Incidence of Central Venous Catheter-Related Bloodstream Infections: Evaluation of Bundle Prevention in Two Intensive Care Units in Central Brazil

Abstract

Background Central venous catheter-associated bloodstream infections (CVC-BSIs) have been associated with increased length of hospital stay, mortality, and healthcare costs, especially in intensive care units (ICUs). The aim of this study was to evaluate the incidence density of CVC-BSIs before and after implementation of the bundle in a hospital of infectious and dermatological diseases in Central Brazil. Methods A retrospective cohort study was conducted in two ICUs (adult and pediatric) between 2012 and 2015. Two periods were compared to assess the effect of the intervention in incidence density of CVC-BSIs: before and after intervention, related to the stages before and after the implementation of the bundle, respectively. Results No significant reduction was observed in the incidence density of CVC-BSIs in adult ICU (incidence rate ratio [IRR]: 0.754; 95.0% CI: 0.349 to 1.621; p-value = 0.469), despite the high bundle application rate in the postintervention period. Similarly, significant reduction in the incidence density in pediatric ICU has not been verified after implementation of the bundle (IRR: 1.148; 95.0% CI: 0.314 to 4.193; p-value = 0.834). Conclusion Not significant reduction in the incidence density of CVC-BSIs was observed after bundle implementation in ICUs, suggesting the need to review the use of process, as well as continuing education for staffs in compliance and correct application of the bundle. Further studies are needed to evaluate the effect of bundle in the reduction of incidence density of CVC-BSIs in Brazil.

Incidentes e eventos adversos em segurança do paciente: uma série temporal de 2019 a 2020

“…Quanto as complicações associadas a cateteres venosos centrais, estudo apontou aquelas ocorridas durante a inserção do cateter como o hematoma, e principalmente, as infecções causadas por Staphylococcus epidermidis e Staphylococcus aureus em unidades de terapia intensiva 14 .…”

Medical Device-Associated Biofilm Infections and Multidrug-Resistant Pathogens

“…The prevalence of NIs due to K. pneumoniae has been reported to be approximately 10% worldwide [173]. Several studies revealed the implication of K. pneumoniae in HAIs, especially in catheter-related infections (CRIs) [18,85,172,[174][175][176][177][178][179]. Since this bacterium is commensal in humans, gastrointestinal colonization represents the major source of transmission and the development of infections towards other sites [180].…”

Epidemiological data on health care-related infections (HAIs) reported in Brazil

“…All were performed in only one establishment providing health services. In one of the studies (YOSHIDA et al, 2019), the research focus was BSI associated with the central venous catheter, where the ID was 3.4 per 1,000 CVC-day in an adult ICU, lower than that presented by the ECDC regarding Italy, where the BSI rate associated with the central venous catheter was 4.8 per 1,000 CVC-day, and significantly higher than the rates of 1.7 per 1,000 CVC-day reported in the same ECDC report (2019) for countries such as Portugal and Luxembourg (ECDC, 2019). The other publications included in this review pointed to the occurrence of BSIs in specific contexts such as BSIs caused by Candida spp.…”

“…(CANELA et al, 2017), ICS in adult transplant patients (FERREIRA et al, 2018;CHUEIRI NETO et al, 2019); Hospital sepsis in adult patients (WESTPHAL et al, 2019), lateonset BSI in neonates (FREITAS et al 2019), making the correlation with multicentric publications unfeasible. The populations that composed the studies had numbers ranging from 11,465 CVC-days (YOSHIDA et al, 2019) to 79 patients (CANELA et al, 2017).…”