Catheter-associated Bloodstream Infections Research Articles

COMPLICATIONS AND RISKS ASSOCIATED WITH PROLONGED PARENTERAL NUTRITION IN PEDIATRIC AND NEONATAL ICU PATIENTS: A SYSTEMATIC REVIEW

Objective: The general objective of this study is to analyze the scientific literature on the complications and risks associated with prolonged parenteral nutrition in pediatric and neonatal patients in intensive care units (ICU), aiming to ensure greater knowledge about this therapeutic practice and its clinical implications. Methodology: The searches were performed through searches in the PubMed Central (PMC) databases. Three descriptors were used in combination with the Boolean term “AND”: Parenteral Nutrition, Neonatal Intensive Care Unit and Risk Factors. A total of 101 articles were found, which were subsequently submitted to the selection criteria. After applying the inclusion and exclusion criteria, 20 studies were selected, of which 10 articles were used for detailed analysis. Results: Parenteral nutrition (PN) is essential in the care of premature newborns and critically ill pediatric patients. However, it is associated with several potential complications, including hepatobiliary, infectious, mechanical and metabolic problems such as hyperglycemia and hypertriglyceridemia. Administration of PN requires careful planning and strict safety policies to minimize risks and maximize clinical benefits. Prolonged PN can lead to serious complications, such as catheter-associated bloodstream infections, cholestasis, and liver dysfunction. Conclusion: Prolonged PN in pediatric and neonatal ICU patients is associated with significant risks that require close surveillance and preventive interventions. Continuous monitoring of glucose, triglyceride levels, and liver function, as well as rigorous infection control practices, are crucial to ensure the safety and efficacy of PN. Further studies are needed to identify management strategies that can reduce these complications and improve clinical outcomes.

Increase in PVC-BSI during the second COVID-19 pandemic year: analysis of catheter and patient characteristics.

Increasing nosocomial infections during the COVID-19 pandemic have been reported. However, data describing peripheral venous catheter associated bloodstream infections (PVC-BSI) are limited. To describe the epidemiology and risk factors for PVC-BSI during the COVID-19 pandemic. We conducted retrospective cohort study of prospectively collected PVC-BSI data in a 2100 bed hospital network in Switzerland. Adult patients with a PVC inserted between January 1, 2020 and December 31, 2021 were included. Risk factors for PVC-BSI were identified through descriptive analysis of patient and catheter characteristics, and univariable marginal Cox models. 206,804 PVCs and 37 PVC-BSI were analysed. Most PVC-BSI were attributed to catheters inserted in the Emergency department (76%) or surgical wards (22%). PVC-BSI increased in 2021 compared to 2020 (hazard ratio 2021 vs. 2020 = 2.73; 95% confidence interval 1.19-6.29), with a numerically higher rate ofStaphylococcus aureus (1/10, 10%, vs. 5/27, 19%) and polymicrobial infection (0/10, 0% vs. 4/27, 15%). PVC insertions, patient characteristics, and catheter characteristics remained similar across the study period. PVC-BSI risk was associated with admission to the intensive care unit (ICU), and use of wide gauge catheter ( < = 16G). Increased PVC-BSI during the COVID-19 pandemic was not explained by catheter or patient factors alone, and may result from system-wide changes. PVC-BSI events are primarily attributed to acute care settings, including the emergency department, surgical wards, and the ICU.

Trends in surveillance indicators for central catheter-associated bloodstream infections in a tertiary hospital in Switzerland

