Central Venous Catheter-related Blood Research Articles

Application of High-Throughput Sequencing Technology in the Pathogen Identification of Diverse Infectious Diseases in Nephrology Departments.

Objective: The purpose of this study was to explore the clinical applications of high-throughput sequencing (HTS) in the identification of pathogens in patients with urinary tract infection (UTI), peritoneal dialysis-associated peritonitis (PDAP), central venous catheter related blood infections (CRBIs), and lung infections in the nephrology department. Methods: Midstream urine samples from 112 patients with UTI, peritoneal fluid samples from 67 patients with PDAP, blood samples from 15 patients with CRBI, and sputum specimens from 53 patients with lung infection were collected. The HTS and ordinary culture methods were carried out in parallel to identify the pathogens in each sample. Pathogen detection positive rate and efficacy were compared between the two methods. Results: The pathogen positive detection rates of HTS in UTI, PDAP, CRBI, and lung infection were strikingly higher than those of the culture method (84.8% vs. 35.7, 71.6% vs. 23.9%, 75% vs. 46.7%, 84.9% vs. 5.7%, p < 0.05, respectively). HTS was superior to the culture method in the sensitivity of detecting bacteria, fungi, atypical pathogens, and mixed microorganisms in those infections. In patients who had empirically used antibiotics before the test being conducted, HTS still exhibited a considerably higher positive rate than the culture method (81.6% vs. 39.0%, 68.1% vs. 14.9%, 72.7% vs. 36.4%, 83.3% vs. 4.2%, p < 0.05, respectively). Conclusions: HTS is remarkably more efficient than the culture method in detecting pathogens in diverse infectious diseases in nephrology, and is particularly potential in identifying the pathogens that are unable to be identified by the common culture method, such as in cases of complex infection with specific pathogens or subclinical infection due to preemptive use of antibiotics.

Study of risk factors and therapeutic outcomes in Central Venous Catheter related Blood Stream infection in neonatal intensive care unit

Study of risk factors and therapeutic outcomes in Central Venous Catheter related Blood Stream infection in neonatal intensive care unit

Pantoea species-A Rare Cause of Central Venous Catheter Related Sepsis in Hemodialysis Patient

There has been a significant increase in nosocomial infections in Intensive Care Units and Oncology Department. Sepsis is a major cause of morbidity and mortality in chronic kidney disease patients. In hemodialysis patient, central venous catheter related blood stream infections are major cause for concern. Most common organisms isolated are gram positive which usually respond to antibiotics and sometimes needing catheter removal. However Pantoea species have been rarely reported as causative agent of CVC sepsis. Herein we report a case of Pantoea species causing CVC sepsis in hemodialysis patient. J Microbiol Infect Dis 2020; 10(2):103-105.

Risk factors for central venous catheter related bloodstream infection: a multicenter study of intensive care unit and haemodialysis unit

The clinical condition of the patient, type of central venous catheter (CVC), site and duration of CVC placement are the factors affecting the risk of infection. The aim of this study was to examine and find out the risk factors of CVC related blood stream infections (CVC-BSI). This cross sectional study was carried out in the Department of Microbiology and Immunology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2011 to June 2012. One hundred patients who were admitted in ICU of BSMMU and ICU and haemodialysis unit of Dhaka Medical College Hospital (DMCH) having central venous catheter, were enrolled in the study. The rate of CVC-BSI was 11% and the incidence was observed to be 11.14/1000 catheter days. Both CVC-BSI and CVC colonization were higher in trilumen than in bilumen central venous catheter. CVC-BSI rate was 12.79% in trilumen whereas there was no CVC-BSI in patient with bilumen catheter. The mean duration from CVC insertion to development of CVC-BSI was 14 days, CVC colonization was 8.41 days and noninfected CVC was 6 days. CVC-BSI and CVC colonization were most common in right femoral vein where CVC-BSI was 18.52% and CVC colonization was 59.26%, whereas no CVC-BSI was found in right internal jugular vein. Risk factors for CVC-BSI included type of CVC, site of CVC placement, duration of catheterization were not found statistically significant in this study. CVC-BSI and CVC colonization were higher in trilumen catheter and rate raised with increased duration of placement and highest number of CVC-BSI and colonization was found in right femoral vein.&#x0D; Bangladesh Med J. 2018 Jan; 47 (1): 18-21

Risk factors and microbial profile of central venous catheter related blood stream infection in medical cardiac care units, National Heart Institute, Egypt.

