Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments
Por:
Guembe, M, Perez-Granda, MJ, Capdevila, JA, Barberan, J, Pinilla, B, Martin-Rabadan, P, Bouza, E, Casademont J., Solchaga V.P,, Costa Cerdá, M. A.
Publicada:
1 nov 2017
Resumen:
Background: The use of peripheral venous catheters (PVCs) has increased outside intensive care units, as has the rate of PVC-associated-bloodstream infection (PVC-BSI). PVCs are widely used in internal medicine departments (IMDs), but data on the incidence of PVC-BSI and its characteristics in IMDs are scarce.
Aim: To assess the incidence of PVC-BSI episodes detected in IMDs in Spain.
Methods: A one-year multi-centre prospective observational cohort study in 14 Spanish IMDs was undertaken. Adult patients admitted with at least one PVC and bacteraemia were included in the study. Demographic and clinical data were provided by local coordinators.
Findings: Seventy episodes of PVC-BSI were recorded, representing an overall rate of 1.64 PVC-BSI episodes/1000 IMD admissions. The mean age of patients was 67.44 (standard deviation 16.72) years. It was estimated that 25.7% of PVCs were no longer necessary. Staphylococcus aureus was the most frequently isolated micro-organism (41.7%). Phlebitis was clinically evident in 44 (62.9%) episodes, and proved to be an independent predictor of catheter insertion in emergency departments (odds ratio 5.44). The crude and attributable mortality rates were 12.9% and 5.7%, respectively.
Conclusions: PVCs carry a significant risk for bacteraemia in Spanish IMDs. Phlebitis is not always clinically evident in patients with bacteraemia in this population. The study findings support the need for educational and interventional preventive measures in both IMDs and emergency departments to reduce the rate of PVC-BSI and associated comorbidities, and costs. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Guembe, M:
Hosp Gen Univ Gregorio Maranon, Dept Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest St Gregorio Maranon, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, C Dr Esquerdo 46, Madrid 28007, Spain
Perez-Granda, MJ:
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Inst Invest St Gregorio Maranon, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Cardiac Surg Postoperat Care Unit, Madrid, Spain
Capdevila, JA:
Soc Espanola Infecc Cardiovasc, Study Grp Infect, Madrid, Spain
Hosp Mataro, Dept Internal Med, Barcelona, Spain
Barberan, J:
Soc Espanola Infecc Cardiovasc, Study Grp Infect, Madrid, Spain
Hosp Monteprincipe, Dept Internal Med, Madrid, Spain
Pinilla, B:
Soc Espanola Infecc Cardiovasc, Study Grp Infect, Madrid, Spain
HGU Gregorio Maranon, Dept Internal Med, Madrid, Spain
Martin-Rabadan, P:
Hosp Gen Univ Gregorio Maranon, Dept Clin Microbiol & Infect Dis, Madrid, Spain
Univ Complutense Madrid, Sch Med, Med Dept, Madrid, Spain
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Inst Invest St Gregorio Maranon, Madrid, Spain
Bouza, E:
Hosp Gen Univ Gregorio Maranon, Dept Clin Microbiol & Infect Dis, Madrid, Spain
Univ Complutense Madrid, Sch Med, Med Dept, Madrid, Spain
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Inst Invest St Gregorio Maranon, Madrid, Spain
Soc Espanola Infecc Cardiovasc, Study Grp Infect, Madrid, Spain
Casademont J.:
Hospital Santa Creu i Sant Pau, Cataluña, Spain
Solchaga V.P,:
Hospital Santa Creu i Sant Pau, Cataluña, Spain
Costa Cerdá, M. A. :
Hospital Universitario de Guadalajara, Castilla La Mancha, Spain
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