Central line-associated bloodstream infections (CLABSI) are associated with relevant morbidity and mortality. Longitudinal dynamics in CLABSI incidence and the spectrum of causative microorganisms are limited. We aimed to describe trends in CLABSI incidence, use of central lines, and causative pathogens. We analysed prospectively collected data on CLABSI at a Swiss tertiary care hospital between January 2016 and December 2023. We investigated longitudinal changes of incidence densities, catheter utilization and causative pathogens. A total of 707 CLABSI were observed, corresponding to an incidence density of 1.69 (95% CI 1.56 - 1.81) CLABSI per 1000 catheter-days. There was no significant trend of CLABSI incidence density per 1000 catheter-days (z=0.86, P=0.391), but an increase of catheter utilization ratio (z=8.88, P<0.001). Coagulase-negative staphylococci (CNS) (n=207, 23.4%) and Enterococcus spp. (n=134, 15.2%; E. faecium n=94, 10.6%; E. faecalis n=37, 4.1%; other Enterococcus spp. n=3, 0.34%) were the most frequent causative pathogens. Over the years, the proportion of Enterococcus spp. (z=3.4, P<0.001), driven by an increase of E. faecium (z=3.2, P=0.001), and yeast (z=2.3, P=0.020) increased, whereas CNS decreased (z=-6.1, P<0.001). Prospective CLABSI surveillance indicated stable incidence densities per 1000 catheter-days, but there were significant shifts of causative microorganisms over time.

Microbiology of catheter-associated bloodstream infection: differences according to catheter type

ObjectivesCatheter-associated bloodstream infections (CABSI) cause preventable morbidity. We compared the microbiological etiology of CABSI across different types of central and peripherally-inserted catheters. MethodsWe analyzed prospectively collected CABSI data in a 2100-bed hospital network in Switzerland between 2016 and 2022. We included: short-term non-tunneled central venous catheters (CVC); long-term catheters (tunneled, or peripherally-inserted central catheters); arterial catheters; dialysis catheters; and peripheral venous catheters (PVC). We used multivariable logistic regression models to describe the risk of Staphylococcus aureus and Gram-negative pathogens according to catheter type. ResultsOverall, 416 CABSI episodes were included, including 60 episodes of S. aureus and 92 episodes of Gram-negative CABSI. Microbiological profiles differed between catheter types. Together, PVC and dialysis catheters accounted for 43/60 (72%) of all S. aureus CABSI. After adjusting for age, sex, and hematology/oncology care, the odds of S. aureus were higher for hemodialysis catheters (odds ratio [OR] 17.3, 95% confidence interval [CI] 5.75-52.2, P <0.01) and PVC (OR 2.96, 95% CI 1.22-7.20, P = 0.02) compared to short-term non-tunneled CVC. Odds of Gram-negative organism as the cause of CABSI were higher in long-term catheters versus short-term non-tunneled CVC (OR 2.70, 95% CI 1.37-5.24). ConclusionsCABSI in catheters other than short-term non-tunneled CVC is more commonly caused by virulent organisms including S. aureus and Gram-negative bacteria. Catheter type should be considered when selecting empirical antimicrobial therapies.

ThP8.5 - The Incidence and Characteristics of Complications Associated with Peripherally Inserted Central Venous Catheter and Midline Utilisation in Surgical Patients: A Retrospective Cohort Study

Abstract Background Peripherally inserted Central venous catheters (PICC lines) and midlines are pervasive clinical interventions. However, they are not devoid of adverse events such as catheter-associated thrombosis, mechanical anomalies, catheter-related bloodstream infections, and cellulitis. This study aims to investigate the nature and prevalence of these complications within a high-volume tertiary care centre. Methods A retrospective cohort study was conducted, including 473 patients subjected to PICC line and midline insertion within the Department of General Surgery during the period from June 2022 to June 2023. Results Over 5949 catheter days, a total of 73 complications were identified, reflecting an incidence rate of 15.43% (12.27 per 1000 catheter days). Notably, catheter-associated infections were predominant, manifesting at a rate of 4.20 per 1000 catheter days (n=25, 5.20%). Accidental withdrawal occurred at a rate of 3.87 per 1000 catheter days (n=23, 4.86%), incorrect positioning at 2.02 per 1000 catheter days (n=12, 2.54%), occlusion at 1.51 per 1000 catheter days (n=9, 1.90%), and rupture at 0.67 per 1000 catheter days (n=4, 0.84%). Conclusion The insertion of PICC and midline is associated with a substantial burden of morbidity, primarily characterised by catheter-associated infections. Emphasis on early identification of catheter-associated bloodstream infections is imperative. Mitigating these complications warrants the institution of a multidisciplinary educational initiative to augment nursing proficiency, coupled with the implementation of a local guideline governing PICC line and midline insertion and care.

