Zhang Yibo, Wang Yichen, Sheng Zike, Wang Qun, Shi Dake, Xu Shirui, Ai Yaping, Chen Erzhen, Xu Yumin
Department of Hospital Infection Management, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Infect Drug Resist. 2023 Jun 5;16:3551-3560. doi: 10.2147/IDR.S406681. eCollection 2023.
Indwelling central venous catheters (CVCs) can cause catheter related bloodstream infection (CRBSI). CRBSI occurring in intensive care unit (ICU) patients may lead to the worse outcomes and extra medical costs. The present study aimed to assess the incidence and incidence density, pathogens and economic burden of CRBSI in ICU patients.
A case-control study was retrospectively carried out in six ICUs of one hospital between July 2013 and June 2018. The Department of Infection Control performed routinely surveillance for CRBSI on these different ICUs. Data of the clinical and microbiological characteristics of patients with CRBSI, the incidence and incidence density of CRBSI in ICUs, the attributable length of stay (LOS), and the costs among patients with CRBSI in ICU were collected and assessed.
A total of 82 ICU patients with CRBSI were included into the study. The CRBSI incidence density was 1.27 per 1000 CVC-days in all ICUs, in which the highest was 3.52 per 1000 CVC-days in hematology ICU and the lowest was 0.14 per 1000 CVC-days in Special Procurement ICU. The most common pathogen causing CRBSI was (15/82, 16.67%), in which 12 (80%) were carbapenem resistant. Fifty-one patients were successfully matched with control patients. The average costs in the CRBSI group were $ 67,923, which were significantly higher (P < 0.001) than the average costs in the control group. The total average costs attributable to CRBSI were $33, 696.
The medical costs of ICU patients were closely related to the incidence of CRBSI. Imperative measures are needed to reduce CRBSI in ICU patients.
留置中心静脉导管(CVC)可导致导管相关血流感染(CRBSI)。重症监护病房(ICU)患者发生CRBSI可能导致更差的预后和额外的医疗费用。本研究旨在评估ICU患者CRBSI的发病率、发病密度、病原体及经济负担。
2013年7月至2018年6月期间,在一家医院的6个ICU进行了一项回顾性病例对照研究。感染控制部门对这些不同的ICU进行了CRBSI的常规监测。收集并评估了CRBSI患者的临床和微生物学特征数据、ICU中CRBSI的发病率和发病密度、归因住院时间(LOS)以及ICU中CRBSI患者的费用。
本研究共纳入82例发生CRBSI的ICU患者。所有ICU的CRBSI发病密度为每1000个CVC日1.27例,其中血液科ICU最高,为每1000个CVC日3.52例,特殊采购ICU最低,为每1000个CVC日0.14例。引起CRBSI最常见的病原体是[此处原文缺失病原体名称](15/82,16.67%),其中12例(80%)对碳青霉烯耐药。51例患者成功与对照患者匹配。CRBSI组的平均费用为67,923美元,显著高于对照组的平均费用(P < 0.001)。CRBSI所致的总平均费用为33,696美元。
ICU患者的医疗费用与CRBSI的发生率密切相关。需要采取必要措施降低ICU患者的CRBSI发生率。