Author:
Lv Yu,Huang Xiaobo,Xiang Qian,Yang Qin,Chen Jin,Cai Minhong,Wang Pingping,Jia Ping,Wang Hui,Xie Caixia,Li Luting,Zhang Dingding,Wei Daoqiong,Wu Jiayu
Abstract
Abstract
Background
To evaluate the effectiveness of enhanced check to the duration of the central venous catheters associated bloodstream infections (CABSIs), and the impact on infection rates.
Methods
A before-after, real-world study in six adult intensive care units was conducted. All adult patients who had only one central venous catheter were included during two consecutive periods. The intervention period, added cross-check that all patients with central venous catheter (CVC) need to be performed, and included nurses' checks for insertion practices and doctors' checks for maintenance practices. Propensity scores matching were used to account for potential confounding, and restricted cubic spline was served as visualizing the CABSI risk.
Results
A total of 2906 patients with 26,157 CVC-days were analyzed. After intervention, the density incidence of CABSI decreased from 10.24 to 6.33/1,000 CVC-days (P < 0.001), and the acute period of rapid increase in CABSI risk was shortened, 6.5 to 5 days for femoral-vein catheterization and 7 to 5.5 days for subclavian-vein catheterization. For jugular-vein catheterization, the acute onset period disappeared.
Conclusion
Enhanced check during the first 7 calendar days after CVC insertion shortens the duration of the CABSI acute phase and tends to decrease CABSI rate.
Funder
Health and Family Planning Commission of the Sichuan Province
Scientific and Technology Department of Sichuan Province
Publisher
Springer Science and Business Media LLC
Subject
Pharmacology (medical),Infectious Diseases,Microbiology (medical),Public Health, Environmental and Occupational Health
Reference40 articles.
1. European Centre for Disease Prevention and Control. Healthcare-associated infections acquired in intensive care units. In: ECDC. Annual epidemiological report for 2017. Stockholm: ECDC; 2019. https://www.ecdc.europa.eu/sites/default/files/documents/AER_for_2017-HAI.pdf Accessed June 1, 2022.
2. Takashima M, Schults J, Mihala G, et al. Complication and failures of central vascular access device in adult critical care settings. Crit Care Med. 2018;46(12):1998–2009. https://doi.org/10.1097/CCM.0000000000003370.
3. Ullman AJ, Marsh N, Mihala G, et al. Complications of central venous access devices: a systematic review. Pediatrics. 2015;136:e1331–44.
4. Ista E, van der Hoven B, Kornelisse RF, et al. Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients of all ages: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(6):724–34. https://doi.org/10.1016/S1473-3099(15)00409-0.
5. Rosenthal VD, Maki DG, Mehta Y, et al. International nosocomial infection control consortium (INICC) report, data summary of 43 countries for 2007–2012. Device associated module. Am J Infect Control. 2014;42(9):942–56. https://doi.org/10.1016/j.ajic.2014.05.029.