The incidence of catheter-related bloodstream infections in different central venous access devices: a network meta-analysis of randomized controlled trials

IntroductionDirect paired meta-analyses and network meta-analysis were conducted to compare the incidence of Catheter-associated bloodstream infections (CRBSIs) in different types of central venous access devices (CVADs).Material and methodsThe PubMed, EMBASE, Web of Science, Cochrane databases, CNKI and CBM were systematically searched from inception to May 31, 2024 for randomized controlled trials (RCTs) comparing the incidence of CRBSIs across various types of CVADs. Literature screening, data extraction, and risk bias evaluation were all independently conducted by two individuals. Direct paired meta-analyses and network me-ta-analysis were performed using RevMan5.3 and Stata14.0 software, respectively.ResultsA total of five literatures were included. Paired meta-analyses revealed that the incidence of CRBSIs was lower in the peripherally inserted central catheters (PICCs) group compared to the central venous catheters(CVCs) group(RR=0.23, 95%CI(0.13-0.43), P&lt;0.00001). The incidence of CRBSIs in PICCs group was observed to be lower compared to that in totally implantable venous access ports(TIVAPs) group (RR=0.45, 95%CI(0.23-0.87), P=0.02). Descriptive analysis revealed a higher incidence of CRBSIs in CVCs group compared to the TIVAP group (RR=2.97, 95%CI(1.65-5.17), P=0.0002). The network meta-analysis revealed a significantly lower incidence of CRBSIs in the PICCs group compared to the CVCs group. However, no statistically significant differences were observed in other comparisons. Based on the cumulative ranking curve test, the incidence of CRBSIs in various CVADs was ranked as follows: PICCs(97.20%)&gt; TIVAPs(50.00%)&gt;CVCs(2.80%).ConclusionsThe available evidence suggests that PICCs exhibit the lowest incidence of CVADs, followed by TIVAPs. Therefore, PICCs should be prioritized when selecting CVADs.

Factors Influencing Central Venous Catheter-Associated Bloodstream Infections in COVID-19 Patients

During the pandemic of COVID-19, the rates of bloodstream infection associated with venous catheter in patients infected with the disease admitted to an intensive care unit rose significantly. In this study, we evaluated the occurrence of bloodstream infections in patients with SARS-CoV-2 and the variables that made the patients more susceptible to the catheter-associated bloodstream infection (CABSI). Blood culture results from patients interned between March 2020 and December 2021 (n= 109) were collected electronically from the hospital information system and then analyzed. The following variables presented statistical relevance after an adjusted model as follows: obesity (p = 0.003) and time of use of catheter before infection (p = 0.019). In conclusion, patients with shorter catheter use time and obesity had higher incidence of CABSI.

Catheter-Associated Bloodstream Infection: a Clinical Overview of Events and Outcomes

Catheter-Associated Bloodstream Infection: a Clinical Overview of Events and Outcomes

