Risk Factors For Catheter-related Infections Research Articles

A meta-analysis of risk factors for a Dacron-cuffed catheter related infection in hemodialysis.

To provide theoretical basis for prevention of a Dacron-cuffed catheter related infection (CRI), the risk factors of CRI in hemodialysis patients were systematically evaluated. Eight databases, including PubMed, Cochrane library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), Wanfang Database and Chinese Scientific Journal Database (VIP), were searched to screen out literatures related to the risk factors of long-term indwelling a Dacron-cuffed CRI in hemodialysis. Meta-analysis of risk factors for a Dacron-cuffed CRI in hemodialysis and publication bias test were performed using RevMan 5.4 software. After screening, 13 literatures involving a Dacron-cuffed CRI were included, with a total of 625 patients, and the infection rate was 11.7%. The combined OR value and 95% confidence interval (CI) of all factors were: Combined with Diabetes (1.94, 1.51 ~ 2.50), Hb (1.82, 1.35 ~ 2.44), age (2.38, 1.06 ~ 5.34), catheter indwelling time (1.79, 1.21 ~ 2.66), serum albumin (2.26, 1.25 ~ 4.08), catheter indwelling site (3.29, 1.74 ~ 6.23) and the number of tube placement (5.40, 2.65 ~ 11.02). The main risk factors for a Dacron-cuffed CRI in hemodialysis were combined with diabetes, hemoglobin level, age, catheter indwelling time, serum albumin level, femoral vein catheter indwelling and catheterization times. In other words, hemodialysis patients are at higher risk of CRI if they have diabetes, or if they have a lower hemoglobin level, or if they are older, or if they have a longer duration of catheterization, or if they have a lower serum albumin level, or if they have a femoral vein catheter, or if they have more catheters.

Retracted: Risk Factors of Catheter-Related Infection in Unplanned Extubation of Totally Implantable Venous-Accessportsin Tumor Patients

Retracted: Risk Factors of Catheter-Related Infection in Unplanned Extubation of Totally Implantable Venous-Accessportsin Tumor Patients

Home parenteral nutrition (HPN) using individually compounded PN administered via multi-chamber Eurotubes versus PN administered via 2/3-chamber bags in patients with metastatic or localized solid tumors requiring HPN: The randomized IKF-010 PEKANNUSS trial of AIO.

e24123 Background: Cancer patients (pts) often experience malnutrition and some of them require HPN. However, HPN is associated with challenges, including the need for nursing service to prepare PN bags and add supplements, severely limiting patient autonomy and flexibility. Moreover, HPN is a major risk factor for catheter-related infections (CRI). Eurotubes is a 7/8/9-multi-chamber system that offers fully individualized PN compounding without need for further line or bag manipulation outside GMP environment. This study evaluates whether HPN via Eurotubes improves patient autonomy compared with HPN via traditional 2/3-chamber bags. Methods: This is a randomized, multicenter, investigator-initiated, phase IV trial. Pts with metastatic/locally advanced tumors and need for HPN were stratified according to ECOG PS, the modified Glasgow Prognostic Score (mGPS) and concurrent systemic treatment and randomized 2:1 to receive HPN via Eurotubes (Arm A) or HPN via 2/3-chamber bags (Arm B). Primary endpoint was patient autonomy defined as the proportion of pts with ≥70% of HPN administrations done without nursing service assistance (self-administration or with help of relatives) as provided in pts diaries in the intent to treat population (ITT). A total of 192 pts were required to show a significant improvement in proportions of pt autonomy from 5 to 20% (80% power; 2-sided α < .05 [Fisher’s exact]). Secondary endpoints included CRI, safety, body weight and serum albumin. Results: Study was terminated for slow recruitment after enrollment of 142 pts of which 131 pts qualified for ITT. Baseline criteria were well balanced regarding ECOG PS, body weight, albumin, mGPS, and nutritional risk score, but more pts in Arm A had metastatic disease (78% vs 61%). In median, pts received HPN for 48 days (1 - 320 days) and median cumulative macronutrients of glucose, 3805g; amino acids, 2100g; and lipids, 2250g. Injections of additional supplements into PN bag at home were required in 11% v 96% of pts for Arm A vs B (p < .01). The primary endpoint was met, with patient autonomy being 52% vs 33% in Arm A vs B (p = .04) and the difference was more pronounced in pts with ECOG PS ≤1 (68% vs 42%). Relative changes in body weight and serum albumin favored the Arm A until visit 5. All grade adverse events related to HPN were lower in Arm A (27% vs 55%; p < .01) as were CRI rates (13% vs 22%; p = .22). Device deficiency (8% vs 7%) and PN related death (1% vs 2%), and median overall survival (6.6 vs 6.8 months) were similar. Conclusions: Eurotubes significantly improved patient autonomy, compared with 2/3-chamber bags and were associated with significantly less HPN-related adverse events. HPN via Eurotubes represents a treatment option that is safe and renders pts more able to self-manage their treatment. Clinical trial information: NCT04105777 .

