Epidemiological analysis of catheter-related bloodstream infections in medical-surgical intensive care units

A retrospective-observational analytical study was carried out to evaluate the epidemiology of catheter-related bloodstream infections (CRBSI) in 773 adult patients hospitalized in the intensive care unit (ICU) of the Hospital Aleman of Buenos Aires, Argentina, between 1 December 2018 and 30 June 2020. During the study period, the incidence of CRBSI was 8.7 cases per 1000 catheter days. The occurrence of CRBSI was found associated with a poor clinical evolution, as evidenced by a stay in the ICU significantly longer than the stay of patients without CRBSI (median: 21.5 days vs. 4 days, p < 0.001). CRBSI-associated mortality was not statistically higher (24% vs. 20%, OR 1.26 [0.61-2.63]). Gram-positive bacteria were the most frequently identified microorganisms (73%), being Staphylococcus epidermidis the most frequent ( 40%). Of the 47 isolates of microorganisms surveyed, 8 (17%) were multi-resistant germs. The permanence time of the catheter was identified as a risk factor for developing CRBSI (OR 1.10 [1.05 - 1.15], p < 0.001) in a multivariate analysis. In this analysis, the risk of infection was not influenced by the anatomical site of insertion of the catheter, the ward where the procedure was performed (ICU vs. operating room/external ward), the skill of the medical practitioner, or the use of ultrasound to guide vascular accesses. We conclude that CRBSIs are a frequent complication in our department with relevant clinical consequences. Knowing the epidemiology and the problems of each service allows programming interventions aimed to correct specific public health problems.