Determination of incidence, risk factors, causative agents, and antimicrobial susceptibilities of central venous catheter?related bloodstream infections in intensive care units

The objective of the study was to determine the incidence, risk factors, causative agents, and antimicrobial susceptibilities of central venous catheter-related bloodstream Infection (CRBSI) in five ICU. The incidence of CRBSI and central line utilization ratio were calculated using the data obtained from Infection Control Committee according to NNIS. The de ? nition of CDC was used for diagnosis of nosocomial CRBSI. Catheter utilization ratios and CRBSI rates were calculated using National Nosocomial Infections Surveillance (NNIS). Seventy patients with CRBSI were evaluated for the risk factors, isolated microorganisms, their susceptibility patterns and mortality rates.The mean rate of CRBSI was 8.07 per 1000 central-catheter-days with a catheter utilization rate of 48%. Duration of catheter >7 day, number of lumen >1, using a non-tunneled central venous catheter and femoral vein localization of the catheter were determined as risk factors for CRBSI (P<0.0001). CRBSI were more frequently observed in patients with blood transfused and history of infection. Systemic inflammatory response syndrome and mortality rates were significantly increased in patients with age>60 years and comorbid conditions such as , trauma, malignancy, using steroid therapy and mechanically ventilation.72 pathogen were isolated in patients with CRBSI 31 (43.06%) were Gram-negative, 28 (28.9%) were Gram-positive bacteria, and 13 (18.05%) were fungal pathogen. Most frequently isolated pathogens were coagulase-negative staphylococci (22.2%), Candida spp.(18.0%), and Acinetobacter spp. (16.6%). Methicilline-resistance was found in 81% of coagulase-negative staphylococci and % 67 of S. aureus. Candida spp. was isolated predominantly in diabetic patients and > 60 years old (p=0.017, p=0.002, respectively)Removel of the catheter as soon as possible and managing of underlying conditions could reduce the risk of CRBSİKey Words: Central venous catheter, bacteremia, Intensive care unit