Unit of Infectious and Tropical Diseases, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Service of Infectious Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
Antimicrob Agents Chemother. 2018 Oct 24;62(11). doi: 10.1128/AAC.00892-18. Print 2018 Nov.
The aim of this study was to describe the etiology and outcome of short-term peripheral venous catheter (PVC)-related bloodstream infections (PVCRBSI) in a 25-year period (1992 to 2016) and to identify predictive factors of Gram-negative PVCRBSI. This was a prospective observational study including all episodes of PVCRBSI. A multivariate logistic regression model adjusted for calendar year was built to explore factors associated with a Gram-negative bacterial etiology. Over the study period, 711 episodes of PVCRBSI were identified. Incidence rate of PVCRBSI increased from 0.06 to 0.13 episodes/1,000 patient-days. A Gram-negative bacterial etiology was demonstrated in 162 (22.8%) episodes. There was a significant increase in the proportion of Gram-negative infections (22.6% in 1992 to 1996 versus 33.2% in 2012 to 2016). Independent predictive factors of Gram-negative PVCRBSI were the following: being in the hospital for more than 7 days with a catheter for more than 3 days (adjusted odds ratio [aOR], 1.80; 95% confidence interval [CI], 1.20 to 2.69), surgery in the previous month (aOR, 2.39; 95% CI, 1.40 to 4.09), and antimicrobial treatment with beta-lactams (aOR, 1.80; 95% CI, 1.16 to 2.78). In conclusion, we reported an increase in the prevalence of Gram-negative PVCRBSI over the last 25 years. Factors associated with a Gram-negative bacterial etiology were being in the hospital for more than 7 days with a catheter for more than 3 days, having undergone surgery, and having received antimicrobial treatment with beta-lactams.
本研究旨在描述 25 年间（1992 年至 2016 年）短期外周静脉导管（PVC）相关血流感染（PVCRBSI）的病因和结果，并确定革兰氏阴性 PVCRBSI 的预测因素。这是一项前瞻性观察性研究，包括所有 PVCRBSI 病例。建立了一个多变量逻辑回归模型，对日历年份进行了调整，以探讨与革兰氏阴性细菌病因相关的因素。在研究期间，共确定了 711 例 PVCRBSI 病例。PVCRBSI 的发病率从 0.06 例/1000 患者天增加到 0.13 例/1000 患者天。在 162 例（22.8%）病例中证实了革兰氏阴性细菌病因。革兰氏阴性感染的比例显著增加（1992 年至 1996 年为 22.6%，2012 年至 2016 年为 33.2%）。革兰氏阴性 PVCRBSI 的独立预测因素包括：住院时间超过 7 天，导管留置时间超过 3 天（调整后的优势比 [aOR]，1.80；95%置信区间 [CI]，1.20 至 2.69），前一个月接受过手术（aOR，2.39；95% CI，1.40 至 4.09）和接受β-内酰胺类抗菌药物治疗（aOR，1.80；95% CI，1.16 至 2.78）。总之，我们报告了过去 25 年来革兰氏阴性 PVCRBSI 患病率的增加。与革兰氏阴性细菌病因相关的因素包括住院时间超过 7 天，导管留置时间超过 3 天，接受过手术以及接受了β-内酰胺类抗菌药物治疗。
