Evaluation of Central Venous Catheter-Related Blood Circulation Infections in Neurology Intensive Care Unit
Abstract
Background: Intravascular catheter interventions are used for fluid-blood transfusion, drug infusion and nutritional solution administration in the neurology ıntensive care units. One of the most important cause of invasive device-related and nosocomial infection is central venous catheter application in intensive care units. We aimed to investigate the risk factors that affecting morbidity and mortality in patients with central venous catheter-related bloodstream infection in neuro intensive care unit.
Materials and Methods: The results of blood samples taken from the catheter, peripheral veins and catheters tips of 154 patients which were treated in the neurology intensive care unit were retrospectively evaluated. A total of 187 central venous catheters, which were applied to 143 subclavian vein, 20 internal jugular vein, and 24 femoral vein were evaluated. The clinical status, physical and neurological examinations of the patients were also evaluated.
Results: The mean duration of catheter duration was 14.11(±11.68) days. Among the patients included the study, only 12 patients had central catheter-related bloodstream infection. Fourteen pathogens (7 Gram negative bacteria, 5 Gram positive bacteria, 2 yeast fungi) were isolated from central catheter-related bloodstream infection. Enterococcus faecalis (n:4) was the most common agent.
Conclusions: It is important to know the surveillance of these infections, risk factors, causative microorganisms and antibiotic susceptibility patterns for the the effectiveness of empirical treatment, reduction of mortality and hospitalization in intensive care intensive care unit.
Keywords
santral venöz kateter enfeksiyonu nöroloji yoğun bakım ünitesi hastane enfeksiyonu central venous catheter infection neurology intensive care unit hospital acquired infection
Supporting Institution
YOK
Thanks
NO CONFLİCT OF INTEREST
References
- 1) Lorente L, Henry C, Martín MM, Jiménez A, Mora ML. Central venous catheter-related infection in a prospective and observational study of 2,595 catheters. Crit Care. 2005; 9(6): 631-5.
- 2) Timsit JF, Baleine J, Bernard L, Calvino-Gunther S, Darmon M, Dellamonica J et al. Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit. Ann Intensive Care. 2020;10(1): 118.
- 3) Gahlot R, Nigam C, Kumar V, Yadav G, Anupurba S. Catheter-related bloodstream infections. Int J Crit Illn Inj Sci. 2014; 4(2): 162-7.
- 4) Kıray S, Yıldırım D, Özçiftçi S, Akın Korhan E, Uyar M. Santral Venöz Kateter Bakımı ve Enfeksiyon: Bir Sistematik Derleme. J Turk Soc Intens Care. 2019; 17:60-74.
- 5) Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital M Kaur, V Gupta, S Gombar, J Chander, T Sahoo Indian Journal of Medical Microbiology, 2015 33(2): 248-254
- 6) Ak O, Batırel A, Ozer S, et al. Nosocomial infections and risk factors in the intensive careunit of a teaching and research hospital: A prospective cohort study. Med Sci Monit. 2011; 17: 29-34
- 7) Oncul A, Koculu S, Elevli K. Bir Devlet Hastanesi’nin yoğun bakım ünitelerinde kazanılan hastane enfeksiyonlarının epidemiyolojisi. Şişli Etfal Hastanesi Tıp Bülteni. 2012; 46: 61-2
- 8) Parameswaran R, Sherchan JB, Varma DM, Mukhopadhyay C,Vidyasagar S. Intravascular catheter-related infections in an Indian tertiary care hospital. J Infect Dev Ctries 2011; 5: 452-8
- 9) Apostolopoulou E, Raftopoulos V, Filntisis G, Kithreotis P, Stefanidis E, Galanis P, Veldekis D. Surveillance of device-associated infection rates and mortality in 3 Greek intensive care units. Am J Crit Care. 2013; 22(3): e12-20
- 10) Atilla, A , Doğanay, Z , Çelik, H , Demirağ, M , Kılıç, S . "Central line-associated blood stream infections: characteristics and risk factors for mortality over a 5.5-year period" . Turk J Med Sci.2017; 47: 646-652
- 11) Horan T, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health-care associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36(5): 309-332
- 12) Jackson SS, Leekha S, Magder LS, Pineles L, Anderson DJ, Trick WE, Woeltje KF, Kaye KS, Stafford K, Thom K, Lowe TJ, Harris AD. The Effect of Adding Comorbidities to Current Centers for Disease Control and Prevention Central-Line-Associated Bloodstream Infection Risk-Adjustment Methodology. Infect Control Hosp Epidemiol. 2017; 38(9): 1019-1024
- 13) O'Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, Masur H, McCormick RD, Mermel LA, Pearson ML, et al.: Guidelines for the prevention of intravascular catheterrelated infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 2002, 51:1-29.
