Catheter-related infections: A Scandinavian observational study on the impact of a simple hygiene insertion bundle

Acta Anaesthesiol Scand. 2020 Feb;64(2):224-231. doi: 10.1111/aas.13477. Epub 2019 Oct 18.

Abstract

Background: Catheter-related infections (CRIs) and catheter-related bloodstream infections (CRBSIs) are among the most frequent hospital acquired infections. CRI/CRBSI studies in Scandinavian cohorts are scarce. The primary aim of this study was to investigate the CRI/CRBSI incidence and the association between potential risk factors, including the introduction of a simple hygiene insertion bundle and CRIs at a large university hospital in Sweden.

Methods: We retrospectively included all patients aged 12 and above who received a central venous catheter (CVC) or a central dialysis catheter during a 2-year period, 1 year before and 1 year after the implementation of a simple hygiene insertion bundle. Microbiological data, including catheter tip cultures and blood cultures, were merged with CVC insertion data.

Results: A total of 1722 catheter insertions in 1428 patients were included. CRI and CRBSI incidence were 1.86/1000 and 0.62/1000 catheter days, respectively. In a multivariable regression model, the implementation of a simple hygiene insertion bundle was the independent factor most strongly associated with significantly lower CRI-incidence (95% confidence interval [CI] of odds ratio [OR] 0.23-0.92, P = .029). Choosing multiple lumen catheters was associated with increasing CRI-incidence (95% CI of OR 1.11-2.39, P = .013).

Conclusion: The incidence of catheter-related infections and catheter-related bloodstream infections in this Scandinavian cohort was low. The implementation of a simple hygiene insertion bundle seems to be an effective intervention for reducing catheter-related infections. The use of multiple-lumen catheters is associated with increased risk of catheter-related infections.

Keywords: catheter-related infections; central venous catheters; critical care; patient care bundles.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / epidemiology*
  • Bacteria / isolation & purification
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / methods*
  • Child
  • Female
  • Humans
  • Hygiene
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult