Epidemiological characteristics and risk factors for patients with catheter-related bloodstream infections in intensive care unit

Abstract

To explore the epidemiological characteristics, bacterial composition and risk factors for patients with catheter-related bloodstream infection (CRBSI) in intensive care unit (ICU). A prospective survey was conduced for 2 605 ICU patients during January 2010 to December 2013. The clinical data of CRBSI and non-CRBSI patients were compared and their relevant risk factors analyzed. Among them, there were 1 773 cases of arteriovenous catheterization. And 94 cases (5.3%) had CRBSI. The 1 000-day catheter infection rate was 9.8. The mortality rates of CRBSI and non-CRBSI patients were 23.4% and 10.7% respectively. And the difference was statistically significant (χ² = 14.38, P < 0.01). The occurrence of CRBSI was a risk factor for mortality. Logistic regression analysis showed that the occurrence of CRBSI was 3.33 folds for venous catheterization time > 6 days over ≤ 6 days (95% CI: 2.04-5.56), 2.50 folds for trauma patients over non-trauma ones (95% CI: 1.49-4.17), 2.98 folds for malignant tumors patients over non-malignant tumors ones (95% CI: 1.61-5.51) and 4.32 folds for diabetics over non-diabetics (95% CI: 2.07-9.01). For different sites of arteriovenous catheterization, the occurrences of CRBSI were not statistically significant. For CRBSI patients with blood culture, the positive microorganisms were gram-negative bacteria (61.7%), gram-positive bacteria (26%) and fungi (12.3%). The occurrence of CRBSI is a risk factor for mortality. And diabetes, trauma and arteriovenous catheterization time > 6 days are risk factors for CRBSI. Comprehensive preventive measures should be taken to reduce the incidence of CRBSI.