Summary
Background
More than 160,000 central-line-associated bloodstream infections (CLABSIs) are estimated
for Europe each year, leading to about 25,000 deaths.
Aim
To characterize the contamination of administration sets in suspected CLABSI cases
in the intensive care unit (ICU).
Methods
In ICU patients (from February 2017 to February 2018) with suspected CLABSI, all sampled
central venous catheters (CVCs) were examined in four segments (from CVC tip to connected
tubing systems) for contamination. A risk factor analysis using binary logistic regression
was performed.
Findings
Fifty-two consecutively sampled CVCs with 1004 elements were analysed with 45 elements
being positive for at least one micro-organism (4.48%). There was a significant association
with the duration of catheterization (P = 0.038, N = 50) with a daily increase of contamination risk by 11.5% (odds ratio: 1.115). The
mean number of CVC manipulations was 40 within 72 h (standard deviation: 20.5), with
no association with contamination risk (P = 0.381). The contamination risk of the CVC segments decreased from proximal to distal.
Non-replaceable components of the CVC had a high risk (14 times higher; P = 0.01). A significant positive correlation was detected between positive tip cultures
and microbial growth in the administration set (r(49) = 0.437; P = 0.001).
Conclusion
Although only a minority of CLABSI-suspect patients had positive blood cultures, the
contamination rate of CVCs and administration set was high, possibly indicating a
relevant underreporting. The finding of identical species in adjacent segments underlines
the role of upward or downward spread of micro-organisms within the tubes; therefore,
aseptic tasks should be emphasized.
Keywords
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Article info
Publication history
Published online: March 09, 2023
Accepted:
February 16,
2023
Received:
November 18,
2022
Identification
Copyright
© 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