Risk Factors of Catheter-Related Infection in Unplanned Extubation of Totally Implantable Venous-Accessportsin Tumor Patients.

Background Totally implantable intravenous ports (TIVAPs) are mostly used for long-term intravenous infusion therapy in cancer patients and can be left in the body for long periods of time for easy management, making them a simple and safe infusion device. Although the risks associated with long-term retention of fully implantable IV ports are less than those associated with other intravenous catheters, various complications may still occur at the time of implantation or during long-term use. Purpose To provide a scientific basis for clinical reduction of implantable intravenous port-associated infection complications by studying the risk factors for catheter-associated infection complications in patients applying implantable intravenous ports. Methods A retrospective study was conducted on oncology patients treated with TIVAP at our hospital between January 2017 and November 2021, with a review of patients who were unplanned for extubation. Their demographic data, underlying disease status, and surgery-related data were counted to summarize and analyze the complications and related influencing factors of implantation and postimplantation. Results A total of 70 individuals with a mean age of 56.49 ± 12.19 years were included in the study. Among them, 39 were male and 64 had the highest percentage of epithelial tumors, followed by tumors of the lymphopoiesis system and mesenchymal tumors with 4 and 2 cases, respectively. Forty-eight of these patients did not have their ports removed as planned due to the occurrence of catheter-related hematogenous infections. In univariate analysis, BMI and neutropenia were risk factors for catheter-associated infections. In the multivariate analysis, BMI (OR = 1.38, 95% CI: 1.07–1.78, p=0.013) was an independent risk factor for catheter-associated infections. Conclusions The overall complication rate of fully implanted intravenous ports was high, but most complications improved with symptomatic management, and no deaths due to port complications were identified. Infection was the most common complication, with catheter-associated bloodstream infection being the most common cause of unplanned port extraction. Patients with a higher BMI were at high risk of developing implantable IV port-associated infections, which may be an independent risk factor for implantable IV port-associated infections.

Evaluating risk factors for catheter-related infections in hemodialysis patients

Introduction: Catheter-related infection in the patients with end-stage renal disease (ESRD) is one of the leading causes of death. Identifying risk factors for infection, including patients’ iron profile, plays an important role in preventing this complication. Objectives: In this study, we aimed to determine the risk factors of catheter-related infections among the ESRD patients in Qazvin, Iran. Patients and Methods: In this observational study, 41 patients with hemodialysis venous catheter-related infection (case group) and 42 patients without catheter-related infection ( control group) in Qazvin educational and medical centers were studied. The definition of functional iron deficiency anemia included ferritin <500 ng/mL and serum iron/total iron-binding capacity (TIBC) <30%. The laboratory evaluation method was based on enzyme-linked immunosorbent assay method. Definition of catheter-related infection in this study consisted of two positive results of the three cultures from blue and red catheter lines and blood at the same time with the same microorganism. Results: In studying iron parameters, a significant difference between serum iron levels and transferrin saturation in the two groups was detected (P values of 0.0016 and 0.003, respectively). Both parameters were higher in the control group. The most common microorganism causing the infection was Staphylococcus aureus (43.9%) and most of the catheters used were of temporary internal jugular vein types. The most important risk factors in the incidence of catheter infection were diabetes mellitus (OR = 5.059) and high serum iron levels (OR = 1.053). Decreased transferrin saturation levels reduced the risk of infection (OR = 0.825). Conclusion: There was a relationship between iron profile and diabetes mellitus and the increased risk of catheter-related infections. To prevent infection, patients with ESRD undergoing hemodialysis with venous catheters, blood sugar and serum iron levels need to be monitored carefully and iron overdose should be prevented in these patients.