IntroductionCatheter related blood stream infection (CRBSI) is the main complication of central venous catheter (CVC) use. The aim of the study is to improve the safety of patients with central venous catheter in National Heart Institute (NHI) medical cardiac care units.MethodsA Prospective cohort study was conducted on one hundred and eleven cardiac patients in (NHI) cardiac care units from August 2017 to February 2018. All patients subjected to central venous catheter (CVC) in cardiac care units, NHI, were included except: 1. Patients with obvious source of infection, 2. Immunocompromised patients, 3. patients having infective endocarditis, 4. patients whose catheter was put outside NHI.ResultsNoncompliance of health care providers to care bundle elements of CVC of Centers for Disease Control and Prevention (CDC) represents a risk factor for CRBSI occurrence. Coagulase negative staphylococci was the most common isolated organism.ConclusionHealth care providers should adhere care bundle elements recommended by CDC during insertion and handling of CVC. This will in turn decrease CRBSI.

Incidence and Outcomes of Central Venous Catheter-related Blood Stream Infection in Patients with Inflammatory Bowel Disease in Routine Clinical Practice Setting.

Patients with inflammatory bowel disease (IBD) occasionally require central venous catheter (CVC) placement to support a therapeutic plan. Given that CVC can predispose patients to infection, this investigation was undertaken to assess the incidence, risk factors, and outcomes of CVC-related blood stream infection (CRBSI) in patients with IBD during routine clinical practice. Data were compiled using retrospective chart reviews of 1367 patients treated at our IBD center between 2007 and 2012 during routine clinical practice. Among the 1367 patients, 314 who had received CVC placements were included. Patients with positive blood culture were considered as "definite" CRBSI, whereas "possible" CRBSI was defined as patients in whom fever alleviated within 48 hours post-CVC without any other infection. Patients' demographic variables including age, body mass index, serum albumin, duration of CVC placement, use of antibiotics, medications for IBD, and perioperative status between CRBSI and non-CRBSI subgroups were compared by applying a multivariate Poisson logistic regression model. Among the 314 patients with CVC placement, there were 83 CRBSI cases (26.4%). The average time to the onset of CRBSI was 22.5 days (range 4-105 days). The jugular vein access was found to be the most serious risk of CRBSI (risk ratio 2.041 versus subclavian vein). All patients with CRBSI fully recovered. In this investigation, regardless of the patients' demographic features including immunosuppressive therapy, up to 30% of febrile IBD patients with CVC showed CRBSI. It is believed that CVC placement per se is a risk of CRBSI in patients with IBD.

Application of cluster care in the catheter-related bloodstream infections

Objective To explore the application value of cluster nursing care in preventing central venous catheter-related bloodstream infections. Methods 200 patients with indwelling central venous catheter in ICU were selected as the research subjects.They were randomly divided into study group and control group by digital table, 100 cases in each group.The patients in the control group received routine nursing.The patients in the study group was given cluster based nursing.The catheter site, catheterization time, infection rate were compared between two groups. Results In the study group, the rates of internal jugular vein set pipe and lock venous catheter and femoral vein set tube were 82.00%(82/100), 14.00%(14/100), 4.00%(4/100), which in the control group were 79.00% (79/100), 15.00%(15/100), 6.00%(6/100), there were no statistically significant differences(P>0.05). The set tube time of the study group was (10.36±4.67)d, which of the control group was (11.28±4.58)d, the difference was not statistically significant(χ2=1.406, P>0.05). The catheter-related bloodstream infection rate of the study group was 1.00%(1/100), which was significantly lower than 9.00%(9/100) of the control group (χ2=6.736, P=0.009). Conclusion Compared with conventional nursing mode, cluster of nursing in patients with indwelling central venous catheter can significantly reduce the incidence of central venous catheter related blood stream infections, it is an effective nursing intervention mode. Key words: Catheter insertion, central vein; Bloodstream infection, catheter; Nursing

Central venous catheter related blood stream infections in an intensive care unit from a tertiary care teaching hospital

