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Central line-associated blood stream infections: characteristics and risk factors for mortality over a 5.5-year
Aynur Atilla1, Zahide Doğanay2, Hale Kefeli Çelik2
1Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey.
Background/Aim:
Central line-associated bloodstream infections (CLABSIs) are associated with substantial morbidity and mortality and the infection rates vary in a wide range1397645907(high: 62.5%; low: 20%) in developing countries. We aimed to investigate the characteristics and the risk factors for mortality in patients with CLABSIs in intensive care units (ICUs) and provide the relevant data.
Materials And Methods:
The electronic medical records database and file records obtained through active surveillance by an infection control committee of a hospital were screened to identify patients with CLABSIs hospitalized from January 2008 through July 2013.
Results:
A total of 166 CLABSI episodes in 158 patients out of 17,553 on 38,562 catheter and 94,512 hospitalization days were evaluated. The infection developed in catheterized patients at a median of 14 days (range 2-88), and the highest infection rate with 13.4% (n = 20) was the femoral region among the places where the catheter was inserted. Of the patients catheterized, 54.4% survived whereas 45.6% died. In patients having Candida infection, the mortality was significantly higher. High APACHE II scores and Candida infections were found to be significant risk factors associated with mortality.
Conclusion:
APACHE II scores and bloodstream infection with Candida species were the most powerful predictors of mortality. In ICU practice, health-care givers must consider the emerging role of Candida for both invasiveness and mortality.
Insights
High APACHE II scores and Candida infections significantly increase mortality risk in patients with central line-associated bloodstream infections (CLABSIs) in intensive care units (ICUs). These factors are critical for predicting patient outcomes.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Medical Microbiology
Background:
- Central line-associated bloodstream infections (CLABSIs) present a significant threat in developing countries, with infection rates varying widely.
- CLABSIs contribute substantially to patient morbidity and mortality, necessitating further investigation into risk factors.
Purpose of the Study:
- To investigate the characteristics of CLABSIs in intensive care unit (ICU) patients.
- To identify risk factors associated with mortality in patients experiencing CLABSIs.
Main Methods:
- A retrospective analysis of electronic medical records and surveillance data from January 2008 to July 2013.
- Inclusion of 166 CLABSI episodes in 158 patients, evaluating hospitalization days and catheter usage.
Main Results:
- The median time to infection was 14 days, with the femoral region showing the highest infection rate (13.4%).
- Mortality was observed in 45.6% of patients; Candida infections were associated with significantly higher mortality.
- High APACHE II scores and Candida infections emerged as significant predictors of mortality.
Conclusions:
- APACHE II scores and Candida bloodstream infections are potent predictors of mortality in ICU patients with CLABSIs.
- Healthcare providers should recognize the increasing importance of Candida in CLABSI invasiveness and mortality within ICU settings.