Central venous catheter-related bacteraemia in burn patients

This study aimed to establish the incidence, significance and microbial aetiology of catheter-related bacteraemia (CRB) in burn patients treated in the Sofia Burns Centre, Bulgaria. During the period 1993-97, 1,346 central venous catheters (CVCs) from 1183 burn patients were investigated. Bacterial growth was found in 367 CVCs. Of a total of 675 bacteraemic episodes registered during the study period, 132 were catheter-related (19.5% of all bacteraemic episodes in 6.6% of all patients). Generalized burn infections were responsible for 29.5% of the bacteraemic episodes in 9.9% of the patients. The main pathogens isolated in cases of CRB were Staphylococcus aureus (84/132), coagulase-negative staphylococci (CNS) (20/132) and Acinetobacter spp. (18/132). The incidence of S. aureus was considerably higher than that of CNS and Acinetobacter spp. A total of 11 patients with CRB died. Contaminated CVCs were the second most common cause of bacteraemia in burn patients, after generalized wound infection. S. aureus and Acinetobacter spp. were equally important as causes of systemic infection. We conclude that careful management of CVCs, prevention and subsequent treatment of CRB are of great importance for a favourable outcome in burn patients.