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Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation

Year 2020, Volume: 22 Issue: 3, 149 - 153, 30.12.2020
https://doi.org/10.18678/dtfd.746887

Abstract

Aim: Intravenous catheter use can cause various infections ranging from infection at the site of catheter entry to bacteremia and colonization. The purpose of this study was to identify the causative micro-organisms, and effects on morbidity-mortality of catheter-related bloodstream infections developing over the last five years.
Material and Methods: Data for 194 patients who underwent central intravenous catheter insertion in our hospital’s intensive care unit and other departments between November 2014 and August 2019 were analyzed retrospectively. Blood samples taken from the catheter or the catheter tip, and blood samples collected simultaneously from the peripheral vein were included in the study, and culture results were recorded. Patients’ demographic data and the effects of the factors identified on morbidity and mortality were subjected to statistical analysis.
Results: Ninety-two (47.4%) of the 194 patients included in the study were female and 102 (52.6%) were male, and mortality rate was 62.4% (n=121). The frequency of underlying medical conditions such as asthma, congestive heart failure, and cerebrovascular event, and receiving treatments such as immunosuppression, transfusion, tracheostomy, nasogastric tube, and mechanical ventilation were higher in mortal cases than non-mortal cases. A total of two hundred and forty microorganisms were detected in 194 patients, 121 (50.4%) of which were Gram negative bacteria, while 68 (28.3%) were Gram positive bacteria, and 51 (21.3%) were Candida species.
Conclusion: As a result, it was observed that the advanced age, underlying diseases and presence of resistant microorganisms were higher in mortal cases.

References

  • Editorial. Health care-associated infections in the USA. Lancet. 2015;385(9965):304.
  • O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections, 2011. Atlanta, GA: Centers for Disease Control and Prevention; 2011.
  • Rickard C, Ullman A, Kleidon T, Marsh N. Ten tips for dressing and securement of IV device wounds. Aust Nursi Midwifery J. 2017;24(10):32-4.
  • O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162-93.
  • Wishnewski N, Kampf G, Gastmeier P, Schlingmann J, Daschner F, Schumacher N, et al. Prevalence of primary bloodstream infection in representative German hospitals and their association with central and peripheral vascular catheters. Zentralbl Bakteriol. 1998;287(1-2):93-103.
  • McHugh SM, Corrigan MA, Dimitrov BD, Morris-Downes M, Fitzpatric KF, Cowman S, et al. Role of patient awareness in prevention of peripheral vascular catheter-related bloodstream infection. Infect Control Hosp Epidemiol. 2011;32(1):95-6.
  • Srinivasan A, Wise M, Bell M, Cardo D, Edwards J, Fridkin S, et al. Vital signs: central line-associated blood stream infections--United States, 2001, 2008, and 2009. MMWR Morb Mortal Wkly Rep. 2011;60(8):243-8.
  • Del Pozo JL. Biofilm-related disease. Expert Rev Anti Infect Ther. 2018;16(1):51-65.
  • Timsit JF, Rupp M, Bouza E, Chopra V, Kärpänen T, Laupland K, et al. A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill. Intensive Care Med. 2018;44(6):742-59.
  • Ulusal Damar Erişimi Yönetimi Rehberi 2019. Hastane İnfeksiyonları Dergisi. 2019;23(Ek 1):1-54.
  • Aktaş E, Sarı EN, Seremet Keskin A, Pişkin N, Külah C, Cömert F. Causative agents of intravenous catheter-related infections and their antibiotic susceptibilities. Mikrobiyol Bul. 2011;45(1):86-92.
  • Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement. CLSI document M100-S24. Wayne, PA: CLSI; 2014.
  • eucast.org [Internet]. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0, valid from 2016-01-01. [Cited: 2020 April 30]. Available from: https://www.eucast.org/fileadmin /src/media/PDFs/EUCAST_files/Breakpoint_tables/v_6.0_Breakpoint_table.pdf.
  • Bekçibaşi M, Dayan S, Aslan E, Kortak MZ, Hoşoğlu S. Risk factors for central venous catheter-related bloodstream infections. Infez Med. 2019;27(3):258-65.
  • Bayazıt N, Erdinç Ş, Dizbay M, Yılmaz GR. Hastane infeksiyonları CDC yeni tanı kriterleri canlı konferans serisi. Hastane İnfeksiyonları Dergisi. 2013;3:270-75.
  • Loveday HP, Wilson JA, Pratt RJ, Golsorkhia M, Tinglea A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;86(Suppl 1):S1-70.
  • Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001;286(6):700-7.
  • Parienti JJ, Mongardon N, Mégarbane B, Mira JP, Kalfon P, Gros A, et al. Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 2015;373(13):1220-9.
  • Zhang M, Xu Y, Jiang Z, Qian J, Zhang Z, Sun N, et al. Study on risk factor of central venous catheter infection in ICU: 1 160 patients report. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017;29(12):1082-6.
  • Gürsoy B, Gelecek S, Yorgancı K. Santral venöz kateter infeksiyonları. Yoğun Bakım Dergisi. 2006;6(4):196-203.
  • Hajjej Z, Nasri M, Sellami W, Gharsallah H, Labben I, Ferjani M. Incidence, risk factors and microbiology of central vascular catheter-related bloodstream infection in an intensive care unit. J Infect Chemother. 2014;20(3):163-8.
  • Wittekamp BH, Chalabi M, van Mook WN, Winkens B, Verbon A, Bergmans DC. Catheter-related bloodstream infections: a prospective observational study of central venous and arterial catheters. Scand J Infect Dis. 2013;45(10):738-45.
  • Pichitchaipitak O, Ckumdee S, Apivanich S, Chotiprasitsakul D, Shantavasinkul PC. Predictive factors of catheter-related bloodstream infection in patients receiving home parenteral nutrition. Nutrition. 2018;46:1-6.
  • Almirante B, Limón E, Freixas N, Guidol F, VINCat program. Laboratory-based surveillance of hospital-acquired catheter-related bloodstream infections in Catalonia. Results of the VINCat program (2007-2010). Enferm Infecc Microbiol Clin. 2012;30(Suppl 3):13-9.
  • Demirel A, Efe İris N, Çevik E, Koçulu S, Baygül A, Taşdelen Fışgın N. Catheter-related bloodstream infections: A multicentric five-year analysis. Klimik Derg. 2019;32(2):117-22.
  • Shah S, Singhal T, Naik R, Thakkar P. Incidence and etiology of hemodialysis catheter related blood stream infections at a tertiary care hospital in Mumbai: A 5 year review. Indian J Nephrol. 2020;30(2):132-3.

