Skip to main content
Log in

Catheter-related infection in critically ill patients

  • Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Objective

To describe the incidence of the catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) of central venous catheters (CVCs) and arterial catheters (ACs).

Design

Prospective, observational study.

Setting

A 24-bed medical-surgical intensive care unit of a 650-bed university hospital.

Patients

We included 988 consecutive patients admitted to the ICU during 18 months.

Measurements

The incidence density of CRLI and CRBSI, per 1000 catheter-days, of CVC and AC.

Results

Central venous catheters had a significantly higher incidence density of CRLI (4.74 vs 0.97/1,000 catheter-days; p<0.001) than ACs. Femoral venous access had a higher incidence density of CRLI than subclavian (13.15 vs 1.81/1,000 catheter-days, p=0.003) and than peripheral access (13.15 vs 2.30/1,000 catheter-days, p<0.001). Jugular venous access had a higher incidence density of CRLI (6.29 vs 1.81/1,000 catheter-days, p<0.001) than subclavian access. We found no significant differences in the incidence density of CRLI and CRBSI between the different AC accesses.

Conclusions

In the CDC guidelines, catheter insertion at the subclavian site is recommended in preference to femoral and jugular accesses, and there is no recommendation about AC site insertion. Our data support these recommendations about CVCs. Because the AC infection rate was very low, our study suggests that the access site is probably not of major importance for this type of catheter.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Pittet D, Tarara D, Wenzel R (1994) Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs and attributable mortality. JAMA 271 (20):1598–1601

    CAS  PubMed  Google Scholar 

  2. Maki DG, Weise CE, Sarafin HW (1977) A semiquantitative culture method for identifying intravenous catheter-related infection. N Engl J Med 296:1305–1309

    CAS  PubMed  Google Scholar 

  3. Garner JS, Jarvis WR, Emori TG, Hotan TC, Hughes JM (1988) CDC definitions for nosocomial infections 1988. Am J Infect Control 16:128–140

    CAS  PubMed  Google Scholar 

  4. Pinilla JC, Ross DC, Martin T, Crump H (1983) Study of the incidence of intravascular catheter infection and associated septicaemia in critically ill patients. Crit Care Med 11:21–25

    CAS  PubMed  Google Scholar 

  5. Damen J, Verhoef J, Bolton DT, Middleton NG, Van der Tweer I, Jonge KD (1985) Microbiologic risk of invasive hemodynamic monitoring in patients undergoing open-heart operation. Crit Care Med 13:548–555

    CAS  PubMed  Google Scholar 

  6. Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E (2001) Complications of femoral and subclavian venous catheterization in critically ill patients. JAMA 286:700–707

    CAS  PubMed  Google Scholar 

  7. Goetz AM, Wagener MM, Miller JM, Muder RR (1998) Risk of infection due to central venous catheters: effect of site of placement and catheter type. Infect Control Hosp Epidemiol 19:842–845

    CAS  PubMed  Google Scholar 

  8. Moro ML, Vigano EF, Cozzi A (1994) Risk factors for central venous catheter-related infections in surgical and intensive care units. The Central Venous Catheter Related Infections Study Group. Infect Control Hosp Epidemiol 15 (4):253–264

    CAS  PubMed  Google Scholar 

  9. Richet H, Hubert B, Nitemberg G, Andremont A, Buu-Hoy A, Ourba C, Veron M, Boisivon A, Bouvier AM (1990) Prospective multicenter study of vascular-catheter-related complications and risk factors for positive central-catheter culture in intensive care unit patients. J Clin Microbiol 28 (11):2520–2525

    CAS  PubMed  Google Scholar 

  10. The National Nosocomial Infections Surveillance System (1998) National nosocomial infections surveillance (NNIS) system report, data summary from October 1986–April 1998, issued June 1998. Am J Infect Control 26:522–533

    PubMed  Google Scholar 

  11. Collignon P, Soni N, Pearson I, Sorrell T, Woods P (1988) Sepsis associated with central vein catheters in critically ill patients. Intensive Care Med 14:227–231

    CAS  PubMed  Google Scholar 

  12. Furfaro S, Gauthier M, Lacroix J, Nadeau D, Laleur L, Mathews S (1991) Arterial catheter-related infections in children. Am J Dis Child 145:1037–1042

    CAS  PubMed  Google Scholar 

  13. Norwood SH, Cormier B, McMahon NG, Moss A, Moore V (1988) Prospective study of catheter-related infection during prolonged arterial catheterization. Crit Care Med 16:836–839

    CAS  PubMed  Google Scholar 

  14. Rijnders BJ, Van Wijngaerden E, Wilmer A, Peetermans WE (2003) Use of full sterile barrier precautions during insertion of arterial catheters: a randomized trial. Clin Infect Dis 36 (6):743–748

    Article  PubMed  Google Scholar 

  15. Safdar N, Maki DG (2002) Inflammation at the insertion site is not predictive of catheter-related bloodstream infection with short-term, non-cuffed central venous catheters Crit Care Med 30 (12):2632–2635

    Google Scholar 

  16. Rijnders BJA, Van Wijngaerden E, Peetermans WE (2002) Catheter-tip colonization as a surrogate end point in clinical studies on catheter-related bloodstream infection: how strong is the evidence?. Clin Infect Dis 35:1053–1058

    Article  PubMed  Google Scholar 

  17. Raad I, Umphrey J, Khan A, Truett LJ, Bodey G (1993) The duration of placement as a predictor of peripheral and pulmonary arterial catheter infections. J Hosp Infect 23:17–26

    CAS  PubMed  Google Scholar 

  18. Brun-Buisson C, Abrouk F, Legran P, Huet Y, Larabi S, Rapin M (1987) Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. Arch Intern Med 147:873–877

    CAS  PubMed  Google Scholar 

  19. Centers for Disease Control and Prevention (2002) Guidelines for the prevention of intravascular catheter-related infections. MMWR 51 (RR-10):1–34

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Leonardo Lorente.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lorente, L., Villegas, J., Martín, M.M. et al. Catheter-related infection in critically ill patients. Intensive Care Med 30, 1681–1684 (2004). https://doi.org/10.1007/s00134-004-2332-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-004-2332-3

Keywords

Navigation