Intravascular catheter colonization and related bloodstream infection in the heart surgery intensive care unit

To study the incidence of catheter tip colonization, catheter-related infections, their risk factors, and to compare these data with other studies.

Since 2006, we have had a through program for the insertion and care of all catheters used at cardiac surgical intensive care unit SICU, Tabriz University of Medical Sciences, Tabriz, Iran, between May 15, 2006 and September 15, 2007. We studied prospectively 183 catheters in 150 patients in relation to insertion data and catheter characteristics, catheterization time and microbiological cultures. These catheters were in place for >48 hours over a 16 months period. Risk factors were analyzed by multivariate analysis.

The analysis included 115 central venous catheter CVCs, 65 arterial catheters ACs, and 3 pulmonary artery catheters PACs inserted in 150 patients. The median time of catheter placement was 4 days. The incidence of positive tip culture was 9.8% and 10 microorganism isolated from 18 colonized catheters. Thirteen Gram-negative bacilli, 4 Gram-positive cocci, and one yeast were isolated. From multivariant analysis, >6 days of catheterization, and insertion site were the variables associated with significantly increased risk of catheter colonization.

Gram-negative bacilli and Gram-positive cocci are the most common microorganisms colonizing CVC and AC from cardiac SICU patients. Duration of catheterization and catheter insertion site were independent risk factors of catheter related infection.