5 research outputs found
Catheter Related Bloodstream Infection (CR-BSI) in ICU Patients: Making the Decision to Remove or Not to Remove the Central Venous Catheter
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 (\u3e15 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
Characteristics of the patients with CR-BSI.
<p>CVC = central venous catheter; SAPS II = simplified acute physiology score; SOFA = Sepsis-related Organ Failure Assessment; APACHE II = Acute Physiology and Chronic Health disease Classification System II, Charlson = comorbidity index.</p
Risk factors for in-hospital mortality.
<p>CVC = central venous catheter; SAPS II = simplified acute physiology score; SOFA = Sepsis-related Organ Failure Assessment; APACHE II = Acute Physiology and Chronic Health disease Classification System II, Charlson = comorbidity index.</p
Microbiological features by diagnostic method.
<p>Microbiological features by diagnostic method.</p