Peripheral venous catheter related blood stream infection in intensive care unit
Keywords:Blood stream infection, Peripheral venous catheter, Septicemia
Background: Peripheral venous catheter related blood stream infections (PVC-BSI) are a common cause of morbidity and mortality in hospitals. Most of the catheter related blood stream infections occurs due to lack of proper aseptic measures. This study points out the risk factors microbial profile and antimicrobial susceptibility of isolates associated with PVC-BSI. The common organisms causing Catheter related BSI are Staphylococcus aureus (41.1%), and Klebsiella species (17.6%) followed by CONS and Enterococcus species. Objective of present study was to isolate and identify the organisms causing PCV-BSI, perform antimicrobial sensitivity testing of isolated organisms and to identify the associated risk factors and preventive measures that should be used.
Methods: The study was conducted over a period of one year from August 2015 to July 2016 in the Department of Microbiology. Study group comprised of all the patients with peripheral venous catheterization who developed signs and symptoms of septicemia after 48 hrs of insertion of PVC. These patients were followed up from the time of catheterization till discharge. Peripheral venous catheter tip was collected under aseptic condition along with peripheral blood samples from a site other than the catheterized one. Samples were collected from patients at any point of time who developed signs and symptoms of septicemia after 48 hrs of catheter insertion. The length of time for which the PVC was in place was recorded.
Results: In total, 87 cases were included in the study with mean catheter duration of 4.8 days accounting for 418 catheter days. Out of these 87 cases, 17 cases developed PVC-BSI (19.5%) and 34 cases developed colonization (24.1%). Staphylococcus species (41.1%) was the most common isolate.
Conclusions: PVC-BSI has a significant role in hospital acquired infections and more studies are needed to establish this.
Gahlot R, Nigam C, Kumar V, Gupta M. Catheter related blood stream infections in ICU: A study from North India. Int J Infect Control. 2013 May 20;9(2).
Parameswaran R, Sherchan JB, Varma D M, Mukhopadhyay C, Vidyasagar S. Intranenous catheter-related infection in an Indian tertiary care hospital. J Infect Dev Ctries. 2011 Jul 4;5(6):452-8.
Mermel LA. Prevention of intravascular catheter- related infections. Ann Intern Med. 2000;132:391-402.
Thomas D, Parameswaran N, Harish BN. Catheter related blood stream infections in the paediatric intensive care unit: A descriptive study. Indian J Crit Care Med. 2013 May;17(3):135.
Henry M, York MK, Thomson RB. Catheter tip cultures; Clinical microbiology procedures handbook. 2nd ed. 2007.
Siegman-Igra Y, Anglim AM, Shapiro DE, Adal KA, Strain BA, Farr BM. Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis. J Clin Microbiol. 1997 Apr;35(4):928-36.
O'grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG et al. Guidelines for the Prevention of Intravascular Catheter-Related Infections. MMWR. 2002;51.
CLSI. Performance standard for antimicrobial susceptibility testing; Twenty-fifth informational supplement. CLSI document M100-S25 (ISBN 1-56238-989-0). Available at file:///C:/Users/medip/Downloads/CLSI_2015.pdf
National Nosocomial Infection Surveillance System (NNIS). System report, data ssummary from January 1992 through June 2004, issued Oct 2004. Am J Infect Control. 2004;32:470-85.
Almuneef MA, Memish ZA, Balkhy HH, Hijari O, Canningham G, Francis C. Rate, risk factors and outcomes of catheter-related bloodstream infection in a paedriatic intensive care unit in Saudi Arabia. J Parenter Enteral Nutr. 2007;31:284-7.
Meadows C, Creagh-Brown B, Nia T, Bonnici K, Finney S. Definition of catheter-related bloodstream infection as a quality improvement measure in intensive care. Crit Care. 2009;13:191.
Tullu MS, Deshmukh CT, Baveja SM. Bacterial profile andantimicrobial susceptibility pattern in catheter related nosocomial infection. J Postgrad Med. 1998;44(1): 7-13.11.
Karpel E, Kunsdorf-Wnuk A, Musioł E, Skorupa A, Arct-Danielak D, Jarosz U. Catheter related blood stream infectionin ICU patients with prolonged central venous catheterisation--cause and prevention. Pol Merkur Lekarski. 2006;21(123):211-7.
Pujol M, Hornero A, Saballs M, Argerich MJ, Verdaguer R, Cisnal M, et al. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect. 2007;67:22-9.
CDC guideline for the prevention of intravenous catheter-related infection, 2011. Available at https://www.ajicjournal.org/article/S0196-6553(11)00085-X/fulltext
Sato A, Nakamura I, Fujita H, Tsukimori A, Kobayashi T, Fukushima S et al. Peripheral venous catheter-related bloodstream infection is associated with severe complications and potential death: a retrospective observational study. BMC Infect Dis. 2017 Dec;17(1):434.