scholarly journals A clinical study of patients with central venous catheter associated bloodstream infections in a tertiary care hospital

2020 ◽  
Vol 9 (11) ◽  
pp. 1665
Author(s):  
R. Abisha Rezia ◽  
R. Vijendra ◽  
Anjana Gopi
Keyword(s):  
Staphylococcus Aureus ◽  
Central Venous Catheter ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Care Hospital ◽  
Central Venous ◽  
Enterococcus Spp ◽  
Acinetobacter Spp

Background: Central venous access puts the patients at risk of iatrogenic complications and is associated with bloodstream infections. Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus and Methicillin Resistant Staphylococcus aureus (MRSA) are responsible for at least two-thirds of the infections followed by Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Enterococcus spp and Acinetobacter spp. Due to the scarcity of Central Venous Catheter associated Blood Stream Infections (CVC-BSI) data, this study was taken up in our tertiary care hospital. Aims: This study is aimed to study the profile of organisms causing CVC-BSI, assess their antimicrobial susceptibility, the clinical course and outcome.Methods: All subjects whose central venous catheter samples (n=84) were sent for culture and sensitivity during the study period were included in this prospective observational study. The study was done in the Department of Microbiology from July 2019 to December 2019. The catheter tips were streaked onto blood agar plate using Roll plate technique. After biochemical identification of the organisms, antimicrobial susceptibility testing was performed by modified Kirby-Bauer disc diffusion method as per the Clinical Laboratory Standard Institute (CLSI) guidelines. Results: Growth of pathogens was seen in 64.3% (n=54). The common organisms were Coagulase Negative Staphylococcus aureus (CONS) in 27.78% (n=15), Enterococcus spp, Klebsiella pneumoniae in 14.8% each (n=8) and Acinetobacter spp in 11.1% (n=6). Resistance was seen with amoxicillin + clavulanic acid, cefepime, ciprofloxacin and cefoperazone. The organisms were sensitive to levofloxacin, tetracycline and vancomycin.Conclusion: Aseptic precautions taken by the healthcare personnel will bring down the infections and curb the spread of multi-drug resistant hospital acquired infections.

scholarly journals Central venous catheter-related bloodstream infections (CVC-BSI) in patients of clinically suspected septicemia

2016 ◽  
Vol 41 (2) ◽  
pp. 89-94
Author(s):  
Zeenat Afroz ◽  
Mohammad Jobayer ◽  
Sharmeen Ahmed ◽  
Shaheda Anwar ◽  
Md Ruhul Amin Mia
Keyword(s):  
Central Venous Catheter ◽  
Venous Blood ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Control Measures ◽  
Causative Organism ◽  
Central Venous ◽  
Pseudomonas Spp ◽  
Acinetobacter Spp

Central venous catheter-related bloodstream infections (CVC-BSI) are associated with morbidity and mortality especially in critically ill patients. This study was performed to find out the rate of CVC-BSI and CVC colonization, causative organism and their antibiogram in patients of Intensive Care Unit (ICU) and Department of Nephrology of tertiary care hospitals. A total of 100 patients from Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) who had CVC and clinically suspected of septicemia were included in the study. Paired CVC blood and peripheral venous blood (PVB) samples were collected from each patient and were cultured by automated blood culture method. CVC-BSI was diagnosed in 11% and CVC colonization in 43% patients by Differential time to positivity (DTP) method. Rate of CVC-BSI was 8/1000 CVC days and 11/1000 CVC days in BSMMU and DMCH respectively whereas CVC colonization rate was 32/1000 CVC days and 47.5/1000 CVC days in BSMMU and DMCH. The most common bacteria causing CVC-BSI was Klebsiella spp. (36.4%) followed by Acinetobacter spp. (27.3%), Pseudomonas spp. (18.2%) and E. coli (18.2%). Among bacteria isolated from CVC colonization majority were Pseudomonas spp. (30.23%) and Staphylococcus epidermidis (30.23%) followed by Acinetobacter spp. (27.91%), Enterococcus spp. (6.98%). Most of the isolated bacteria causing CVC-BSI were resistant to commonly used antibiotics, but showed good sensitivity to imipenem and colistin. Information about CVC-BSI, colonization and antibiogram of this study can help to guide the selection of suitable antibiotics for empirical therapy and to improve infection control measures of the hospital.

High success rate in salvage of catheter-related bloodstream infections due to Staphylococcus aureus, on behalf of project group of Italian society of nephrology

2019 ◽  
Vol 21 (3) ◽  
pp. 336-341
Author(s):  
Salvatore Mandolfo ◽  
Adriano Anesi ◽  
Milena Maggio ◽  
Vanina Rognoni ◽  
Franco Galli ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Central Venous Catheter ◽  
Prognostic Index ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Catheter Removal ◽  
Renal Unit ◽  
Chronic Haemodialysis ◽  
Central Venous

