortality. JAMA 1994;271:1598–1601.CrossRefGoogle ScholarPubMed
5.Arnow, PM, Quimosing, EM, Brech, M. Consequences of intravascular catheter sepsis. Clin Infect Dis 1993;16:778–784.Google Scholar
6.Maki, DG. Infections due to infusion therapy. In: Bennett, JV, Brachman, PS, eds. Hospital Infections, ed. 3. Boston: Little, Brown; 1992.Google Scholar
7.Kamal, GD, Pfaller, MA, Rempe, LE, Jebson, PJ. Reduced intravascular catheter infection by antibiotic bonding: a prospective, randomized, controlled trial. JAMA 1991;265:2364–2368.Google Scholar
8.Maki, DG, Stolz, SM, Wheeler, S, Mermel, LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized controlled trial. Ann Intern Med 1997;127:257–266.Google Scholar
9.Centers for Disease Control and Prevention Working Group. Guidelines for the prevention of intravascular catheter-related infections. MMWR 2002;51(RR-10):1–26.Google Scholar
10.Hospital Infection Control Practices Advisory Committee. Guideline for prevention of intravascular device-related infections: Part II. Recommendation for the prevention of nosocomial intravascular device-related infections. Am J Infect Control 1996;24:277–293.Google Scholar
11.Armstrong, CW, Mayhall, CG, Miller, KB, et al.Prospective study of catheter replacement and other risk factors for infection of hyperalimentation catheters. J Infect Dis 1986;154:808–816.Google Scholar
12.Nelson, DB, Kien, CL, Mohr, B, Frank, S, Davis, SD. Dressing changes by specialized personnel reduce infection rates in patients receiving central venous parenteral nutrition. JPEN J Parenter Enteral Nutr 1986;10:220–222.Google Scholar
13.Faubion, WC, Wesley, JR, Khaldi, N, Silva, J. Total parenteral nutrition catheter sepsis: impact of the team approach. JPEN J Parenter Enteral Nutr 1986;10:642–645.CrossRefGoogle ScholarPubMed
14.Tomford, JW, Hershey, CO, McLaren, CE, Porter, DK, Cohen, DI. Intravenous therapy team and peripheral venous catheter-associated complications: a prospective control study. Arch Intern Med 1984;144:1191–1194.Google Scholar
15.Mermel, LA. New technologies to prevent intravascular catheter-related bloodstream infections. Emerg Infect Dis 2001;7:197–199.Google Scholar
16.Rijnders, BJ, Van Wijngaerden, E, Wilmer, A, Peetermans, WE. Use of full sterile barrier precautions during insertion of arterial catheters: a randomized trial. Clin Infect Dis 2003;36:743–748.Google Scholar
17.Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992-June 2001, issued August 2001. Am J Infect Control 2001;29:404–421.Google Scholar