Peculiarities of clabsi in oncologic hospitals

Currently, healthcare-associated infections (HAIs) are one of the most dangerous complications for hospitalized patients. The economic damage caused by HCAI in the Russian Federation annually is about 15 billion rubles; in addition, HCAI occupy the tenth place among the causes of mortality of the population. Catheter-associated bloodstream infection holds the leading place in the structure of ISMP morbidity. The concept of CVC-AIC (catheter-associated bloodstream infections or CLABSI), in turn, is included in CAIC. Purpose of the study. To analyze the current literature data of domestic and foreign authors for the years 2012-2022 concerning CAIC in patients of oncologic hospitals with CVCs, including subcutaneous central venous port catheters. Material and Methods. A review of 38 literature sources for the last 10 years was performed, including current information on catheter-associated bloodstream infections, measures to prevent them, and modern treatment approaches. Results. The studies have shown that the combination of drug resistance in microorganisms and immunity reduction in cancer patients, which occurs against the background of chemotherapy, makes them a risk group for the development of CAICs and episodes of their recurrence. Ensuring epidemiological safety of bloodstream catheterization in such patients is an important step in the prevention of CAIC. This is one of the priority tasks of oncoepidemiology today. Conclusion. The leading role in the occurrence of catheter-associated bleeding plays the term of catheterization and the condition of the patient, his age, stage of cancer development and concomitant chronic diseases. One of the most vulnerable risk groups are cancer patients from hemoblastosis chemotherapy and bone marrow and hematopoietic stem cell transplantation units. This may be due to the use of immunosuppressant drugs to suppress graft rejection, which significantly reduce patients' immunity. According to the results of studies, infection with drug-resistant Gram-negative microorganisms, including multidrug-resistant ones, is prevalent in cancer patients with CAIC. When using povidone iodine, there is a tendency to decrease the incidence of CAIC, but the use of chlorhexidine alcohol solution showed better results. A direct correlation was observed between the use of surgically implanted intravascular devices for long-term function and a lower incidence of CAIC, particularly in pediatric oncology.

Surveillance of catheter-associated bloodstream infections: development and validation of a fully automated algorithm

BackgroundMost surveillance systems for catheter-related bloodstream infections (CRBSI) and central line-associated bloodstream infections (CLABSI) are based on manual chart review. Our objective was to validate a fully automated algorithm for CRBSI and CLABSI surveillance in intensive care units (ICU).MethodsWe developed a fully automated algorithm to detect CRBSI, CLABSI and ICU-onset bloodstream infections (ICU-BSI) in patients admitted to the ICU of a tertiary care hospital in Switzerland. The parameters included in the algorithm were based on a recently performed systematic review. Structured data on demographics, administrative data, central vascular catheter and microbiological results (blood cultures and other clinical cultures) obtained from the hospital’s data warehouse were processed by the algorithm. Validation for CRBSI was performed by comparing results with prospective manual BSI surveillance data over a 6-year period. CLABSI were retrospectively assessed over a 2-year period.ResultsFrom January 2016 to December 2021, 854 positive blood cultures were identified in 346 ICU patients. The median age was 61.7 years [IQR 50–70]; 205 (24%) positive samples were collected from female patients. The algorithm detected 5 CRBSI, 109 CLABSI and 280 ICU-BSI. The overall CRBSI and CLABSI incidence rates determined by automated surveillance for the period 2016 to 2021 were 0.18/1000 catheter-days (95% CI 0.06–0.41) and 3.86/1000 catheter days (95% CI: 3.17–4.65). The sensitivity, specificity, positive predictive and negative predictive values of the algorithm for CRBSI, were 83% (95% CI 43.7–96.9), 100% (95% CI 99.5–100), 100% (95% CI 56.5–100), and 99.9% (95% CI 99.2–100), respectively. One CRBSI was misclassified as an ICU-BSI by the algorithm because the same bacterium was identified in the blood culture and in a lower respiratory tract specimen. Manual review of CLABSI from January 2020 to December 2021 (n = 51) did not identify any errors in the algorithm.ConclusionsA fully automated algorithm for CRBSI and CLABSI detection in critically-ill patients using only structured data provided valid results. The next step will be to assess the feasibility and external validity of implementing it in several hospitals with different electronic health record systems.

Analysis of Risk Factors for Peripherally Inserted Central Venous Catheter-Associated Bloodstream Infection