Clinical characteristics of catheter-related infection in patients with chronic renal failure End Stage Renal failure undergoing semi-permanent catheter placement during maintenance hemodialysis through tunnelled cuffed hemodialysis catheter.

Objective:To analysis the relevant infections and risk factors of patients undergoing hemodialysis semi-permanent catheter (tunneled cuffed) placement during for maintenance hemodialysis.Methods:A total of 158 patients with chronic renal failure (CRF) End stage renal failure (ESRF) treated in our hospital from September 2018 to September 2021 were retrospectively analyzed. All the patients underwent semi-permanent catheter placement during maintenance hemodialysis. The occurrence of catheter-related infections in the patients were recorded. The patients with catheter-related infections were included in the infection group, and the others without infection in the non-infection group. The differences in hypertension, gender, diabetes, age, catheter indwelling time and dialysis time between the two groups were analyzed, and the distribution of pathogens in the patients with infections was analyzed.Results:The patients were followed up for 13 to 36 months, with an average of (22.18 ± 6.09) months. Among the 158 patients who underwent going semi-permanent catheter placement, 42 (26.58%) presented semi-permanent catheter-related infections, including four cases of catheter-related bacteremia, 16 cases of tunnel infection and 22 cases of catheter exit-site infection. Among total of 42 strains of pathogens were isolated from the 42 patients with catheter-related infections, including 243 strains of Gram-positive cocci were identified in 24/42(57.14%), and 163 strains of Gram-negative bacilli were identified 16/42(38.10%) and one starin of fungus was identified in 2/42 patients. Statistically significant differences were found in dialysis duration time, hypoalbuminemia, average mean age, diabetes and catheter indwelling time between patients with and without catheter-related infections (P < 0.05). Hypoalbuminemia, catheter indwelling time and diabetes were risk factors for catheter-related infections (P < 0.05).Conclusions:Patients with ESRF CRF are at risk and prone to catheter-related infections during hemodialysis using catheter, mainly tunnel infection and catheter exit-site infection. Gram-positive cocci are the main pathogens. Hypoalbuminemia, too long catheter indwelling time and diabetes are the risk factors for infections.

Evaluation of risk factors for catheter-related infections with gram-negative bacteria in Tehran, Iran

Introduction: Catheter infection is due to gram-negative, gram-positive bacteria, and fungi. Gram-positive bacteria are the most prevalent cause of catheter infection, although gram-negative bacteria seem to have escalated in recent years, which may have numerous risk factors. In this report, we intended to study these risk factors. Objectives: This study aimed to investigate the risk factors for catheter-related infections caused by gram-negative bacteria in hemodialysis patients, to prevent catheter-related infections, which are unfortunately abundant. Patients and Methods: This cross-sectional study was conducted on128 hemodialysis patients known cases Hasheminejad hospital in Tehran, Iran in 2019. Patients were assigned into two groups as the case group (catheter-related infection caused by gram-negative bacteria) (n=64) and the control group (catheter-related infection caused by gram-positive bacteria) (n=64). Risk factors for catheter-related infection, including hemoglobin, phosphorus, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), total iron-binding capacity (TIBC), catheter insertion site, urinary tract infection (UTI), urinary tract manipulation, and urinary tract anomalies were obtained and analyzed via SPSS version 26. Results: Two groups were significantly different in serum albumin level (3.7±0.5 g/dL in gram-negative group and 3.9 ± 0.5 g/dL in gram-positive group; P=0.009) and in UTI (23.4 % in gram-negative group and 7.8 % in gram-positive group; P=0.015). Additionally, no significant differences were observed in serum ferritin, phosphorus, ESR, CRP, TIBC, duration, and site of catheter insertion. Regression analysis shows that, for every unit increase in albumin, the chance of developing a gram-negative catheter infection is 0.356, or about one-third. In other words, with decreasing each unit of albumin, the chance of a gram-negative catheter infection is 2.8 times (reverse 0.356). Conclusion: Serum albumin levels were significantly low in gram-negative group. Moreover, UTIs were significantly higher in this group. It is also important to consider hypoalbuminemia and UTI as risk factors for catheter infection with gram-negative bacteria.

Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang

Background. Chronic kidney disease (CKD) is a terminal disease requiring hemodialysis. Hemodialysis requires vascular access using a double lumen catheter (DLC). However, the use of DLC may increase complications mainly infection, either infection of exit site or bloodstream. This study is aimed to seek risk factors contributing to the incidence of central catheter-related infections in CKD patients with DLC undergoing HD at Dr. M. Djamil Hospital, Padang.&#x0D; Methods. This study is a prospective study on patients undergoing HD at Dr. M. Djamil Hospital, Padang. This study using consecutive sampling technique. Data were analyzed using SPSS version 25.0.&#x0D; Results. This study involved 40 CKD patients undergoing HD. Majority of the samples had bloodstream infections (67.5%). Clinical manifestations of purulent secretion, duration of catheter used, and hypoalbuminemia had significant differences in the incidence of DLC infection based on bloodstream infection and exit site infection (p&lt;0.05). The most common bacterial found was Pseudomonas aeruginosa (22.5%) which was sensitive to ceftazidime, cefepime, meropenem, amikacin, gentamicin, ciprofloxacin.&#x0D; Conclusion. Factors contributing to the incidence of DLC-related infections at Dr. M. Djamil Hospital are duration of catheter use and hypoalbuminemia. Pseudomonas aeruginosa is the most common cause of DLC-related infections.

Increased risk of catheter-related infection in critically ill patients given catecholamine inotropes during continuous renal replacement therapy.

Previous in vitro studies have shown that catecholamine inotropes are potent stimulators of bacterial growth and biofilm formation on catheter surfaces. This study aimed to investigate the effects of administering catecholamine inotropes during continuous renal replacement therapy (CRRT) on catheter-related infections in critically ill patients. This single-center retrospective cohort study included patients requiring CRRT in an intensive care unit from 2016 to 2017, who were divided into those who received and did not receive catecholamine inotropes for ≥24 h (catecholamine and control groups, respectively). The primary endpoint was catheter-related infection, including catheter-related colonization (CRCOL) and catheter-related bloodstream infection (CRBSI). We included 235 patients with 297 dialysis catheters. The catecholamine group had higher proportions of cardiovascular disease (p=0.002), shock (p < 0.001), mechanical ventilation (p < 0.001), and antibiotic use (p=0.013). There was no significant between-group difference in the CRBSI incidence (5.742 vs. 3.143 events/1000 catheter-days; p=0.205). However, the CRCOL incidence was significantly higher in the catecholamine group than in the control group (6.221 vs. 0.898 events/1000 catheter-days; p=0.006). The prominent pathogenic bacteria were gram-negative bacteria. After adjusting for confounding factors in multivariate logistic models, catecholamine inotropes (OR: 3.575, 95% CI: 1.422-9.912, p=0.008) and immunosuppression (OR: 2.980, 95% CI: 1.137-7.812, p=0.026) were independently associated with a higher risk of catheter-related infections. We observed a similar incidence of catheter-related infection with that in other CRRT patients. Using catecholamine inotropes in those patients increased CRCOL risk, which is consistent with previous in vitro studies. Our findings suggest that catecholamine inotropes is an independent risk factor for catheter-related infections in critically ill patients undergoing CRRT.