- 14) O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011; 52(9): e162-93
- 15) Crump JA, Collignon PJ. Intravasculer associated infections. Eur J Clin Microbiol Infect Dis 2000; 19: 1-8.
- 16) Fraenkel DJ, Rickard C, Lipman J. Can we achieve consensus on central venous catheter-related infections?. Anaesth Intensive Care 2000; 28: 475-90
Nöroloji Yoğun Bakım Ünitesinde Santral Venöz Kateter İle İlişkili Kan Dolaşım Enfeksiyonlarının Değerlendirilmesi
Abstract
Amaç: Nöroloji Yoğun Bakım Ünitesinde intravasküler kateter girişimi, sıvı, kan transfüzyonu, ilaç infüzyonu ve nutrisyonel solüsyon uygulaması için kullanılır. Araç ilişkili enfeksiyonlar ve hastane enfeksiyonlarının en önemli nedenlerinden biri yoğun bakımlarda santral venöz kateter uygulamasıdır. Kateterin deriye giriş bölgesinde görülebilen lokal enfeksiyonlardan, tromboflebit, bakteriyemi, septisemi gibi sistemik infeksiyonlara kadar değişik enfeksiyonlar görülebilmektedir. Çalışmamızda NYBÜ santral venöz kateter ile ilişkili kan dolaşım enfeksiyonu olan hastalarda morbidite ve mortaliteyi etkileyen risk faktörlerinin araştırılması hedeflenmiştir.
Gereç ve Yöntem: Nöroloji yoğun bakım ünitesinde tedavi olan 154 hastanın kateter ucu, kateterden ve eş zamanlı periferik venden alınan kan örnekleri kültür antibiyogram sonuçları retrospektif olarak değerlendirilmiştir. Çalışmada 143 subklavian ven, 20 internal juguler ven, 24 femoral vene uygulanmış olan toplam 187 santral venöz kateter incelenmiştir. Hastaların klinik durumu, fizik ve nörolojik muayeneleri eş zamanlı olarak değerlendirilmiştir.
Bulgular: Çalışmamızda kateter kalış süre ortalaması14,11(±11,68) gün olarak saptanmıştır. Çalışmaya katılan hastalar içinde sadece 12 hastada santral kateter ilişkili kan dolaşım enfeksiyonu saptanmıştır. Santral kateter ilişkili kan dolaşım enfeksiyonu saptanan hastalarda 14 etken (7 gram negatif bakteri, 5 Gram pozitif bakteri, 2 maya mantarı) izole edilmiştir. En sık izole edilen bakterinin Enterococcus faecalis (n:4) olduğu tespit edilmiştir.
Sonuç: Nöroloji yoğun bakım ünitesinde kateter uygulanan hastalarımızda santral kateter ilişkili kan dolaşım enfeksiyonun insidansı beklenenden daha az bulunmuştur. Enfeksiyon hastalıkları hekimlerinin YBÜ’inde düzenli vizit yapmaları, hastaların yakın izlemi ve başlanmış ampirik tedavinin kültür antibiyograma göre hızlı düzenlenmesi de enfeksiyon gelişimini önlemekte etkilidir. Kateter uygulamalarının en sık yapıldığı yerler olan yoğun bakım ünitelerinde bu enfeksiyonların oranı, risk faktörleri, etken mikroorganizmalar ve antibiyotik duyarlılık paternlerinin bilinmesi, ampirik tedavinin etkinliği, mortalite ve yoğun bakım yatış sürelerinin azaltılması açısından önem taşımaktadır.