Purpose: Despite guidelines on the prevention of central venous line-associated bloodstream infection, it is left to the clinical judgment of the attending physician to determine the risk of infection and how long a central line should remain in place. This study aimed to identify risk factors for peripherally inserted central venous catheter (PICC)-associated infection.Methods: This retrospective study included 1,136 patients with a PICC who were hospitalized at the National Health Insurance Service Ilsan Hospital (January 2015 to January 2022). Electronic medical records were reviewed for patients with positive blood cultures. Patients with suspicion of infection at the PICC insertion site or with unclear infection at other sites were defined as having a PICC-associated infection.Results: Thirty-five patients (3.08%) had a PICC-associated infection. There were significant differences in hypertension (&lt;i&gt;p&lt;/i&gt; = 0.026), lung disease (&lt;i&gt;p&lt;/i&gt; = 0.001), PICC duration &gt; 14 days, and antibiotic use before PICC insertion (&lt;i&gt;p&lt;/i&gt; = 0.016) between no PICC-associated infection, and infection in the bloodstream. Total parenteral nutrition with PICC was not significantly different between groups. Logistic regression analysis identified hypertension, lung disease, PICC duration &gt; 14 days (OR 2.088, 95% CI 1.032-4.224, &lt;i&gt;p&lt;/i&gt; = 0.041), and antibiotic use before PICC insertion (OR 0.159, 95% CI 0.049-0.515, &lt;i&gt;p&lt;/i&gt; = 0.002) as independent risk factors for PICC-associated infection.Conclusion: The study suggested that PICCs maintained longer than 14 days is a risk factor for PICC-associated infection. Antibiotic use prior to PICC insertion was observed as a negative factor for PICC-associated infection.

Risk factors for catheter-associated bloodstream infection in hemodialysis patients: A meta-analysis.

This meta-analysis aimed to elucidate the risk factors contributing to catheter-associated bloodstream infection in hemodialysis patients. Comprehensive literature searches were conducted in both English and Chinese databases, which encompassed PubMed, Cochrane Library, Embase, CNKI, Wanfang Data, VIP Database and China Biomedical Literature Database. The search timeframe extended from each database's inception to March 8, 2023. Two independent researchers executed literature screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Statistical analysis of the data was performed using RevMan 5.3 software, facilitating the identification of significant risk factors associated with catheter-related bloodstream infections in hemodialysis patients. This meta-analysis is registered with PROSPERO under the registration number CRD42023406223. Forty-nine studies were incorporated into this meta-analysis, from which 22 risk factors were examined. Through the analysis, 17 risk factors exhibited statistical significance (P < 0.05): age (OR = 1.52, 95% CI [0.49, 4.68]), diabetes (OR = 2.52, 95% CI [1.95, 3.25]), kidney disease (OR = 3.45, 95% CI [1.71, 6.96]), history of catheter-associated infection (OR = 2.79, 95% CI [1.96, 3.98]), hypertension (OR = 1.43, 95% CI [1.08, 1.91]), dialysis duration (OR = 3.06, 95% CI [1.70, 5.50]), catheter placement site (OR = 1.91, 95%CI [1.35, 2.70]), catheter duration (OR = 2.06, 95% CI [1.17, 3.60]), number of catheterizations (OR = 4.22, 95% CI [3.32, 5.37]), catheter types (OR = 3.83, 95% CI [2.13, 6.87]), CD4+ cells (OR = 0.33, 95% CI [0.18, 0.63]), albumin (ALB, OR = 2.12, 95% CI [1.15, 3.91]), C-reactive protein (CRP, OR = 1.73, 95% CI [1.47, 2.03]), hemoglobin (Hb, OR = 1.48, 95% CI [0.54, 4.07]), procalcitonin (PCT, OR = 1.05, 95% CI [1.03, 1.06]), inadequate hand hygiene (OR = 5.32, 95% CI [1.07, 26.37]), and APACHE II scores (OR = 2.41, 95% CI [1.33, 4.37]). This meta-analysis suggests that age, diabetes, kidney disease, history of catheter-associated infection, hypertension, dialysis duration, catheter placement site, catheter duration, number of catheterizations, catheter type, CD4+ cells, albumin, C-reactive protein, hemoglobin, procalcitonin, inadequate hand hygiene, and APACHE II scores significantly influence the incidence of catheter-associated bloodstream infection in hemodialysis patients.

Incidence of Catheter-Associated Bloodstream Infections in Stem Cell Recipients-Should We Be "PICCy"?

