Hospital São Paulo, Universidade Federal de São Paulo, SP, Brazil.
Braz J Infect Dis. 2011 Jul-Aug;15(4):328-31.
Central venous catheters (CVC) are devices of great importance in health care. The advantages gained from the use of catheters outweigh the complications that might result from their use, among which bloodstream infections (BSI). In spite of its importance, few national studies have addressed this issue.
The aim this study was to determine the incidence of BSI in patients with CVC, hospitalized in ICU, as well as the variables associated with this complication.
Multicentric cohort study carried out at ICUs of three hospitals at Universidade Federal de São Paulo complex.
A total of 118 cases of BSI in 11.546 catheters day were observed: 10.22 BSI per 1,000 catheters day. On average, BSI was associated to seven additional days of hospital stay in our study (p < 0.001), with a significant difference between types of catheters. Concerning the place of insertion, there was no statistical difference in BSI rates.
We concluded that a patient who uses a catheter for longer than 13 days presents a progressive risk for infection of approximately three times higher in relation to a patient who uses the catheter for less than 13 days (p < 0.001). The median duration of catheter use was 14 days among patients with BSI and 9 days in patients without infection (p < 0.001). There was higher prevalence of gram-negative infections. The risk factors for BSI were utilization of multiple-lumen catheters, duration of catheterization and ICU length of stay.
中心静脉导管（CVC）在医疗保健中非常重要。导管的使用带来的益处大于其使用可能带来的并发症，其中包括血流感染（BSI）。尽管其重要性，很少有国家研究涉及这个问题。
本研究旨在确定 ICU 中 CVC 患者发生 BSI 的发生率，以及与该并发症相关的变量。
在圣保罗联邦大学综合医院的三个 ICU 进行了多中心队列研究。
共观察到 118 例 11546 导管日的 BSI：每 1000 个导管日发生 10.22 例 BSI。平均而言，BSI 在我们的研究中与住院时间增加了 7 天相关（p<0.001），且不同类型的导管之间存在显著差异。关于插入部位，BSI 发生率没有统计学差异。
我们得出结论，导管使用时间超过 13 天的患者感染的风险大约增加了两倍（p<0.001），而导管使用时间少于 13 天的患者感染的风险较低。BSI 患者的导管使用中位数为 14 天，无感染患者为 9 天（p<0.001）。革兰氏阴性感染的患病率较高。BSI 的危险因素包括使用多腔导管、导管插入时间和 ICU 住院时间。