Introduction – Central venous catheters (CVC) have become essential in the management of critically ill patients and patient who requires long-term medical care. CRBSI (Catheter Related Blood Stream Infection) is one of the most frequent and lethal complication of catheter use. The objective of this study was to determine incidence of CRBSIs and antibiotic susceptibility pattern of isolated bacteria in an ICU set up. Methods – This study was carried out in patients admitted at ICU during a 3 year period (January 2012 to December 2014). A total of 434 samples were received in the laboratory with clinical diagnosis of septicemia after central venous catheterization. Semi quantitative method (roll-plate) was used for catheter tip culture. Peripheral blood cultures were obtained and were processed by standard methods. Results – Out of 434 catheters a total of 256 (59%) catheter tips were colonized. Staphylococcus aureus (42%) were most common colonizers followed by Enterobacteriaceae family, gram negative non-fermenters and Candida albicans. Incidence of CRBSI was 7.8% (33/434) or 9.5 per 1000 catheter days. Staphylococcus aureus was the major (63%) cause of CRBSI followed by Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli. MRSA rate was 76%. All the Acinetobacter baumannii and 33% Pseudomonas aeruginosa were MDR. All the Escherichia coli and Klebsiella pneumoniae were ESBL producers with 33% Klebsiella pneumoniae being MDR. Discussion - Since CVCs are increasingly being used in the critical care and have direct bearing on the mortality and morbidity, regular microbiological surveillance need to be undertaken to prevent complication.

Effectiveness of Self Instructional Module on Central Venous Catheter Care among ICU Nurses

Central venous catheters are often used as mandatory devices when caring critically ill patients. Catheter-related blood stream infections are associated with significantly increased morbidity, mortality, and expenditures. Despite technological advances, an estimated 250,000 catheter related blood stream infections occur annually. Advanced practice nurses possess the power to influence catheter-related line infections in their critical care units. Understanding current recommendations for catheter material selection, site selection, site preparation, and site care can affect rates of catheter-related bloodstream infections 3 . Central venous catheterization can be lifesaving but is associated with complication rates of approximately 15%. 10 A study done at Escort Heart Centre, New Delhi shows that mortality due to central venous catheter related blood stream infection was 22.9% as compared with 0.2% in non central venous catheter related blood stream infection 11 . Many Studies shows that education of nurses and proper care of central venous catheters can reduces infection rates by 41 to 66% in adult ICUs. Hence, this study was aimed to determine effectiveness of self instructional module on central venous catheter care. The aim of the study was to impart the current recommendation regarding nursing care of patient with central venous catheter among staff nurses working in ICU. An Evaluative approach was used for the present study. Using purposive sampling technique 50 samples were selected from Chettinad Hospital and Research institute, Tamil Nadu, India. The tool used was self administered questionnaire. The collected data was analyzed using descriptive and inferential statistics. The findings of the study revealed a significantly increase in the staff nurses knowledge score after administration of self instructional module. The mean pre test score was 9.80 % and the mean post test score was 16.58 % and the difference between pre test and post test knowledge score was 6.78%.Based on the objectives of the study the findings of the level of knowledge score on staff nurses shows that they were able to gain adequate knowledge. The study shows that the staff nurses in post test were having average of moderately 30 % knowledge and adequate 70 % of knowledge regarding nursing care of patients with central venous catheter. Self instructional module is effective in increasing the knowledge regarding nursing care of patients with Central venous catheter among staff nurses.

Prevention of central venous catheter-related bloodstream infections: is it time to add simulation training to the prevention bundle?

Study ObjectiveTo study the impact of adding simulation-based education to the pre-intervention mandatory hospital efforts aimed at decreasing central venous catheter-related blood stream infections (CRBSI) in intensive care units (ICU). DesignPre- and post-intervention retrospective observational investigation. Setting24-bed ICU and a 562-bed university-affiliated, urban teaching hospital. PatientsICU patients July 2004-June 2008 were studied for the development of central venous catheter related blood stream infections (CRBSI). MeasurementsICU patients from July 2004-June 2008 were studied for the development of central venous catheter-related blood stream infections (CRBSI). Pre-Interventionmandatory staff and physician education began in 2004 to reduce CRBSI. The CRBSI-prevention program included online and didactic courses, and a pre- and post-test. Elements in the pre-intervention efforts included hand hygiene, full barrier precautions, use of Chlorhexidine skin preparation, and mask, gown, gloves, and hat protection for operators. A catheter-insertion cart containing all supplies and checklist were was a mandatory element of this program; a nurse was empowered to stop the procedure for non-performance of checklist items. InterventionAs of July 1, 2006, a mandatory simulation-based program for all intern, resident, and fellow physicians was added to teach central venous catheter (CVC) insertion. MeasurementsData collected pre- and post-intervention were CRBSI incidence, number of ICU catheter days, mortality, laboratory pathogen results, and costs. Main ResultsThe pre-intervention CRBSI incidence of 6.47/1,000 catheter days was reduced significantly to 2.44/1,000 catheter days post-intervention (58%; P < 0.05), resulting in a $539,902 savings (USD; 47%), and was attributed to shorter ICU and hospital lengths of stay. ConclusionsFollowing simulation-based CVC program implementation, CRBSI incidence and costs were significantly reduced for two years post-intervention.

