Central Venous Catheter–Associated Infection: An Experience of a High Complexity Hospital

Abstract

Abstract Background Central line–associated bloodstream infections (CLABSIs) are among the pathologies that increase mortality and morbidity in hospitalized patients with some type of device. Objective The aim of this study was to describe the clinical, microbiological, therapeutic characteristics, and economic costs associated with CLABSI. Methodology This study is a retrospective cohort study in subjects hospitalized at the Central Military Hospital of Bogotá, Colombia, describing the clinical, microbiological, and therapeutic characteristics in patients undergoing the insertion of a central venous catheter (CVC) and comparing them between subjects who did or did not develop infection. Central line–associated bloodstream infections were defined based on the criteria of the Infectious Diseases Society of America, a significant P < 0.05 was considered. Results A total of 821 patients were evaluated, of which 75 had a diagnosis of CLABSI, reaching a frequency of 9.1%. Patients with CVC infection were 12 years younger on average compared with the control group (55 vs 67 years; P = 0.001), 85.3% of the population with CVC-associated infection were men compared with 62.0% (P = 0.023) of the group without CLABSI. The CVC anatomical insertion sites with the highest proportion in both study groups were at the jugular and right subclavian levels (P = 0.001). The overall mortality of the study population was 24.6%, reaching 32% in the population with CLABSI compared with 23.9% in the control group (P = 0.254). Patients with CLABSI present higher associated costs during hospitalization (P = 0.013) and total costs (P = 0.028). Conclusions The younger population, the male sex, and the anatomical insertion of the CVC at the jugular and right subclavian levels presented a higher proportion of CLABSI. The costs associated with hospitalization and total costs were higher in the group of patients with CLABSI.