1090: Central Venous Catheter Dressing Disruptions as a Risk Factor for Catheter-Related Infections

1090: Central Venous Catheter Dressing Disruptions as a Risk Factor for Catheter-Related Infections

Risk factors for catheter-related infections in patients receiving permanent dialysis catheter

BackgroundDue to rising vascular comorbidities of patients undergoing dialysis, the prevalence of permanent hemodialysis catheters as hemodialysis access is increasing. However, infection is a major complication of these catheters. Therefore, identification of potential predicting risk factors leading to early infection related complications is valuable, in particular the significance the CRP (C-reactive protein)-value is of interest.MethodsIn this retrospective study 151 permanent hemodialysis catheters implanted in 130 patients were examined. The following data were collected at the time of catheter implantation: CRP-value, history of catheter-related infection, microbiological status, immunosuppression and diabetes mellitus. The primary outcomes were recorded over the 3 months following the implantation: catheter-related infection, days of hospital stay and death. Catheter removal or revision, rehospitalization and use of antibiotics were identified as secondary outcomes.ResultsWe identified a total of 27 (17.9%) infections (systemic infection: 2.26 episodes/ 1000 catheter days, local infection: 0.6 episodes/ 1000 catheter days). The development of an infection was independent of the CRP-value (p = 0.66) as well as the presence of diabetes mellitus (p = 0.64) or immunosuppression (p = 0.71). Univariate analysis revealed that infection was more frequent in patients with MRSA-carriage (p < 0.001), in case of previous catheter-related infection (p < 0.05) and of bacteremia or bacteriuria in the period of 3 months before catheter implantation (p < 0.001). Catheter removal or revision (p = 0.002), rehospitalization (p = 0.001) and use of antibiotics (p = 0.02) were also more often observed in patients with MRSA-carriage.ConclusionsThe CRP-value at the time of implantation of a permanent hemodialysis catheter is not associated with the development of early catheter related infections, but an individual history of catheter-related infection, MRSA-carriage and bacteremia or bacteriuria in the period of 3 months prior to catheter implantation are significant risk factors.

Vascular Access in Patients Treated with Continuous Renal Replacement Therapy: A Report from a Single Center in China.

Our aim was to analyze the practice pattern of vascular access use and complication rates in patients receiving continuous renal replacement therapy from a large Chinese urban medical center. Patients who had received continuous renal replacement therapy (CRRT) from April to October 2014 in our center were included in this study. Demographic data, primary disease, department for hospitalization, blood pressure, heart rate, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE II) score, presence of mechanical ventilation, CRRT modalities, choice of functioning vascular access, site and duration of catheter insertion, presence of recatheterization, cumulative catheter indwelling time, catheter malfunction and catheter-related infections, as well as laboratory test results, were collected. A total of 292 patients were enrolled in our study, including 175 males (59.9%) and 117 females (40.1%), aged 50.8 ± 18.6 years (range, 12 to 94 years). Acute kidney injury, multiple organ dysfunction syndrome, and systemic inflammatory response syndrome were the main indications for treatment with CRRT. Initial vascular access was non-cuffed temporary catheters in 280 patients and was preferentially obtained in the right internal jugular vein (54.3%). There were 32 (11.4%) patients requiring re-catheterization. Catheter malfunction occurred in 7.14% of all patients, and the median time of catheter malfunction was found at the 5th day. By multivariate analysis, it was found that the main risk factors of catheter malfunction were cumulative treatment time of CRRT and the level of hemoglobin. The average time of catheter-related infections was 10.7 days after insertion and the catheter-related infections occurred at a rate of 7.19 per 1000 catheter days. The main risk factors for catheter-related infections were cumulative time of catheterization and the level of serum albumin. In this cohort of critically ill patients, the main risk factors for catheter malfunction were cumulative CRRT time and the level of hemoglobin. In addition, the main risk factors for catheter-related infections were cumulative time of catheterization and the level of serum albumin.