Background: Catheter-related bloodstream infections caused by Staphylococcus aureus represent one of the most fearful infections in chronic haemodialysis patients with tunnelled central venous catheters. Current guidelines suggest prompt catheter removal in patients with positive blood cultures for S. aureus. This manoeuvre requires inserting a new catheter into the same vein or another one and is not without its risks. Methods: A protocol based on early, prompt diagnosis and treatment has been utilized in our renal unit since 2012 in an attempt to salvage infected tunnelled central venous catheters. We prospectively observed 247 tunnelled central venous catheters in 173 haemodialysis patients involving 167,511 catheter days. Results: We identified 113 catheter-related bloodstream infections (0.67 episodes per 1000 days/tunnelled central venous catheter). Forty were caused by S. aureus, including 19 by methicillin-resistant S. aureus (79% saved) and 21 by methicillin-sensitive S. aureus (90% saved), of which 34 (85%) were treated successfully. Eight recurrences occurred and six (75%) were successfully treated. A greater than 12 h time to blood culture positivity for S. aureus was a good prognostic index for successful therapy and tunnelled central venous catheter rescue. Conclusion: Our data lead us to believe that it is possible to successfully treat catheter-related bloodstream infection caused by S. aureus and to avoid removing the tunnelled central venous catheter in many more cases than what has been reported in the literature. On the third day, it is mandatory to decide whether to replace the tunnelled central venous catheter or to carry on with antibiotic therapy. Apyrexia and amelioration of laboratory parameters suggest continuing systemic and antibiotic lock therapy for no less than 4 weeks, otherwise, tunnelled central venous catheter removal is recommended.

scholarly journals 183. Candidaemia in Children and Importance of Central Venous Catheter Removal

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S112-S113
Author(s):  
Kamile Arikan ◽  
Sevtap Arıkan-Akdaglı ◽  
Ates Kara
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Blood Stream ◽  
Attributable Mortality ◽  
Care Hospital ◽  
Central Venous ◽  
Candida Spp

Abstract Background Candida is the most common cause of invasive fungal infection in healthcare settings and is associated with significant increases in healthcare resource utilization and attributable mortality. Methods This study was conducted in a pediatric tertiary care hospital from Turkey. We conducted a retrospective analysis in children ≤18 years with blood culture-proven candidaemia identified between December 2013 and November 2017. Sociodemographic variables,underlying condition, mortality, additional risk factors, origin of specimens were all recorded. Results A total of 236 episodes of candidaemia were identified over the study period. The median age of the patients was 600 days (4-6482). 106 specimens (44.9%) were cultured from patients under 1 year of age and 15 of 106 specimens were cultured from neonates. The most frequently isolated Candida spp. were C. albicans (42.%), followed by C. parapsilosis (30.5%), C. glabrata (7.6%), C. tropicalis (6.4%), C. krusei (2.5%), C. lusitaine (2.5%), C. dubliniensis (2.1%), C. kefir (0.8%), and C. pelliculosa (0.4%). In 11 of the 236 episodes (4.5%), two Candida spp were cultured at the same time.The most common coinfection was C. albicans and C. parapsilosis. 112 of the 236 episodes (47.5%) was due to central venous catheter-related blood stream infection. 47.5% of these patients were receiving total parenteral nutrition at the time of candidemia. Concomitant coagulase negatif staphylococcus bacteremia was present in 50 of 236 candidemia episodes (21.2%). Of 236 isolates, 74 (31.4%) was cultured from peripheral blood culture only, 95 (40.3%) from central venous catheter only, 67 (28.4%) from both peripheral and central catheter blood culture.Trombocytopenia was noted in 117 episodes (49.6%) and neutropenia in 45 episodes (19.1 Of the 112 central venous catheter-related candidemia, 35 (31.3%) resulted in death within 30 days from the onset of candidaemia (Figure 1). In 49 (45.%) episodes of central venous catheter-related candidemia, catheter was not removed and 40% of these episodes resulted as death.Catheter removal, thrombocytopenia, total parenteral nutrion were found to be associated with increased mortality in children under 1 year of age (P < 0.001). Conclusion Clinicians must be aware of candidemia in children due to high risk of mortality. Disclosures All authors: No reported disclosures.

scholarly journals Correlation between Vancomycin MIC Values and Those of Other Agents against Gram-Positive Bacteria among Patients with Bloodstream Infections Caused by Methicillin-Resistant Staphylococcus aureus

2009 ◽  
Vol 53 (12) ◽  
pp. 5141-5144 ◽  
Author(s):  
N. Patel ◽  
P. Lubanski ◽  
S. Ferro ◽  
M. Bonafede ◽  
S. Harrington ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Care Hospital ◽  
Gram Positive ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Included Patient

ABSTRACT An increase in the distribution of vancomycin MIC values among methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) isolates has been noted. It is postulated that the shift in vancomycin MIC values may be associated with a concurrent rise in the MIC values of other anti-MRSA agents. Scant data are available on the correlation between vancomycin MIC values and the MIC values of other anti-MRSA agents. This study examined the correlation between vancomycin MIC values and the MIC values of daptomycin, linezolid, tigecycline, and teicoplanin among 120 patients with bloodstream infections caused by MRSA at a tertiary care hospital between January 2005 and May 2007. For each included patient, the MIC values of the antibiotics under study were determined by the Etest method and were separated into the following two categories: day 1 (index) and post-day 1 (subsequent). For subsequent isolates, the MIC values for each antibiotic from the post-day 1 terminal isolate were used. Among the index isolates, there was a significant correlation (P value, <0.01) between the MIC values for vancomycin and daptomycin and between the MIC values for vancomycin and teicoplanin. The MIC values for daptomycin were significantly correlated with linezolid, tigecycline, and teicoplanin MIC values. Among the 48 patients with subsequent isolates, vancomycin MIC values were significantly correlated with MIC values for daptomycin, linezolid, and teicoplanin (ρ value of ≥0.38 for all comparisons). This study documented an association between vancomycin MIC values and the MIC values of other anti-MRSA antibiotics among patients with bloodstream infections caused by MRSA primarily treated with vancomycin.

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