Matarrese Agustín N, Ivulich Daniel I, Cesar Germán, Alaniz Fernando, Ruiz Juan J, Osatnik Javier
Servicio de Terapia Intensiva, Hospital Alemán de Buenos Aires, Argentina. E-mail:
Servicio de Terapia Intensiva, Hospital Alemán de Buenos Aires, Argentina.
Medicina (B Aires). 2021;81(2):159-165.
A retrospective-observational analytical study was carried out to evaluate the epidemiology of catheter-related bloodstream infections (CRBSI) in 773 adult patients hospitalized in the intensive care unit (ICU) of the Hospital Alemán of Buenos Aires, Argentina, between 1 December 2018 and 30 June 2020. During the study period, the incidence of CRBSI was 8.7 cases per 1000 catheter days. The occurrence of CRBSI was found associated with a poor clinical evolution, as evidenced by a stay in the ICU significantly longer than the stay of patients without CRBSI (median: 21.5 days vs. 4 days, p < 0.001). CRBSI-associated mortality was not statistically higher (24% vs. 20%, OR 1.26 [0.61-2.63]). Gram-positive bacteria were the most frequently identified microorganisms (73%), being Staphylococcus epidermidis the most frequent (40%). Of the 47 isolates of microorganisms surveyed, 8 (17%) were multi-resistant germs. The permanence time of the catheter was identified as a risk factor for developing CRBSI (OR 1.10 [1.05 - 1.15], p < 0.001) in a multivariate analysis. In this analysis, the risk of infection was not influenced by the anatomical site of insertion of the catheter, the ward where the procedure was performed (ICU vs. operating room/external ward), the skill of the medical practitioner, or the use of ultrasound to guide vascular accesses. We conclude that CRBSIs are a frequent complication in our department with relevant clinical consequences. Knowing the epidemiology and the problems of each service allows programming interventions aimed to correct specific public health problems.
开展了一项回顾性观察分析研究,以评估2018年12月1日至2020年6月30日期间在阿根廷布宜诺斯艾利斯阿莱曼医院重症监护病房(ICU)住院的773例成年患者中导管相关血流感染(CRBSI)的流行病学情况。在研究期间,CRBSI的发生率为每1000导管日8.7例。发现CRBSI的发生与临床转归不良相关,证据是在ICU的住院时间明显长于无CRBSI患者的住院时间(中位数:21.5天对4天,p<0.001)。CRBSI相关死亡率在统计学上没有更高(24%对20%,OR 1.26[0.61-2.63])。革兰氏阳性菌是最常鉴定出的微生物(73%),其中表皮葡萄球菌最为常见(40%)。在所检测的47株微生物分离株中,8株(17%)为多重耐药菌。在多变量分析中,导管留置时间被确定为发生CRBSI的一个危险因素(OR 1.10[1.05-1.1