Recurrent catheter-related bloodstream infections: Risk factors and outcome.

Abstract

OBJECTIVE:

To identify risk factors for recurrent catheter related bloodstream infections (CR-BSIs). The study was undertaken at the University of Utah Hospital and involved patients who had a CR-BSI followed by catheter removal and reinsertion between January 1998 and February 2002.

DESIGN:

A retrospective chart review for the cohort study of catheters initially infected, which were then followed to study risk factors for a subsequent infection. Both central line and peripherally inserted central line catheters were included in the study. A recurrent CR-BSI was defined as positive blood cultures after three negative cultures, coupled with positive catheter tip culture or no other evident new source of infection.

RESULTS:

Twenty-five (34%) of 73 patients had a recurrent CR-BSI. The first CR-BSI occurred a mean of 20.4 days after catheter insertion whereas recurrence developed a mean of 12.1 days after reinsertion (p = 0.392). Coagulase-negative staphylococci (60%) were the most common cause of recurrent infection. The recurrence was more common among the patients who were given blood product transfusion (hazard ratio (HR) 2.3; confidence interval (CI) 1.02-5.67, p = 0.049). In 20 (27%) patients, catheters were changed over a guidewire. The guidewire catheter exchange was not found to be associated with an increased risk of recurrent infection (p = 0.582).

CONCLUSION:

Catheter replacement to a new site, instead of rewiring, was not shown to decrease the risk for recurrent infection. The transfusion of blood products was associated with an increased risk for recurrent infection.

• Authors: Ayşe Erbay, Onder Ergönül, Gregory J Stoddard, Matthew H Samore
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 10 Issue 5 Pg. 396-400 (Sep 2006) ISSN: 1201-9712 [Print] Canada
• PMID: 16702008 (Publication Type: Journal Article)

Topics

• Adult
• Catheterization, Central Venous
• Catheters, Indwelling (microbiology)
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Sepsis (etiology, microbiology)
• Staphylococcal Infections (etiology, microbiology)
• Staphylococcus (isolation & purification)
• Transfusion Reaction