The management of patients undergoing HSCT requires a multipurpose central venous catheter. Peripheral catheters (PCs), such as peripherally inserted central catheters (PICCs) and MidLine catheters (MLCs), appear to be adequate vascular catheters to be used for stem cell infusion, although their utilization in this indication is not yet common. We analyzed the infectious complications such as blood stream infection (BSI), febrile neutropenia (FN) and central line-associated bloodstream infection (CLBSI) in patients undergoing stem cell infusion through PC and conventionally inserted central catchers (CICCs), and evaluated their impacts on transplantation outcomes. Our results reveal no statistically significant differences between different types of catheter in terms of FN, BSI and CLABSI. Moreover, transplantation outcomes were comparable between the groups. Interestingly, according to our data, there were no differences in terms of abovementioned infectious complications between individuals who received antibiotic prophylaxis and those who did not. Our study has shown that infection complications are independent of the intravenous device and antibiotic prophylaxis. Considering that PCs are not associated with life-threatening complications, they should be considered more frequently in the stem cell transplantation setting.

Risk factors for arterial catheter failure and complications during critical care hospitalisation: a secondary analysis of a multisite, randomised trial

ObjectivesArterial catheters (ACs) are critical for haemodynamic monitoring and blood sampling but are prone to complications. We investigated the incidence and risk factors of AC failure.MethodsSecondary analysis of a multi-centre randomised controlled trial (ACTRN 12610000505000). Analysis included a subset of adult intensive care unit patients with an AC. The primary outcome was all-cause device failure. Secondary outcomes were catheter associated bloodstream infection (CABSI), suspected CABSI, occlusion, thrombosis, accidental removal, pain, and line fracture. Risk factors associated with AC failure were investigated using Cox proportional hazards and competing-risk models.ResultsOf 664 patients, 173 (26%) experienced AC failure (incidence rate [IR] 37/1000 catheter days). Suspected CABSI was the most common failure type (11%; IR 15.3/1000 catheter days), followed by occlusion (8%; IR 11.9/1,000 catheter days), and accidental removal (4%; IR 5.5/1000 catheter days). CABSI occurred in 16 (2%) patients. All-cause failure and occlusion were reduced with ultrasound-assisted insertion (failure: adjusted hazard ratio [HR] 0.43, 95% CI 0.25, 0.76; occlusion: sub-HR 0.11, 95% CI 0.03, 0.43). Increased age was associated with less AC failure (60–74 years HR 0.63, 95% CI 0.44 to 0.89; 75 + years HR 0.36, 95% CI 0.20, 0.64; referent 15–59 years). Females experienced more occlusion (adjusted sub-HR 2.53, 95% CI 1.49, 4.29), while patients with diabetes had less (SHR 0.15, 95% CI 0.04, 0.63). Suspected CABSI was associated with an abnormal insertion site appearance (SHR 2.71, 95% CI 1.48, 4.99).ConclusionsAC failure is common with ultrasound-guided insertion associated with lower failure rates.Trial registration Australian New Zealand Clinical Trial Registry (ACTRN 12610000505000); date registered: 18 June 2010.

Prevention of catheter-associated bloodstream infections and care of central venous catheter (CVC)

To address the spread of pathogenic agents and minimize the risk of infection, it is essential to apply measures for proper antiseptic treatment of the surgical site prior to an invasive medical procedure to effectively reduce the incidence of surgical site infection and associated complications. Knowledge of the concepts and standards for the use of antiseptic and disinfectant agents helps health care providers to effectively prevent the spread of infectious agents and provides a scientific basis for their rational use. Research on the mechanisms of action of antiseptics has not only scientific but also practical importance for nurses and clinicians, which is related to more effective use of these drugs in professional activities and potential development of new promising compounds and their combinations.

Factors associated with the disinfection of devices attached to peripheral intravenous catheters performed by the nursing team in pediatric units.

