Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019
Por:
Badia-Cebada, L, Penafiel, J, Saliba, P, Andres, M, Camara, J, Domenech, D, Jimenez-Martinez, E, Marron, A, Moreno, E, Pomar, V, Vaque, M, Limon, E, Masats, U, Pujol, M, Gasch, O
Publicada:
12 may 2022
Resumen:
Background: Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim: To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat).
Methods: A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000 patient days. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000 patient days and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results: During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate: 0.20 episodes/1,000 patient days). Patients' median age was 64.1 years; 36.6% (3,403/9,290) were female. In total, 73.7% (n = 6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n = 5,822) were related to central venous catheter (CVC), 24.1% (n = 2,236) to peripheral venous catheters (PVC) and 13.3% (n = 1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR: 0.94; 95%CI: 0.93-0.96), especially in the ICU (IRR: 0.88; 95%CI: 0.87- 0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR: 0.88; 95%CI: 0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC: 1.08; 95%CI: 1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions: Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards.
Filiaciones:
Badia-Cebada, L:
Hosp Univ Parc Tauli, Internal Med Dept, Sabadell, Spain
Univ Autonoma Barcelona, Sch Med, Sabadell, Spain
Penafiel, J:
Hosp Univ Bellvitge, Unit Stat, Inst Invest Biomed Bellvitge IDIBELL, Lhospitalet De Llobregat, Spain
Saliba, P:
VINCat Programme Infect Control Catalan Programme, Barcelona, Spain
Andres, M:
Hosp Consorci Terrassa, Dept Internal Med, Infect Dis Unit, Terrassa, Spain
Camara, J:
Hosp Univ Bellvitge, Dept Microbiol, LHospitalet De Llobregat, Spain
Inst Invest Biomed Bellvitge IDIBELL, Lhospitalet De Llobregat, Spain
ISCIII, CIBER Enfermedades Resp CIBERes, Madrid, Spain
Domenech, D:
Hosp Josep Trueta, Girona, Spain
Jimenez-Martinez, E:
Hosp Univ Bellvitge, Inst Invest Biomed Bellvitge IDIBELL, Lhospitalet De Llobregat, Spain
Marron, A:
Hosp Univ Parc Tauli, Infect Dis Dept, Sabadell, Spain
Moreno, E:
Parc Sanitari St Joan de Deu, St Boi De Llobregat, Spain
Pomar, V:
Hosp Santa Creu & Sant Pau, Infect Dis Unit, Dept Internal Med, Barcelona, Spain
Vaque, M:
Hosp Barcelona, Barcelona, Spain
Limon, E:
VINCat Programme Infect Control Catalan Programme, Barcelona, Spain
Masats, U:
Hosp Univ Motua Terrassa, Terrassa, Spain
Pujol, M:
Inst Invest Biomed Bellvitge IDIBELL, Lhospitalet De Llobregat, Spain
Hosp Univ Bellvitge, Dept Infect Dis, Lhospitalet De Llobregat, Spain
Gasch, O:
Univ Autonoma Barcelona, Sch Med, Sabadell, Spain
Hosp Univ Parc Tauli, Infect Dis Dept, Sabadell, Spain
Inst Invest & Innovacio Parc Tauli, Sabadell, Spain
Green Published, gold, All Open Access, Gold, Green
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