Peripherally inserted central venous catheter placed and maintained by a dedicated nursing team for the administration of antimicrobial therapy vs. another type of catheter: a retrospective case–control study

Author(s):  
Jose Tiago Silva ◽  
Almudena Lagares-Velasco ◽  
Mario Fernández-Ruiz ◽  
Gema González-Monterrubio ◽  
M. Dolores Pérez-Cárdenas ◽  
...  
1999 ◽  
Vol 20 (01) ◽  
pp. 26-30 ◽  
Author(s):  
Michelle Onorato ◽  
Michael J. Borucki ◽  
Gwen Baillargeon ◽  
David P. Paar ◽  
Daniel H. Freeman ◽  
...  

AbstractObjective:To determine the risk factors for colonization or infection with methicillin-resistantStaphylococcus aureusin human immunodeficiency virus (HIV)-infected patients.Design:Retrospective matched-pair case-control study.Setting:Continuity clinic and inpatient HIV service of a university medical center.Population:Patients with HIV infection from the general population of eastern and coastal Texas and from the Texas Department of Criminal Justice.Data Collection:Patient charts and the AIDS Care and Clinical Research Program Database were reviewed for the following: age, race, number of admissions, total hospital days, presence of a central venous catheter, serum albumin, total white blood cell count and absolute neutrophil count, invasive or surgical procedures, any cultures positive forS aureus, and a history of opportunistic illnesses, diabetes, or dermatologie diagnoses. Data also were collected on the administration of antibiotics, antiretroviral therapy, steroids, cancer chemotherapy, and subcutaneous medications.Results:In the univariate analysis, the presence of a central venous catheter, an underlying dermatologie disease, lower serum albumin, prior steroid therapy, and prior antibiotic therapy, particularly antistaphylococcal therapy or multiple courses of antibiotics, were associated with increased risk for colonization or infection with methicillin-resistantS aureus. Multivariate analysis yielded a model that included presence of a central venous catheter, underlying dermatologie disease, broad-spectrum antibiotic exposure, and number of hospital days as independent risk factors for colonization or infection with methicillin-resistantS aureus.Conclusions:In our HIV-infected patient population, prior hospitalization, exposure to broad-spectrum antibiotics, presence of a central venous catheter, and dermatologie disease were risk factors for acquisition of methicillin-resistantS aureus


2003 ◽  
Vol 24 (4) ◽  
pp. 269-274 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Jennie L. Mayfield ◽  
Teresa Garison ◽  
Patricia M. McLendon ◽  
John F. DiPersio ◽  
...  

AbstractObjective:To characterize risk factors for Stenotrophomonas maltophilia bloodstream infection in oncology patients.Design:A 3:1 case–control study.Setting:Stem Cell Transplant and Leukemic Center at Barnes–Jewish Hospital (St. Louis), a 1,442-bed, tertiary-care teaching hospital with a 26-bed transplantation ward.Method:From June 1999 to April 2001,13 patients with S. maltophilia bacteremia were compared with 39 control-patients who were on the transplantation unit on the same day as the case-patients' positive blood cultures. Information collected included patient demographics, medical history, history of transplantation, transplantation type, graft versus host disease, neutropenia, antibiotic use, chemotherapy, mucositis, diarrhea, the presence of central venous catheter(s), cultures, and concomitant infections.Results:Significant risk factors for S. maltophilia bacteremia included severe mucositis (7 [53.8%] of 13 vs 8 [20.5%] of 39; P = .034), diarrhea (7 [53.8%] of 13 vs 8 [20%] of 39; P = .034), and the use of metronidazole (9 [69.2%] of 13 vs 8 [20.5%] of 39; P = .002). In addition, the number of antibiotics used (median, 9 vs 5; P < .001), duration of mucositis (median, 29 vs 15 days; P = .032), and length of hospital stay (median, 34 vs 22 days; P = .017) were significantly different between case- and control-patients. Nine S. maltophilia isolates tested by pulsed-field gel electrophoresis were found to be distinctly different.Conclusion:Interventions to ameliorate the severity of mucositis, reduce antibiotic pressure, prevent diarrhea, and promote meticulous central venous catheter care may help prevent S. maltophilia bloodstream infection in oncology patients. The role of gastrointestinal tract colonization as a potential source of S. maltophilia bacteremia in oncology patients deserves further investigation.


