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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 3, Pages 169-176
http://dx.doi.org/10.1155/2006/781735
Original Articles

Central Venous Catheter-Associated Blood Stream Infections Occurring in Canadian Intensive Care Units: A Six-Month Cohort Study

Donna Holton, Shirley Paton,1 John Conly,2 Joanne Embree,3 Geoffrey Taylor,4 William Thompson,5 and Canadian Nosocomial Infection Surveillance Program

1Public Health Agency of Canada, Ottawa, Canada
2University Health Network, Toronto, Ontario, Canada
3Health Sciences Centre, Winnipeg, Manitoba, Canada
4University of Alberta Hospital, Edmonton, Alberta, Canada
5Moncton Hospital, Moncton, New Brunswick, Canada

Received 3 April 2006; Accepted 3 April 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

OBJECTIVE: To determine the rate and risk factors associated with central venous catheter (CVC)-associated bloodstream infections (BSIs) in Canadian intensive care units (ICUs).

DESIGN: A prospective, active six-month cohort with a nested case-control study.

SETTING: Forty-one ICUs located in 19 Canadian hospitals.

METHODS: Data were collected using a standardized format on all CVCs and patients when a CVC was inserted for more than 48 h. Results of microbiological studies and therapeutic interventions were recorded when a BSI occurred.

RESULTS: There were 182 BSIs from 3696 CVC insertions in 2531 patients. Coagulase-negative staphylococci were responsible for 73% of the BSIs. Mean rates of CVC-associated BSIs per 1000 CVC days were 6.9, 6.8 and 5.0 in adult, neonatal and pediatric ICUs, respectively. Significant factors associated with BSI included duration of CVC insertion (OR=1.2, 95% CI 1.1 to 1.3), receiving total parenteral nutrition (OR=4.1, 95% CI 1.2 to 14.3) and having one or more CVCs (OR=3.1, 95% CI 1.5 to 6.5). In the case-control study, 80% of the variance in a backward elimination logistic regression analysis was explained by duration of CVC insertion (OR=1.2 per day), receiving chemotherapy (OR=6.1), more than one CVC insertion during the study (OR=3.5), insertion of a CVC with two or more lumens (OR=2.3), using the CVC to administer total parenteral nutrition (OR=1.6) and having a surgical wound other than a clean wound (OR=1.6).

CONCLUSION: The present study identified risk factors explaining 80% of the variance associated with BSIs and is one of the largest reports on the rate of CVC-associated BSIs occurring in the ICU setting.