Kateter İlişkili Kan Dolaşımı Enfeksiyonlarında Mortalite ile İlişkili Faktörlerin Araştırılması: Beş Yıllık Gözlem

Year 2020, Volume: 22 Issue: 3, 149 - 153, 30.12.2020
https://doi.org/10.18678/dtfd.746887

Abstract

Amaç: İntravenöz kateter kullanımı hastalarda kateter girişindeki enfeksiyondan bakteriyemi ve kolonizasyona kadar çeşitli enfeksiyonlara neden olabilir. Bu çalışmanın amacı, son beş yılda gelişen kateter ilişkili kan dolaşımı enfeksiyonlarının etken mikroorganizmalarını tanımlamak ve morbidite-mortalite üzerine etkisini ortaya koymaktır.
Gereç ve Yöntemler: Kasım 2014 ve Ağustos 2019 tarihleri arasında hastanemizin yoğun bakım ünitesinde ve hastanemizin diğer bölümlerinde santral intravenöz kateter yerleştirilen 194 hastanın verileri geriye dönük olarak incelendi. Kateterden veya kateter ucundan alınan kan örnekleri ve periferik venden aynı anda toplanan kan örnekleri çalışmaya dahil edildi ve alınan kan örneklerinin kültür sonuçları kaydedildi. Hastaların demografik verileri ile saptanan faktörlerin morbidite ve mortalite üzerine olan etkileri istatistiksel olarak değerlendirildi.
Bulgular: Çalışmaya dahil edilen 194 hastanın 92’si (%47,4) kadın, 102'si (%52,6) erkek cinsiyette idi ve mortalite oranı %62,4 (n=121) idi. Astım, konjestif kalp yetmezliği ve serebrovasküler olay gibi altta yatan tıbbi durumların sıklığı ve immünosupresyon, transfüzyon, trakeostomi, nazogastrik tüp ve mekanik ventilatör uygulanması gibi tedavilerin sıklığı mortal olgularda mortal olmayan olgulardan daha fazla idi. Yüz doksan dört hastada toplam 240 adet mikroorganizma üremesi saptanmış olup bunların 121 (%50,4)'i Gram negatif bakteri, 68 (%28,3)'i Gram pozitif bakteri ve 51 (%21,3)'i Candida spp idi.
Sonuç: Sonuç olarak ileri yaş, altta yatan hastalıklar ve dirençli mikroorganizma varlığının mortal olgularda daha fazla olduğu görülmüştür.