Microbe Isolation from Blood, Central Venous Catheters, and Fluid Collections after Liver Resections.

Our goal was to evaluate the microbe species responsible for bacteremia or infections related to central venous catheter (CVC) or fluid collections after liver resection. Data from 112 patients (68 males, 44 females) who underwent liver resection over a period of 63 months were reviewed. Patient and tumor characteristics, intra-operative and post-operative data, and the results from cultures of peripheral blood, CVC tips and drained intra-abdominal or intra-throracic fluid collections were collected. There were positive blood cultures in 20 patients (17.9%). Coagulase-negative staphylococci (CoNS) and bacteria of enteric flora were the micro-organisms found most frequently and half of the cases had multiple isolated microbe species. The construction of a bilioenteric anastomosis was an independent risk factor for microbe isolation in peripheral blood (odds ratio [OR]: 11, p = 0.01). Furthermore, there were positive cultures of the CVC tip in 14 patients (12.5%), with CoNS being the micro-organism found most frequently and most cases had only one isolated microbe species. No specific risk factor for catheter-related infections was detected. In addition, there were positive cultures of drained fluid collections in 19 patients (17%), with bacteria of enteric flora being the micro-organisms found most frequently and the majority of cases had multiple isolated microbe species. The construction of a bilioenteric anastomosis (OR: 23.5, p = 0.002) and the laparoscopic approach (OR: 4.7, p = 0.0496) were independent risk factors for microbe isolation in drained fluid collections. Finally, the presence of positive blood cultures was associated with the presence of positive culture of CVC tips (p = 0.018) and drained fluid collections (p = 0.001). Post-operative bacteremia, colonization of CVCs, and contamination of fluid collections occur frequently after liver resections and various microbe species may be involved. Patients who undergo hepatectomy and a synchronous construction of a bilioenteric anastomosis are at increased risk of bacteremia development and contamination of fluid collections.

Analysis on risk factors of catheter-related infections of external ventricular drainage

Objective To explore the risk factors of catheter-related infections of external ventricular drainage (EVD) , so as to provide evidence for effective prevention and control measures. Methods A total of 428 patients′ clinical data were collected by retrospective case analysis in cluster sampling, who underwent external ventricular drainage in Neurosurgery Department of a class Ⅲ grade A hospital in Shanghai from January 2014 to October 2016. The incidence of EVD infection was analyzed. At the same time, univariate analysis and multivariate Logistic regression analysis were adopted for risk factors of EVD related infection. Results The catheter-related ventricular infections occurred in 36 of 428 cases of patients, with the incidence rate 8.41%. The detection rate of pathogens in cerebrospinal fluid was 75.00%, and Gram-negative bacteria were the main pathogens (78.13%) , among which the most common was Acinetobacter baumannii (28.11%) . Univariate analysis showed that the incidence of catheter-related ventricular infection was related to gender, age, admission diagnosis, diabetes mellitus, preoperative pulmonary infection, Glasgow Coma Scale (GCS) score, American Society of Anesthesiologists (ASA) physical status classification, duration of EVD, type of EVD, number of catheters, frequency of replacing catheter, frequency of sampling cerebrospinal fluid (P<0.05) . Multivariate Logistic regression suggested that duration of EVD, number of catheters, pulmonary infection and frequency of sampling cerebrospinal fluid were independent risk factors causing catheter-related ventricular infection (OR=1.070, 13.236, 6.800, 6.248) . Conclusions The catheter-related ventricular infection can be caused by single factor or the synergistic action of multiple factors. The control of pulmonary infection and the management of blood glucose level are helpful to reduce the infection of EVD related infection. Key words: Risk factors; Neurosurgical procedures; External ventricular drainage; Catheter-related infection

