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[Bacteremia originated in intravascular cannulae: an epidemiologic study of 91 episodes]
J Torné Cachot1, J C Soriano Giménez, S Tomás Vecina
1Servicio de Medicina Interna, Hospital del Mar, Universidad Autónoma de Barcelona.
Insights
Intravascular cannula bacteriemia (ICB) is common in intensive care units, with Staphylococcus epidermidis being the most frequent cause. Advanced age significantly increases mortality risk from ICB.
Area of Science:
- Epidemiology
- Infectious Diseases
- Hospital-Acquired Infections
Context:
- Analysis of intravascular cannula bacteriemia (ICB) in a Barcelona university hospital.
- ICB accounted for 26.7% of all hospital bacteriemia episodes.
- Majority of ICB cases (60.6%) were diagnosed in intensive care areas.
Purpose:
- To analyze the epidemiology of intravascular cannula bacteriemia.
- Identify common microorganisms and types of cannulae associated with ICB.
- Determine risk factors and outcomes, including mortality and hospitalization duration.
Summary:
- 91 ICB episodes were analyzed.
- Most common pathogens: Staphylococcus epidermidis (27.8%), Pseudomonas aeruginosa (18.5%), Staphylococcus aureus (14.4%).
- Central venous catheters (55%) and arterial lines (29%) were most frequently implicated.
- Arterial line-associated bacteriemia: shorter interval (7.7 days), often Gram-negative.
- Central venous catheter-associated bacteriemia: longer interval (11.2 days), often Gram-positive.
- Overall mortality: 17%; infection-attributed mortality: 6%.
- Age > 65 years was the sole significant prognostic factor for mortality (33% mortality rate).
- Mean hospitalization: 49.9 days; mean treatment cost: 830,000 ptas/patient.
Impact:
- Highlights the significant burden of ICB in a hospital setting.
- Provides insights into pathogen and device-specific risks.
- Identifies elderly patients as a high-risk group for ICB mortality.
- Informs infection control strategies and resource allocation in healthcare settings.
Abstract:
This reports the analysis of an epidemiologic study of intravascular cannula bacteriemia (ICB) in a Barcelona university hospital. There were 91 episodes of ICB representing the 26.7% of the total hospital bacteriemia. In 60.6% of ICB the diagnosis was made in an intensive care area. The most common microorganisms were Staphylococcus epidermidis (27.8%), Pseudomonas aeruginosa (18.5%), and Staphylococcus aureus (14.4%). Intravascular cannulae with higher incidence of bacteriemia were the central venous catheters (55%) and the arterial lines (29%). Bacteriemia produced by arterial lines had short free period interval (7.7 days) and in 80% of the cases were produced by Gram negative bacteria whereas that bacteriemia produced by central venous catheters had a long free period (11.2 days) and the most frequent agents were Gram positive bacteria. The overall mortality was 17% and that attributed to the infection 6%. An age above 65 years had a mortality rate of 33% and was identified as the only significant prognostic factor (p less than 0.001). The mean hospitalization period was 49.9 days and the cost of the treatment 830.000 ptas/patient.