References

  • Editorial. Health care-associated infections in the USA. Lancet. 2015;385(9965):304.
  • O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections, 2011. Atlanta, GA: Centers for Disease Control and Prevention; 2011.
  • Rickard C, Ullman A, Kleidon T, Marsh N. Ten tips for dressing and securement of IV device wounds. Aust Nursi Midwifery J. 2017;24(10):32-4.
  • O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162-93.
  • Wishnewski N, Kampf G, Gastmeier P, Schlingmann J, Daschner F, Schumacher N, et al. Prevalence of primary bloodstream infection in representative German hospitals and their association with central and peripheral vascular catheters. Zentralbl Bakteriol. 1998;287(1-2):93-103.
  • McHugh SM, Corrigan MA, Dimitrov BD, Morris-Downes M, Fitzpatric KF, Cowman S, et al. Role of patient awareness in prevention of peripheral vascular catheter-related bloodstream infection. Infect Control Hosp Epidemiol. 2011;32(1):95-6.
  • Srinivasan A, Wise M, Bell M, Cardo D, Edwards J, Fridkin S, et al. Vital signs: central line-associated blood stream infections--United States, 2001, 2008, and 2009. MMWR Morb Mortal Wkly Rep. 2011;60(8):243-8.
  • Del Pozo JL. Biofilm-related disease. Expert Rev Anti Infect Ther. 2018;16(1):51-65.
  • Timsit JF, Rupp M, Bouza E, Chopra V, Kärpänen T, Laupland K, et al. A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill. Intensive Care Med. 2018;44(6):742-59.
  • Ulusal Damar Erişimi Yönetimi Rehberi 2019. Hastane İnfeksiyonları Dergisi. 2019;23(Ek 1):1-54.
  • Aktaş E, Sarı EN, Seremet Keskin A, Pişkin N, Külah C, Cömert F. Causative agents of intravenous catheter-related infections and their antibiotic susceptibilities. Mikrobiyol Bul. 2011;45(1):86-92.
  • Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement. CLSI document M100-S24. Wayne, PA: CLSI; 2014.
  • eucast.org [Internet]. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0, valid from 2016-01-01. [Cited: 2020 April 30]. Available from: https://www.eucast.org/fileadmin /src/media/PDFs/EUCAST_files/Breakpoint_tables/v_6.0_Breakpoint_table.pdf.
  • Bekçibaşi M, Dayan S, Aslan E, Kortak MZ, Hoşoğlu S. Risk factors for central venous catheter-related bloodstream infections. Infez Med. 2019;27(3):258-65.
  • Bayazıt N, Erdinç Ş, Dizbay M, Yılmaz GR. Hastane infeksiyonları CDC yeni tanı kriterleri canlı konferans serisi. Hastane İnfeksiyonları Dergisi. 2013;3:270-75.
  • Loveday HP, Wilson JA, Pratt RJ, Golsorkhia M, Tinglea A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;86(Suppl 1):S1-70.
  • Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001;286(6):700-7.
  • Parienti JJ, Mongardon N, Mégarbane B, Mira JP, Kalfon P, Gros A, et al. Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 2015;373(13):1220-9.
  • Zhang M, Xu Y, Jiang Z, Qian J, Zhang Z, Sun N, et al. Study on risk factor of central venous catheter infection in ICU: 1 160 patients report. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017;29(12):1082-6.
  • Gürsoy B, Gelecek S, Yorgancı K. Santral venöz kateter infeksiyonları. Yoğun Bakım Dergisi. 2006;6(4):196-203.
  • Hajjej Z, Nasri M, Sellami W, Gharsallah H, Labben I, Ferjani M. Incidence, risk factors and microbiology of central vascular catheter-related bloodstream infection in an intensive care unit. J Infect Chemother. 2014;20(3):163-8.
  • Wittekamp BH, Chalabi M, van Mook WN, Winkens B, Verbon A, Bergmans DC. Catheter-related bloodstream infections: a prospective observational study of central venous and arterial catheters. Scand J Infect Dis. 2013;45(10):738-45.
  • Pichitchaipitak O, Ckumdee S, Apivanich S, Chotiprasitsakul D, Shantavasinkul PC. Predictive factors of catheter-related bloodstream infection in patients receiving home parenteral nutrition. Nutrition. 2018;46:1-6.
  • Almirante B, Limón E, Freixas N, Guidol F, VINCat program. Laboratory-based surveillance of hospital-acquired catheter-related bloodstream infections in Catalonia. Results of the VINCat program (2007-2010). Enferm Infecc Microbiol Clin. 2012;30(Suppl 3):13-9.
  • Demirel A, Efe İris N, Çevik E, Koçulu S, Baygül A, Taşdelen Fışgın N. Catheter-related bloodstream infections: A multicentric five-year analysis. Klimik Derg. 2019;32(2):117-22.
  • Shah S, Singhal T, Naik R, Thakkar P. Incidence and etiology of hemodialysis catheter related blood stream infections at a tertiary care hospital in Mumbai: A 5 year review. Indian J Nephrol. 2020;30(2):132-3.
There are 26 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Nevin İnce 0000-0002-0129-4536