Peripheral intravenous catheterization, as well as drug administration through it, represents one of the most performed procedures by the Nursing team and, for that, precautions need to be adopted to offer harm-free care. To verify the association of Nursing professionals' work shift and training time with proper disinfection of intravenous catheter devices in pediatric units. A cross-sectional and analytical study conducted between June and August 2021 in three hospitalization units of a Pediatric Hospital. The inclusion criterion was drug administration via peripheral intravenous catheters performed by Nursing professionals. The data were analyzed according to inferential statistics, adopting p ≤ .05 as significance level. There were a total of 385 observations of drug administration procedures. The device was not disinfected in 60.3% of the cases, there was no friction at the suitable time in 86.3%, and the disinfectant was not allowed to dry in 72.5%. The work shift exerted no influence on performance of the disinfection procedure (p = .376). However, longer training time was associated with a lower rate in performing such procedure (p < .001). Performing friction below the recommended time can cause a false sense of prevention of catheter-associated bloodstream infection; therefore, training sessions and strategies for adherence to the disinfection procedures should be considered, mainly for professionals with more training time.

Prevention of Catheter-Associated Bloodstream Infections in Hemodialysis Patients

This study aimed to assess the efficacy of preventive measures against catheter-associated bloodstream infections in hemodialysis patients. Seventy patients undergoing hemodialysis treatment at our hospital from January 2020 to January 2023 were recruited and randomly assigned in a 1:1 ratio to receive either conventional nursing (control group) or targeted preventive nursing (observation group), with 35 cases in each group. Outcome measures for nursing effects assessment included nursing outcomes, the incidence of catheter-related bloodstream infections, patient stress, and quality of life. Targeted preventive nursing demonstrated a significantly lower incidence of catheter-related bloodstream infection and adverse catheter events compared to conventional care (P &lt;0.05). Moreover, targeted preventive nursing significantly reduced catheter retention duration in comparison to conventional care (P &lt;0.05). The higher quality of nursing associated with targeted preventive nursing was evident in the elevated nursing quality scores (P &lt;0.05). Patients who underwent targeted preventive nursing exhibited milder stress compared to those receiving routine care, as indicated by lower hemodialysis stress scale (HSS) scores (P &lt;0.05). Furthermore, the observation group, receiving targeted preventive nursing, reported higherWorld Health Organization quality of life (WHOQOL-BREF) scores than the control group, suggesting an improved quality of life (P &lt;0.05). Targeted preventive care for catheter-associated bloodstream infections in hemodialysis patients not only fortifies the rigor and standard of care but also effectively reduces the infection rate, shortens catheter retention time, alleviates patient stress, and enhances their overall quality of care and survival.

Catheter-associated Bloodstream Infection in Children with Tunneled Central Venous Catheters: A Single-center Experience.

Tunnelled catheters improve venous access in haematological diseases and malignancies, but are associated with complications. We prospectively analysed the episodes of CABSI and its associated risk factors. To study the incidence and risk factors for CABSI in children with tunnelled central venous catheters (both Hickmans and Chemoports). This is a prospective observational study done at our institute. Children under the age of 18 who underwent insertion of a Hickman or Chemoport from March 2018 to Dec 2022 were enrolled. Episodes of CABSI were noted and its risk factors were analysed. In total, 258 catheters were inserted in 250 children. Age ranged from 1 month to 18 years (median 67 months) with 60% being boys. A total of 152 Hickmans, 106 chemoports were inserted. Indications for insertions were for requirement of BMT and chemotherapy in majority of cases. CABSI were seen in 28.6% of catheters. Younger children (< 4years), Neutropenia (counts < 1000) and use of TPN were significantly associated with CABSI(p value<0.05). Infection was more with externalized catheters (Hickman) than implantable ports (Chemoports) but was not statistical significant(p value>0.05). Almost 30% of catheters with CABSI required removal because of florid sepsis. Others could be salvaged with aggressive antibiotics. CABSI is a serious complications related to tunnelled catheter. Smaller children (<4 years), neutropenia and usage of TPN is a risk factor for development of CABSI. It can be treated with appropriate antibiotics and required removal in almost a third of all the cases.