2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S246-S246
Author(s):  
Dantuluru Muralidhar Varma ◽  
Srikant Prasad Rao ◽  
Sudha Vidyasagar ◽  
Kalwaje Eshwara Vandana

2006 ◽  
Vol 17 (3) ◽  
pp. 169-176 ◽  
Author(s):  
Donna Holton ◽  
Shirley Paton ◽  
John Conly ◽  
Joanne Embree ◽  
Geoffrey Taylor ◽  
...  

OBJECTIVE:To determine the rate and risk factors associated with central venous catheter (CVC)-associated bloodstream infections (BSIs) in Canadian intensive care units (ICUs).DESIGN:A prospective, active six-month cohort with a nested case-control study.SETTING:Forty-one ICUs located in 19 Canadian hospitals.METHODS:Data were collected using a standardized format on all CVCs and patients when a CVC was inserted for more than 48 h. Results of microbiological studies and therapeutic interventions were recorded when a BSI occurred.RESULTS:There were 182 BSIs from 3696 CVC insertions in 2531 patients. Coagulase-negative staphylococci were responsible for 73% of the BSIs. Mean rates of CVC-associated BSIs per 1000 CVC days were 6.9, 6.8 and 5.0 in adult, neonatal and pediatric ICUs, respectively. Significant factors associated with BSI included duration of CVC insertion (OR=1.2, 95% CI 1.1 to 1.3), receiving total parenteral nutrition (OR=4.1, 95% CI 1.2 to 14.3) and having one or more CVCs (OR=3.1, 95% CI 1.5 to 6.5). In the case-control study, 80% of the variance in a backward elimination logistic regression analysis was explained by duration of CVC insertion (OR=1.2 per day), receiving chemotherapy (OR=6.1), more than one CVC insertion during the study (OR=3.5), insertion of a CVC with two or more lumens (OR=2.3), using the CVC to administer total parenteral nutrition (OR=1.6) and having a surgical wound other than a clean wound (OR=1.6).CONCLUSION:The present study identified risk factors explaining 80% of the variance associated with BSIs and is one of the largest reports on the rate of CVC-associated BSIs occurring in the ICU setting.


2020 ◽  
Vol 25 (3) ◽  
pp. 45-55
Author(s):  
Sandeep Tripathi ◽  
Kimberly Burkiewicz ◽  
Jonathan A. Gehlbach ◽  
Yanzhi Wang ◽  
Michele Astle

Highlights Abstract Introduction: Catheter-associated deep vein thrombosis (CADVT) in children has been recognized as a significant hospital-acquired condition. This study was undertaken to retrospectively analyze the impact of CADVT on outcomes and to identify risk factors for the development of deep vein thrombosis in children with central venous catheters. Methods: This was a single-center retrospective case-control study of patients with central venous catheters in a pediatric intensive care unit (ICU) from January 2014 to December 2018. Forty-one patients with central venous catheters who developed CADVT were compared with 100 random controls. Central venous catheter type, along with patient and disease-specific characteristics, were compared between the two groups by univariate and multivariate regression. Outcome comparison was made after adjusting for confounding variables. Results: Median time from insertion to the development of CADVT was 4 days (interquartile range, 2–9). Forty percent (16/40) of patients had a blood urea nitrogen greater than 20 mg/dL, and 86.6% (13/15) had a C-reactive protein greater than 1 mg/dL within 48 hours of development of CADVT. Central venous catheter duration (odds ratio [OR], 1.05), mechanical ventilation (OR, 7.49), and upper versus lower extremity site of the central venous catheter (OR, 0.324) were associated with the development of CADVT. Ultrasound guidance occurred significantly less in patients who developed CADVT (39.3% vs 70.7%); however, it was not independently associated with increased risk. Age, body mass index, mechanical ventilation, and severity of illness–adjusted hospital and ICU length of stay were significantly higher in patients who developed CADVT. Conclusions: CADVT is independently associated with worse outcomes. Ultrasound guidance and site selection are potential modifiable risk factors in the development of CADVT in pediatric patients. Future studies should target an effective chemoprophylaxis regimen.


2000 ◽  
Vol 21 (5) ◽  
pp. 330-333 ◽  
Author(s):  
Olivier Lambotte ◽  
Jean-Christophe Lucet ◽  
Laurent Fleury ◽  
Marie-Laure Joly-Guillou ◽  
Elisabeth Bouvet

AbstractA retrospective case-control study compared 40 human immunodeficiency virus (HIV)-infected patients with 43 nosocomial bacteremias (NB) to 77 HIV-infected patients without NB. Presence of a peripheral venous catheter (PVC) was associated with occurrence of NB and was significantly more frequent in NB without an identified source. PVCs probably are an underestimated source of NB in HIV-infected patients.


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