461: Standardizing Central Venous Line Care in Inpatient Pediatric Hematopoietic Stem Cell Transplant Recipients: Does it Make a Difference in Reducing Catheter Related Blood Stream Infection Rates?

Central venous catheter related blood stream infections (CRBSI) increase morbidity and mortality in pediatric hematopoietic stem cell transplant (HSCT) recipients. There are limited data in the pediatric HSCT population regarding the incidence of CRBSI. Studies in adult oncology and HSCT patients have reported the average rate to be 2.5 CRBSI per 1000 patient-days. We hypothesized that adherence to evidence-based practices shown to reduce CRBSI in short term central venous lines (CVLs) would also reduce CRBSI in long term CVLs.

P-034A 2種類の輸液システムによる中心静脈カテーテル感染率の差異についての検討(代謝・栄養, 第44回日本小児外科学会学術集会)

P-034A 2種類の輸液システムによる中心静脈カテーテル感染率の差異についての検討(代謝・栄養, 第44回日本小児外科学会学術集会)

Epidemiology of central venous catheter related blood stream infections in pediatric patients

Purpose:The purpose of this study is to investigate the pathogens of central venous catheter-related blood stream infections and search for the association among the insertion site, the duration and the underlying conditions with the prevalence of central venous catheter-related blood stream infections under 15 years old. Methods:A retrospective study was performed from Jan, 2003 to Dec, 2003 in Severance Hospital on 112 patients who undertook central venous catheter insertions. Results:We examined 112 patients who undertook central venous catheter insertion. The mean age of patients was 4.77±4.12 years old. Coagulase negative Staphylococci was the most common organism of central venous catheter-related blood stream infections accounting for 33.9 percent, followed by Eenterococcus faecium(9.3 percent), and Staphylococcus aureus(7.5 percent), The most common insertion site was the right femoral vein, followed by the right jugular vein and the left femoral vein. The mean insertion period was 14.17±12.00 days. Conclusion:Central venous catheter-related blood stream infections were not only related to the underlying conditions, but also to the insertion site. We need to study the clinical importance of coagulase negative Staphylococci as it is part of the normal flora of the skin. In future, more studies are needed to take preventive measures and improve treatment methods

Central venous catheter—related blood stream infections: incidence, risk factors, outcome, and associated pathogens

Objective: To determine the incidence, risk factors, outcome, and pathogens of central venous catheter—related bloodstream infections (CVC-BSIs). Design: Prospective study. Setting: Escorts Heart Institute and Research Centre, New Delhi, India. Participants: One thousand three hundred fourteen consecutive patients undergoing cardiac operations who were admitted to the intensive care unit with CVC. Interventions: All patients were assigned into CVC-BSI (n = 35) and non—CVC-BSI (n = 1,279) groups. Measurement and main results: Of the 1,314 patients in the study, 35 (2.6%) had CVC-BSI. On univariate analysis, significant risk factors were use of multilumen catheters, coexistent infections, intra-aortic balloon counterpulsation (IABC), total ventilation hours, emergency surgery, acute physiology, age, chronic health evaluation score (APACHE II), and steroids. On multivariate analysis, duration of catheterization (24.5 ± 10.9 v 6.1 ± 3.2; p < 0.001), coexistent infections (57.11% v 2.61%; p < 0.001), IABC (77.1% v 4.1%; p = 0.005), and temperature (38.2 ± 0.6 v 37.4 ± 0.3; p < 0.001) were independent predictors of CVC-BSI. Pathogens isolated were Escherichia coli (47%), Acinetobacter species (11.7%), Enterobacter species (5.8%), Proteus species (5.8%), methicillin-resistant Staphylococcus species (11.7%), coagulase-negative Staphylococcus species (5.8%), and Candida (11.7%). The mortality rate in CVC-BSI was 22.9% as compared with 0.2% in non—CVC-BSI cases ( p < 0.001). Conclusion: By univariate analysis, the risk factors for CVC-BSI were use of multilumen catheters, duration of catheterization, total ventilation hours, IABC, emergency surgery, APACHE II score, coexistent infections, and steroids. On multivariate analysis, duration of catheterization, IABC, coexistent infections, and temperature were independent predictors of CVC-BSI. The mortality was increased with CVC-BSI.