Effectiveness of nanoparticle-based antimicrobial agents in the prevention and treatment of Central Venous Catheter-Associated Bloodstream Infections

Background In healthcare settings, Central Venous Catheter-Associated Bloodstream Infections (CVC-BSIs) present a serious problem since they raise morbidity, mortality, and medical expense rates. The management of these illnesses is made more challenging by the development of antimicrobiotic resistance. Nanotechnology has attracted interest recently as a viable method for creating new antimicrobial agents. By putting antibacterial nanomaterials onto the catheter’s appear, that may reduce the likelihood of getting sick by stopping germs from adhering and growing. Antimicrobial additives can be released gradually finishes, protecting over time through bioengineering sectors. To prevent and treat CVC-BSIs, this study will assess the efficacy of antimicrobial medicines based on nanoparticles. Methods In the network Meta-Analyses (MA) and Systematic Review (SR), we looked for studies published from January 2010 to September 2021 using the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, CINAHL, and Web of Science databases. Ten papers in all were included in the review following the screening of the publications using inclusion and exclusion criteria. Results In contrast to conventional catheters, the implementation of Antimicrobial Catheters (AC) and the use of chlorhexidine (CHG) or Silver Sulfadiazine (SS) demonstrated notably reduced occurrences of Central Venous Catheter-Associated Bloodstream Infections (CVC-BSIs) per 1000 Catheter Days (CD) (with Odds Ratios (ORs) and 95% Credibility Intervals (CrIs) of 0.66 and 0.54, respectively) by bioengineering sectors. Moreover, these interventions were linked to the lowest rate of Catheter Colonization (CC), with ORs as well as 95% CrIs of 0.45 and 0.31, respectively, underscoring their potential as effective strategies for minimizing the risk of infections associated with catheter use as well as bioengineering sectors innovations. Conclusions As a result, CVC-BSI has shown significant promise for prevention and treatment with nanoparticle-based antimicrobial medicines. Due to their special characteristics and modes of action, they are strong candidates for improving the security and effectiveness of central venous catheter use in clinical settings. Due to ongoing research and development in this area, nanoparticle-based coatings and therapies may be used to lessen the impact of CVC-BSIs and enhance patient outcomes.

Epidemiology and antimicrobial resistance trends of Acinetobacter species in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data.

Acinetobacter spp., in particular A. baumannii, are opportunistic pathogens linked to nosocomial pneumonia (particularly ventilator-associated pneumonia), central-line catheter-associated blood stream infections, meningitis, urinary tract infections, surgical-site infections, and other types of wound infections. A. baumannii is able to acquire or upregulate various resistance determinants, making it frequently multidrug-resistant, and contributing to increased mortality and morbidity. Data on the epidemiology, levels, and trends of antimicrobial resistance of Acinetobacter spp. in clinical settings is scarce in the Gulf Cooperation Council (GCC) and Middle East and North Africa (MENA) regions. A retrospective 12-year analysis of 17,564 non-duplicate diagnostic Acinetobacter spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010-2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET. Species belonging to the A. calcoaceticus-baumannii complex were mostly reported (86.7%). They were most commonly isolated from urine (32.9%), sputum (29.0%), and soft tissue (25.1%). Resistance trends to antibiotics from different classes during the surveillance period showed a decreasing trend. Specifically, there was a significant decrease in resistance to imipenem, meropenem, and amikacin. Resistance was lowest among Acinetobacter species to both colistin and tigecycline. The percentages of multidrug-resistant (MDR) and possibly extensively drug-resistant (XDR) isolates was reduced by almost half between the beginning of the study in 2010 and its culmination in 2021. Carbapenem-resistant Acinetobacter spp. (CRAB) was associated with a higher mortality (RR: 5.7), a higher admission to ICU (RR 3.3), and an increased length of stay (LOS; 13 excess inpatient days per CRAB case), as compared to Carbapenem-susceptible Acinetobacter spp. Carbapenem-resistant Acinetobacter spp. are associated with poorer clinical outcomes, and higher associated costs, as compared to carbapenem-susceptible Acinetobacter spp. A decreasing trend of MDR Acinetobacter spp., as well as resistance to all antibiotic classes under surveillance was observed during 2010 to 2021. Further studies are needed to explore the reasons and underlying factors leading to this remarkable decrease of resistance over time.