Mosquera Jorge Mario Angulo, Assis Reveiz Jorge Karim, Barrera Lena, Liscano Yamil
Grupo de Investigación en Salud Integral (GISI), Department of Health, Universidad Santiago de Cali, Cali 760035, Colombia.
Department of Research and Education, Clínica de Occidente S.A., Cali 760044, Colombia.
J Clin Med. 2024 Sep 11;13(18):5376. doi: 10.3390/jcm13185376.
Central line-associated bloodstream infections (CLABSIs) are a significant healthcare challenge globally, increasing mortality risk and complicating central vascular catheter use. In Colombia, few studies have assessed the impact of CLABSIs on hospital stay and mortality. To determine the association between CLABSIs and discharge outcomes and hospital stay duration in adult patients at a tertiary care institution in Cali, Colombia, from 1 January 2015 to 31 December 2018. A nested case-control study was conducted. The odds of mortality associated with CLABSIs were estimated using conditional logistic regression. Non-conditional logistic regression was used to determine the odds of mortality when CLABSIs were caused by resistant microorganisms. Hospital stay duration, catheter duration, and time from catheter insertion to discharge were compared between patients with and without CLABSIs. The most frequent etiological agents were identified. Patients with CLABSIs had 3.89 times the odds of mortality (95% CI [1.33-11.31], = 0.013) compared to those without CLABSIs. The odds of mortality for patients with resistant microorganism CLABSIs were 4.04 times (95% CI [1.17-13.96], = 0.027) higher than those with sensitive microorganism CLABSIs. Hospital stay duration (median = 51 days vs. 17 days; = 0.000), catheter duration (median = 19 days vs. 7 days; < 0.001), and time from catheter insertion to discharge (median = 40 days vs. 9 days; < 0.001) were significantly longer in CLABSI patients. was the most isolated pathogen (20.2%), followed by (14.9%). CLABSI patients have longer catheter and hospitalization durations and higher mortality risk. Resistant microorganism CLABSIs are associated with elevated mortality risk. This study corroborates the positive relation between CLABSI and the mortality risk, which is influenced by resistant bacteria, though causality is not established. CLABSI is also linked to longer hospital stays, underscoring the need for improving infection control strategies.
中心静脉导管相关血流感染（CLABSIs）是全球医疗保健领域面临的一项重大挑战，它会增加死亡风险并使中心血管导管的使用变得复杂。在哥伦比亚，很少有研究评估CLABSIs对住院时间和死亡率的影响。为了确定2015年1月1日至2018年12月31日期间，哥伦比亚卡利一家三级医疗机构成年患者中CLABSIs与出院结局及住院时间之间的关联，开展了一项巢式病例对照研究。使用条件逻辑回归估计与CLABSIs相关的死亡几率。当CLABSIs由耐药微生物引起时，使用非条件逻辑回归来确定死亡几率。比较了有CLABSIs和无CLABSIs患者的住院时间、导管留置时间以及从导管插入到出院的时间。确定了最常见的病原体。与无CLABSIs的患者相比，有CLABSIs的患者死亡几率高3.89倍（95%置信区间[1.33 - 11.31]，P = 0.013）。耐药微生物CLABSIs患者的死亡几率比敏感微生物CLABSIs患者高4.04倍（95%置信区间[1.17 - 13.96]，P = 0.027）。CLABSI患者的住院时间（中位数 = 51天对17天；P = 0.000）、导管留置时间（中位数 = 19天对7天；P < 0.001）以及从导管插入到出院的时间（中位数 = 40天对9天；P < 0.001）明显更长。[病原体名称1]是最常分离出的病原体（20.2%），其次是[病原体名称2]（14.9%）。CLABSI患者的导管留置时间和住院时间更长，死亡风险更高。耐药微生物CLABSIs与更高的死亡风险相关。本研究证实了CLABSI与死亡风险之间的正相关关系，尽管未确定因果关系，但这种关系受耐药细菌影响。CLABSI还与更长的住院时间有关，这凸显了改进感染控制策略的必要性。
