Risk factors for central venous catheter-related infections in general surgery

Central venous catheter (CVC) infection is a common problem during hospitalization and nosocomial bloodstream infection in these patients is associated with increased morbidity, mortality, and health care cost. This prospective study examined the risk factors of CVC-related infections.

During a 6-month period, a total of 281 patients who underwent central venous catheterization after general surgery were enrolled.

The mean duration from CVC insertion to the development of infection was 7.12 days. The rate of bloodstream infection without isolation of the same organism from the catheter was 1.4% (4/281). The rate of catheter-related bloodstream infection was 6.0% (17/281). The rate of catheter bacteremia, defined as positive culture from a catheter blood sample in a patient without signs of infection, was 8.5% (24/281). The incidence of catheter-related bloodstream infection was 7.5/1000 catheter-days. Risk factors for catheter-related infection on univariate analysis included place of insertion (operating room or surgical ward), total parenteral nutrition (TPN), more than 3 tubings, and duration of catheterization. TPN was a significant risk factor in the logistic regression analysis.

Established infection control guidelines should be rigorously observed with regard to catheter use and various risk factors controlled to prevent the occurrence of CVC-related infection, especially in patients receiving TPN.