The Incidence and Risk of Central Venous Catheter Malpositioning: A Prospective Cohort Study in 1619 Patients

This prospective cohort study was conducted to determine the frequency of infections caused by extended-spectrum beta-lactamase- (ESBL-) producing organisms, various bacteria producing ESBL, antibiotic susceptibility of these organisms, and the risk factors associated with these infections in a neonatal intensive care unit in a tertiary care hospital in North India. Of the 150 neonates enrolled in the study, 47 culture-positive neonates were included in the study cohort and were divided into two groups: ESBL-positive (8 neonates) and ESBL-negative (39 neonates) cohorts. Various organisms were isolated from 72 culture samples in these 47 neonates. Of these, 10 culture samples grew ESBL-positive organisms and 62 samples grew ESBL-negative organisms. The frequency of ESBL-producing organisms was found to be 5.3%. ESBL infection incidence densities were found to be 3.4 per 1000 patient-days.Klebsiella(60%) was the most common organism producing ESBL followed byEscherichia coli(30%) andPseudomonas(10%). Eighty percent of the ESBL-producing organisms were sensitive to piperacillin-tazobactam. Risk factors found significant by univariate analysis (P<0.05) were preterm, low birthweight, perinatal asphyxia, respiratory distress syndrome, anaemia, metabolic acidosis, prolonged mechanical ventilation (>7 days), length of hospitalization, length of level 3 stay, prior antibiotic use, central venous catheter duration, peripherally inserted central venous catheter duration, and total parenteral nutrition duration. Factors that retained significance in the logistic regression model were duration of hospital stay (adjusted OR: 0.958, CI: 0.920–0.997, andPvalue = 0.037) and gestational age (adjusted OR: 1.39, CI: 1.037–1.865, andPvalue = 0.028). There was no significant difference in the mortality between the two groups.

Download Full-text

Central venous catheter-related infection: a cohort study evaluating dedicated central venous catheter packs

Critical Care ◽

10.1186/cc8078 ◽

2009 ◽

Vol 13 (Suppl 4) ◽

pp. P22

Author(s):

S Mukerji ◽

R Daniels ◽

K Maung ◽

A Mattin

Keyword(s):

Cohort Study ◽

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous ◽

Catheter Related Infection

Download Full-text

Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

Infection Control and Hospital Epidemiology ◽

10.1086/501658 ◽

1999 ◽

Vol 20 (7) ◽

pp. 494-498 ◽

Cited By ~ 25

Author(s):

Pascal Astagneau ◽

Sylvie Maugat ◽

Tuan Tran-Minh ◽

Marie-Cécile Douard ◽

Pascale Longuet ◽

...

Keyword(s):

Cohort Study ◽

Central Venous Catheter ◽

Cancer Patients ◽

Venous Catheter ◽

Central Venous ◽

Hiv Patients ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Hiv And Cancer

Objectives:To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.Design:Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.Setting:Services of infectious diseases and oncology of 12 university hospitals in Paris, France.Participants:In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.Results:Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.Conclusions:Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

Download Full-text

Early prophylaxis of central venous catheter-related thrombosis using 1% chlorhexidine gluconate and chlorhexidine-gel-impregnated dressings: a retrospective cohort study

Scientific Reports ◽

10.1038/s41598-020-72709-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Tomoko Yamashita ◽

Ayako Takamori ◽

Akira Nakagawachi ◽

Yoshinori Tanigawa ◽

Yohei Hamada ◽

...

Keyword(s):

Cohort Study ◽

Central Venous Catheter ◽

Retrospective Cohort Study ◽

Critically Ill Patients ◽

Retrospective Cohort ◽

Venous Catheter ◽

Chlorhexidine Gluconate ◽

Central Venous ◽

Chlorhexidine Gel ◽

Catheter Related Thrombosis

Abstract To determine the prophylactic effect of using combined 1% alcoholic chlorhexidine gluconate and chlorhexidine gel-impregnated dressings (CGCD) on catheter-related thrombosis (CRT) in critically ill patients. This retrospective cohort study was performed in an intensive care unit from November 2009 to August 2014. The CRT incidence diagnosed with ultrasound examination was compared between patients applying CGCD and combined 10% aqueous povidone-iodine and standard transparent dressings (PITD) after central venous catheter insertion into the internal jugular vein for ≥ 48 h. CRT was stratified into early (within 7 days) and late (days 8–14) thromboses. Multivariate analyses using logistic regression models clarified the relationships between early- and late-CRT risks and skin antiseptic and catheter site dressing combinations. CRT occurred in 74 of 134 patients (55%), including 52 with early CRT and 22 with late CRT. Patients receiving CGCD had a significantly lower incidence of early CRT than those receiving PITD (odds ratio = 0.18; 95% confidence interval = 0.07–0.45, p < .001). No significant association was evident between using CGCD and late CRT (p = .514). Compared to PITD, CGCD reduced the CRT risk over 7 days in critically ill patients. UMIN Clinical Trials Registry: UMIN000037492.

Download Full-text