Incidence Rate, Pathogens and Economic Burden of Catheter-Related Bloodstream Infection: A Single-Center,...

Area of Science:

• Infectious Diseases
• Healthcare Economics
• Critical Care Medicine

Background:

• Indwelling central venous catheters (CVCs) are essential in intensive care units (ICUs) but pose a risk for catheter-related bloodstream infections (CRBSI).
• CRBSI in ICU patients is associated with adverse clinical outcomes and increased healthcare expenditures.
• Understanding the incidence, causative pathogens, and economic impact of CRBSI is vital for effective infection control strategies.

Purpose of the Study:

• To determine the incidence and incidence density of CRBSI in ICU patients.
• To identify the common pathogens responsible for CRBSI and their antimicrobial resistance patterns.
• To assess the economic burden, including attributable costs, associated with CRBSI in the ICU setting.

Main Methods:

• A retrospective case-control study was conducted across six ICUs over a five-year period (July 2013 - June 2018).
• Routine CRBSI surveillance was performed by the hospital's Infection Control Department.
• Data collected included clinical and microbiological characteristics, incidence, incidence density, attributable length of stay, and costs for patients with CRBSI.

Main Results:

• The overall CRBSI incidence density was 1.27 per 1000 CVC-days, with significant variation among ICUs (0.14 to 3.52 per 1000 CVC-days).
• Klebsiella pneumoniae was the most frequent pathogen (16.67%), with a high rate of carbapenem resistance (80%).
• CRBSI patients incurred significantly higher average costs ($67,923) compared to controls, with an attributable cost of $33,696 per patient.

Conclusions:

• The incidence of CRBSI in ICUs is directly linked to increased medical costs.
• Effective strategies to prevent and manage CRBSI are urgently needed to mitigate adverse outcomes and reduce financial strain.
• Targeted interventions focusing on high-risk ICUs and carbapenem-resistant organisms are warranted.