Central venous catheter-related bloodstream infections (CVC-BSI) in patients of clinically suspected septicemia.

Md Ruhul Amin Mia,Mohammad Jobayer,Shaheda Anwar,Sharmeen Ahmed,Zeenat Afroz

doi:10.3329/bmrcb.v41i2.29989

Abstract

Central venous catheter-related bloodstream infections (CVC-BSI) are associated with morbidity and mortality especially in critically ill patients. This study was performed to find out the rate of CVC-BSI and CVC colonization, causative organism and their antibiogram in patients of Intensive Care Unit (ICU) and Department of Nephrology of tertiary care hospitals. A total of 100 patients from Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) who had-CVC and clinically suspected of septicemia were included in the study. Paired CVC blood and peripheral venous blood (PVB) samples were collected from each patient and were cultured by automated blood culture method. CVC-BSI was diagnosed in 11% and CVC colonization in 43% patients by Differential time to positivity (DTP) method. Rate of CVC-BSI was 8/1000 CVC days and 11/1000 CVC days in BSMMU and DMCH respectively whereas CVC colonization rate was 32/1000 CVC days and 47.5/1000 CVC days in BSMMU and DMCH. The most common bacteria causing CVC-BSI was Klebsiella spp. (36.4%) followed by Acinetobacter spp. (27.3%), Pseudomonas spp. (18.2%) and E. coli (18.2%). Among bacteria isolated from CVC colonization majority were Pseudomonas spp. (30.23%) and Staphylococcus epidermidis (30.23%) followed by Acinetobacter spp. (27.91%), Enterococcus spp. (6.98%). Most of the isolated bacteria causing CVC-BSI were resistant to commonly used antibiotics, but showed good sensitivity to imipenem and colistin. Information about CVC-BSI, -colonization and antibiogram of this study can help to guide the selection of suitable antibiotics for empirical therapy and to improve infection control measures of the hospital.

Highlights

Intravenous catheterization is one of the most common invasive procedures among patients admitted in hospitals
Central intravenous catheter are infected with the greatest frequency[2] and central venous catheter-related bloodstream infection (CVC-BSI) is the third most frequent nosocomial infection and is a threat to patient’s safety.[3]
Among 43 bacteria isolated from CVC colonization Pseudomonas spp. were 30.23%, Staphylococcus epidermidis 30.23%, Acinetobacter spp. 27.91%, Enterococcus spp. 6.98%, Klebsiella spp and Staphylococcus aureus was 2.33% (Table III)

Summary

Introduction

Intravenous catheterization is one of the most common invasive procedures among patients admitted in hospitals. This study was designed to acquire information about the CVC-BSI rate, type of organism causing CVC-BSI and their antibiotic susceptibility pattern in tertiary care hospitals. Materials and Methods growth was present identification of the organism was done by colony morphology, Gram staining and biochemical tests This cross sectional descriptive type of study was conducted during the period of July 2011 to June 2012. 1) Positive CVC-BSI: When difference in time between CVC blood culture positivity and PVB culture positivity is ≥120 minutes and isolated organism is identical in genus, species and antibiotic susceptibility pattern.

Result

Discussion

Findings

Conclusion