Risk factors for catheter-related infections in patients on hemodialysis

Background/Aim. Catheter-related infections are a significant morbidity and mortality cause in patients on hemodialysis. The objective of this study was to determine the incidence, to analyze risk factors and to identify etiological causes of catheter-related infections in these patients. Methods. The study was carried out at the Clinic for Nephrology and Clinical Immunology of the Clinical Centre of Vojvodina, from August, 2012 to May, 2015. One hundred and thirteen patients on chronic hemodialysis participated in the study. The risk factors of catheterrelated infections in the infected patients were to those in the control group, as follows: demographic and laboratory parameters, co-morbidities and the use of immunosuppressive therapy, the length of hemodialysis treatment, urgent catheter placement, the position and placement difficulties, the number of insertions and catheter maneuvering, the existence of permanent vascular access in maturation or without a vascular access in the course of catheter positioning, catheter life, surgical procedures (? 30 days from catheter placing), the length of hospitalization and isolated infection causes. Results. One hundred and ninety-seven catheters were placed in 113 patients, among which 182 of them temporary. The total number of catheter days was 17.842, the incidence of infections was 3.53/1,000 catheter days. During the monitoring period, 63 catheter-related infections were diagnosed, 54 (85.7%) with temporary and 9 (14.3%) with permanent catheters. Multivariate logistic regression analysis (with border values/ levels determined by receiver operating characteristic ? ROC analysis) determined independent predictors of catheter-related infections in the following order: hemoglobin levels &lt; 95 g/l (p &lt; 0.001) and albumin levels &lt; 33 g/l (p = 0.041), catheter duration of &gt; 90 days (p = 0.004), &gt; 2/day catheter maneuvering (p = 0.011) and the duration of hospitalization of &gt; 15 days (p = 0.003). The main pathogen was Staphylococcus spp. Coagulase negative. Conclusion. Intensifying of prevention measures and infection control would significantly reduce the frequency of catheter-related infections and the number of hospitalizations. The timely creation of a native arteriovenous fistula would decrease the use of hemodialysis catheters.

Risk factors of catheter-related infection and coping strategies about power peripherally inserted central catheter in patients with breast cancer

Objective To discuss risk factors of catheter-related infection and coping strategies about power peripherally inserted central catheter (POWER PICC) in patients with breast cancer, and to provide the evidence-based nursing basis for standard operational procedure of POWER PICC. Methods A total of 323 patients with breast cancer underwent chemotherapy by three directional valve PICC, and a total of 322 patients did by POWER PICC. Risk factors of catheter-related infection were analyzed by univariate analysis and logistic multiple regression analysis. Results The catheter-related infection rate of POWER group was higher than that of three directional valve group[11.49% (37/322) vs 5.26% (17/323); χ2=8.152, P<0.01]. Four risk factors of catheter-related infection in the POWER group were screened by univariate analysis, including material of catheter, position of puncture, treatment for wound surface and sort of connector. Unconditional multiple analysis was conducted, regarding bacterial colonization as dependent variable and other factors as independent variable. The result demonstrated that individual care strategy for PICC was the risk factor of catheter-related infection of POWER PICC. Conclusions Understanding of the property of POWER PICC material and applying individual care strategy to enhance advantage and avoid disadvantage can prevent catheter-related infection of POWER PICC effectively. Key words: Breast cancer; Risk factor; Power peripherally inserted central catheter; Catheter-related infection; Individual care

Risk Factor for Catheter-related Infection in Patients with Tunneled Hemodialysis Catheters and the Treatment of Pathogens

Risk Factor for Catheter-related Infection in Patients with Tunneled Hemodialysis Catheters and the Treatment of Pathogens

The incidence and risk factors of peripherally inserted central catheter-related infection among cancer patients