References
- 1) Lorente L, Henry C, Martín MM, Jiménez A, Mora ML. Central venous catheter-related infection in a prospective and observational study of 2,595 catheters. Crit Care. 2005; 9(6): 631-5.
- 2) Timsit JF, Baleine J, Bernard L, Calvino-Gunther S, Darmon M, Dellamonica J et al. Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit. Ann Intensive Care. 2020;10(1): 118.
- 3) Gahlot R, Nigam C, Kumar V, Yadav G, Anupurba S. Catheter-related bloodstream infections. Int J Crit Illn Inj Sci. 2014; 4(2): 162-7.
- 4) Kıray S, Yıldırım D, Özçiftçi S, Akın Korhan E, Uyar M. Santral Venöz Kateter Bakımı ve Enfeksiyon: Bir Sistematik Derleme. J Turk Soc Intens Care. 2019; 17:60-74.
- 5) Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital M Kaur, V Gupta, S Gombar, J Chander, T Sahoo Indian Journal of Medical Microbiology, 2015 33(2): 248-254
- 6) Ak O, Batırel A, Ozer S, et al. Nosocomial infections and risk factors in the intensive careunit of a teaching and research hospital: A prospective cohort study. Med Sci Monit. 2011; 17: 29-34
- 7) Oncul A, Koculu S, Elevli K. Bir Devlet Hastanesi’nin yoğun bakım ünitelerinde kazanılan hastane enfeksiyonlarının epidemiyolojisi. Şişli Etfal Hastanesi Tıp Bülteni. 2012; 46: 61-2
- 8) Parameswaran R, Sherchan JB, Varma DM, Mukhopadhyay C,Vidyasagar S. Intravascular catheter-related infections in an Indian tertiary care hospital. J Infect Dev Ctries 2011; 5: 452-8
- 9) Apostolopoulou E, Raftopoulos V, Filntisis G, Kithreotis P, Stefanidis E, Galanis P, Veldekis D. Surveillance of device-associated infection rates and mortality in 3 Greek intensive care units. Am J Crit Care. 2013; 22(3): e12-20
- 10) Atilla, A , Doğanay, Z , Çelik, H , Demirağ, M , Kılıç, S . "Central line-associated blood stream infections: characteristics and risk factors for mortality over a 5.5-year period" . Turk J Med Sci.2017; 47: 646-652
- 11) Horan T, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health-care associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36(5): 309-332
- 12) Jackson SS, Leekha S, Magder LS, Pineles L, Anderson DJ, Trick WE, Woeltje KF, Kaye KS, Stafford K, Thom K, Lowe TJ, Harris AD. The Effect of Adding Comorbidities to Current Centers for Disease Control and Prevention Central-Line-Associated Bloodstream Infection Risk-Adjustment Methodology. Infect Control Hosp Epidemiol. 2017; 38(9): 1019-1024
- 13) O'Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, Masur H, McCormick RD, Mermel LA, Pearson ML, et al.: Guidelines for the prevention of intravascular catheterrelated infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 2002, 51:1-29.
- 14) O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011; 52(9): e162-93
- 15) Crump JA, Collignon PJ. Intravasculer associated infections. Eur J Clin Microbiol Infect Dis 2000; 19: 1-8.
- 16) Fraenkel DJ, Rickard C, Lipman J. Can we achieve consensus on central venous catheter-related infections?. Anaesth Intensive Care 2000; 28: 475-90
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 30, 2021 |
| Published in Issue | Year 2021 Volume: 6 Issue: 3 |
Cite
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