Dilek Yekenkurul 0000-0002-4456-7485

Emel Çalışkan 0000-0002-9451-7865

Ali Rıza Gürbüz This is me 0000-0002-0106-9582

Selvi Yener 0000-0001-5022-940X

Publication Date December 30, 2020
Submission Date June 16, 2020
Published in Issue Year 2020 Volume: 22 Issue: 3

Cite

APA İnce, N., Yekenkurul, D., Çalışkan, E., Gürbüz, A. R., et al. (2020). Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation. Duzce Medical Journal, 22(3), 149-153. https://doi.org/10.18678/dtfd.746887
AMA İnce N, Yekenkurul D, Çalışkan E, Gürbüz AR, Yener S. Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation. Duzce Med J. December 2020;22(3):149-153. doi:10.18678/dtfd.746887
Chicago İnce, Nevin, Dilek Yekenkurul, Emel Çalışkan, Ali Rıza Gürbüz, and Selvi Yener. “Investigation of the Factors Associated With Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation”. Duzce Medical Journal 22, no. 3 (December 2020): 149-53. https://doi.org/10.18678/dtfd.746887.
EndNote İnce N, Yekenkurul D, Çalışkan E, Gürbüz AR, Yener S (December 1, 2020) Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation. Duzce Medical Journal 22 3 149–153.
IEEE N. İnce, D. Yekenkurul, E. Çalışkan, A. R. Gürbüz, and S. Yener, “Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation”, Duzce Med J, vol. 22, no. 3, pp. 149–153, 2020, doi: 10.18678/dtfd.746887.
ISNAD İnce, Nevin et al. “Investigation of the Factors Associated With Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation”. Duzce Medical Journal 22/3 (December 2020), 149-153. https://doi.org/10.18678/dtfd.746887.
JAMA İnce N, Yekenkurul D, Çalışkan E, Gürbüz AR, Yener S. Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation. Duzce Med J. 2020;22:149–153.
MLA İnce, Nevin et al. “Investigation of the Factors Associated With Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation”. Duzce Medical Journal, vol. 22, no. 3, 2020, pp. 149-53, doi:10.18678/dtfd.746887.
Vancouver İnce N, Yekenkurul D, Çalışkan E, Gürbüz AR, Yener S. Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation. Duzce Med J. 2020;22(3):149-53.