Catheter related bloodstream infection (CR-BSI) in ICU patients: making the decision to remove or not to remove the central venous catheter

Rodrigo Octávio Deliberato; Alexandre R Marra; Thiago Domingos Corrêa; Marinês Dalla Vale Martino; Luci Correa; Oscar Fernando Pavão Dos Santos; Michael B Edmond

doi:10.1371/journal.pone.0032687

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Catheter related bloodstream infection (CR-BSI) in ICU patients: making the decision to remove or not to remove the central venous catheter

Journal article

Open access

Peer reviewed

Catheter related bloodstream infection (CR-BSI) in ICU patients: making the decision to remove or not to remove the central venous catheter

Rodrigo Octávio Deliberato, Alexandre R Marra, Thiago Domingos Corrêa, Marinês Dalla Vale Martino, Luci Correa, Oscar Fernando Pavão Dos Santos and Michael B Edmond

PloS one, Vol.7(3), e32687

2012

DOI: 10.1371/journal.pone.0032687

PMCID: PMC3293859

PMID: 22403696

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Abstract

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

Decision Making

Humans

Middle Aged

Bacteremia - mortality

Intensive Care Units - statistics & numerical data

Male

Fungemia - mortality

Hospitals - statistics & numerical data

Catheter-Related Infections - mortality

Female

Aged

Retrospective Studies

Catheterization, Central Venous - adverse effects

Details

Title: Subtitle: Catheter related bloodstream infection (CR-BSI) in ICU patients: making the decision to remove or not to remove the central venous catheter
Creators: Rodrigo Octávio Deliberato - Critical Care Unit, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. rodrigo.deliberato@einstein.br
Alexandre R Marra
Thiago Domingos Corrêa
Marinês Dalla Vale Martino
Luci Correa
Oscar Fernando Pavão Dos Santos
Michael B Edmond
Resource Type: Journal article
Publication Details: PloS one, Vol.7(3), e32687
DOI: 10.1371/journal.pone.0032687
PMID: 22403696
PMCID: PMC3293859
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: Public Library of Science; United States
Language: English
Date published: 2012
Academic Unit: Internal Medicine
Record Identifier: 9983905527902771

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