scholarly journals Effect of Central Line Duration and Other Risk Factors on Central Line-Associated Bloodstream Infection in Severe Adult Burns Patients at a Large Tertiary Referral Burns Centre: A 5-Year Retrospective Study

2022 ◽  
Vol 3 (1) ◽  
pp. 18-26
Author(s):  
Alexandra Miller ◽  
Elizabeth Vujcich ◽  
Jason Brown

Central line-associated bloodstream infection (CLABSI) and catheter-related bloodstream infection (CLABSI with a positive catheter tip culture, CRBSI) are preventable causes of morbidity and mortality for severe adult burns patients. Routine central line changes as a CLABSI prevention strategy in burns patients is controversial due to the paucity of evidence to guide the appropriate timing of line changes. This study aimed to address this evidence gap by investigating risk factors associated with central line sepsis, including the duration of central line insertion, in a population of severe adult burns patients (burns involving ≥20% total body surface area (TBSA)) admitted to the Royal Brisbane and Women’s Hospital Intensive Care Unit over five years (2015–2019 inclusive). On multivariate analysis, central line duration and burn TBSA were identified as independent risk factors for CLABSI, with central line duration the most significant predictor (p = 0.0008; OR 1.177, 95% CI 1.072–1.299). No risk factor independently predicted CRBSI. CLABSI detection occurred a median of 8.5 days (IQR 6.0–11.0) post central line insertion. These findings suggest further research to assess the efficacy of routine line changes prior to the at-risk period of 6–11 days post central line insertion in reducing CLABSI in severe adult burns patients may be beneficial.

2014 ◽  
Vol 36 (2) ◽  
pp. 214-216 ◽  
Author(s):  
Devin Callister ◽  
Pauline Limchaiyawat ◽  
Samantha J. Eells ◽  
Loren G. Miller

Little is known about central line–associated bloodstream infection risk factors in the bundle era. In our case-control investigation, we found that independent risk factors for central line–associated bloodstream infection at our center included the number of recent lab tests, catheter duration, and lack of hemodynamic monitoring as the insertion indication.Infect Control Hosp Epidemiol 2014;00(0): 1–3


2018 ◽  
Vol 23 ◽  
pp. S19-S20
Author(s):  
Hitender Gautam ◽  
Abdul Hakim Choudhary ◽  
Sarita Mohapatra ◽  
Seema Sood ◽  
Bimal Kumar Das ◽  
...  

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Hung-Jen Tang ◽  
Hsin-Lan Lin ◽  
Yu-Hsiu Lin ◽  
Pak-On Leung ◽  
Yin-Ching Chuang ◽  
...  

2021 ◽  
pp. 75-77
Author(s):  
Saba Shama ◽  
Anuradha De ◽  
Jayanthi Shastri

Introduction: Enterococci are the most common aerobic and facultative anaerobic gram-positive cocci. They show intrinsic resistance to many antibiotics, acquire resistance genes and are capable of transferring resistance genes. Immunosuppression, abdominal surgery, structural abnormalities of urinary tract, long hospital/ICU stay, previous antibiotic use, mechanical ventilation, etc. are all risk factors for enterococcal infections. Objectives: A study was undertaken to nd out the risk factors and outcomes of Enterococcus species isolated from clinical specimens. Material and Methods: Single enterococcal isolates recovered from clinical specimens received for bacterial culture in this hospital during a period of one and half years were included in the study. Clinical details of the patient and risk factors were noted down in a structured proforma. Enterococci were identied and speciated by standard biochemical tests. Patient was followed up to see the outcome. Total 96 enterococci Results: were isolated during this period from hospitalized patients, out of which 86 were Enterococcus faecalis, 8 E. faecium and 2 E. solitarius. Out of these, 4.2% isolates were vancomycin resistant enterococci. Out of 96, 52.1% had a hospital stay >7 days, 28.1% were on mechanical ventilation and 19.8% had central line insertion. In this study, 26% patients with enterococcal infection expired. Mortality among patients with E. faecium infection was more (62.5%) than among patients with E. faecalis infection (23.3%). Mortality in patients whose hospital stay was >7 days was 42%, whereas those on mechanical ventilation was 48.1% and those with central line insertion was 52.6%. This study revealed that in Conclusion: enterococcal infections, hospital stay of >7 days, mechanical ventilation and central line insertion are signicantly associated with mortality.


2022 ◽  
Vol 12 (1) ◽  
pp. 47
Author(s):  
Yi-Ling Lin ◽  
I-Chen Chen ◽  
Jung-Hsing Yen ◽  
Chih-Sheng Lai ◽  
Yueh-Chi Tsai ◽  
...  

Background: Invasive candidiasis (IC) is a major cause of morbidities and mortality in patients hospitalized with major burns. This study investigated the incidence of IC in this specific population and analyzed the possible risk factors. Materials and Methods: We retrospectively analyzed data from the National Health Insurance Research Database (NHIRD) of Taiwan. We identified 3582 patients hospitalized with major burns on over 20% of their total body surface area (TBSA) during 2000–2013; we further analyzed possible risk factors. Result: IC was diagnosed in 452 hospitalized patients (12.6%) with major burns. In the multivariate analysis, patients older than 50 years (adjusted odds ratio (OR) = 1.96, 95% confidence interval (CI) 1.36–2.82), those of female sex (adjusted OR = 1.33, 95% CI 1.03–1.72), those with burns on the head (adjusted OR = 1.33, 95% CI 1.02–1.73), and those with burns over a greater TBSA had higher risks of IC. Conclusion: Treating IC is crucial in healthcare for major burns. Our study suggests that several risk factors are associated with IC in patients hospitalized with major burns, providing reliable reference value for clinical decisions.


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