Incidence of central venous and Foley’s catheter related bacteraemia, organisms responsible and antibiotic sensitivity pattern: in cardio-thoracic intensive theraputic unit following elective surgery, in a tertiary care hospital of Kolkata, India

Abstract

Background: Mortality from bacteraemia related to indwelling Central Venous Pressure (CVP) lines could be as high as 12 - 25% and that due to indwelling urinary catheters about 5%, in critically ill patients. Hence, initiation of early and aggressive antibiotic therapy, often even before the culture- sensitivity reports are available is necessary. Objectives of the study was to find out the incidence of bacteraemia related to indwelling CVP catheters &/or Foley’s catheters in post operative patients in Cardio-thoracic Intensive Theraputic Unit (ITU) and to understand the antibiotic sensitivity patterns against the organisms causing such bacteraemiaMethods: 48 hours after their insertion, CVP catheter tips, Foley’s catheter tips and Peripheral blood samples were collected for cultures in 50 patients who underwent elective cardiothoracic surgery, over a period of one year and results were interpreted.Results: Incidence of bacteraemia associated with indwelling CVP catheters was 8% and was caused by both - Gram positive (Staphylococcus aureus, Enterococcus faecium) and Gram negative (Acinetobacter baumanii, Pseudomonas aeruginosa) organisms. Foley’s catheter was not related to such blood stream infection. Vancomycin and Linezolid were effective against the Gram positive organisms; while Piperacillin- Tazobactam, Meropenem, Polymyxin B and Colistin were effective against the Gram negative organisms.Conclusions: Indwelling CVP catheters were associated with blood stream infection in 4 post operative patients in our ITU. An idea about the organisms responsible, as well as their antibiogram may help in early initiation of antibiotics empirically before culture-sensitivity reports are available.