Catheter Related Bloodstream Infection (CR-BSI) in ICU Patients: Making the Decision to Remove or Not to Remove the Central Venous Catheter

Authors

Rodrigo O. Deliberato, Hospital Israelita Albert Einstein
Alexandre R. Marra, Hospital Israelita Albert Einstein
Thiago D. Correa, Hospital Israelita Albert Einstein
Marines D. V. Martino, Hospital Israelita Albert Einstein
Luci Correa, Hospital Israelita Albert Einstein
Oscar Fernando Pavao dos Santos, Hospital Israelita Albert Einstein
Michael B. Edmond, Virginia Commonwealth UniversityFollow

Document Type

Article

Original Publication Date

2012

Journal/Book/Conference Title

PLOS ONE

Volume

7

DOI of Original Publication

10.1371/journal.pone.0032687

Comments

Originally Published at http://dx.doi.org/10.1371/journal.pone.0032687

Date of Submission

November 2014

Abstract

Background

Approximately 150 million central venous catheters (CVC) are used each year in the United States. Catheter-related bloodstream infections (CR-BSI) are one of the most important complications of the central venous catheters (CVCs). Our objective was to compare the in-hospital mortality when the catheter is removed or not removed in patients with CR-BSI.

Methods

We reviewed all episodes of CR-BSI that occurred in our intensive care unit (ICU) from January 2000 to December 2008. The standard method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and a positive semi quantitative (>15 CFU) culture of a catheter segment from where the same organism was isolated. The conservative method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and one of the following: (1) differential time period of CVC culture versus peripheral culture positivity of more than 2 hours, or (2) simultaneous quantitative blood culture with 5:1 ratio (CVC versus peripheral).

Results

53 CR-BSI (37 diagnosed by the standard method and 16 by the conservative method) were diagnosed during the study period. There was a no statistically significant difference in the in-hospital mortality for the standard versus the conservative method (57% vs. 75%, p = 0.208) in ICU patients.

Conclusion

In our study there was a no statistically significant difference between the standard and conservative methods in-hospital mortality.

Rights

Copyright: © 2012 Deliberato et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Is Part Of

VCU Internal Medicine Publications