BackgroundAs the use of peripherally inserted central catheters (PICCs) increased in chemotherapy, the identification of complications and risk factors became essential to prevent patient harm. But little is known about PICC-related infection and risk factors among patients with cancer. Our study was to identify the prevalence, patterns, and risk factors of catheter-related infections associated with PICCs.MethodsA 3-year prospective cohort study was conducted in a university-affiliated hospital. All patients with cancer who met inclusion criteria were enrolled. The patients were followed up until catheter removal. Tip cultures were routinely performed at the time of catheter removal. The general information was recorded at the time of PICC insertion, weekly care, and removal. Univariable and multivariable logistic regression analyses were applied for identification of risk factors.ResultsIn total, 912 cancer patients with 912 PICCs of 96,307 catheter days were enrolled. Ninety-four developed PICC-related infection; 46 were exit-site infection, 43 were catheter bacterial colonization, and five were PICC-related bloodstream infection. The median time from catheter insertion to infection was 98.26 days. Multivariate analysis showed StatLock fixing (odds ratio [OR] =0.555, 95% confidence interval [CI]: 0.326–0.945) and tip position located in the lower one-third of the superior vena cava (OR =0.340, 95% CI: 0.202–0.571) were associated with lower PICC infection rate. Catheter care delay (OR =2.612, 95% CI: 1.373–4.969) and indwelling mostly in summer (OR =4.784, 95% CI: 2.681–8.538) were associated with higher infection incidence.ConclusionStatLock fixing and tip position located in the lower one-third of the superior vena cava were protective factors against PICC-related infection, while catheter care delay and indwelling mostly in summer were risk factors. Policy and measures targeting these factors may be necessary to reduce the risk of infection.

维持性血液透析导管相关感染危险因素分析

目的：探讨引起血液透析患者导管相关感染的主要危险因素，为制定相关的预防和治疗措施提供科学依据。方法：选取2008年1月~2O14年12月我院留置中心静脉导管进行维持性血液透析的970例患者的临床资料进行回顾性分析，采用单因素和多因素Logistic回归分析对有导管相关性感染组和无导管相关性感染组的各项临床指标进行分析，找出影响导管相关感染的危险因素。结果：970例留置中心静脉导管病人中引起导管相关性感染者82例(8.45%)，置管部位、导管留置天数、原发病因、血浆白蛋白水平是导管相关性感染的独立危险因素。结论：维持性血液透析患者留置中心静脉导管容易发生相关感染，且与多个因素有关，应针对这些因素进行积极纠正，才能有效预防感染发生。 Objective: To analyze the main risk factors of catheter-related infection in hemodialysis patients, so as to provide scientific proof to make the preventive and treatment measures. Methods: The clinical data of the 970 cases of maintenance hemodialysis patients from January 2008 to December 2014 were studied retrospectively; Stepwise logistic regression analysis was performed to identify risk factors associated with catheter-related infection. Results: Catheter related infection in 82 (8.45%) cases from 970 cases of central venous catheter patients. The site of catheter, catheter-retaining number of days, the primary cause, plasma albumin level, were independent risk factors of catheter-related infection. Conclusion: Patients in maintenance hemodialysis with indwelling central venous catheter related infection was easy to occur, and related to many factors, these factors should be focused on positive correction, to prevent infection.

Sustained low incidence of central venous catheter-related infections over six years in a Swedish hospital with an active central venous catheter team

There are limited data on the long-term effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors over a 6-year period in a hospital with an active CVC team. We conducted a continuous prospective study aiming to include all CVCs used at our hospital during the years 2004 to 2009, evaluating colonization, CRI, CRBSI, and possible risk factors. A total of 2,772 CVCs was used during the study period. Data on culture results and catheterization time were available for 2,045 CVCs used in 1,674 patients. The incidences of colonization, CRI, and CRBSI were 7.0, 2.2, and 0.6 per 1,000 CVC-days, respectively. Analysis of quarterly incidences revealed 1 occasion with increasing infection rates. Catheterization time was a risk factor for CRI but not for CRBSI. Other risk factors for CRI were hemodialysis and CVC use in the internal jugular vein compared with the subclavian vein. Hemodialysis was the only risk factor for CRBSI. We found that a CRI prevention program led by an active CVC team and adhered to by the entire staff at a county hospital is successful in keeping CVC infections at a low rate over a long period of time.