Prevalence and antimicrobial susceptibility pattern of isolated microorganisms from central venous catheters in ICU patients

Khorvash, Farzin; Abbasi, Saeed; Meidani, Mohsen; Shakeri, Mehrnoosh

Prevalence and antimicrobial susceptibility pattern of isolated microorganisms from central venous catheters in ICU patients

Authors

¹ Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

² Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran

³ Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

⁴ Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The abundance of infections associated with intensive care unit (ICU) is increasing due to the increased use of aggressive medical equipments like the central venous catheter (CVC). This study was designed and performed in 2010-2011 at Alzahra hospital, which is a referral center. This study aimed at determining the relative abundance and microbial sensitivity of organisms, which were creating contamination with CVCs in hospitalized patients in the ICUs of Alzahra hospital.
Materials and Methods: This is a cross-sectional study performed on 71 patients who were hospitalized in the Alzahra hospital ICU and had CVCs during 2010-2011. The data obtained was analyzed by SPSS version 20 software and descriptive statistical approaches and chi-square and t-test trials.
Results: In the sample culture obtained from the patients' catheter in 19 cases (26/8%), no microorganism was grown and in 52 cases (73.3%) at least one type of microorganism including bacteria or fungus was grown. In this study, average hospitalization time in patients who got positive results from their catheter culture was significantly more compared with patients who did not grow any kinds of microorganism in their sample cultures.
Conclusion: In this study, CVCs microbial contamination has a high prevalence, which is a major cause of prolonged patients staying in ICUs, and therefore, it is essential to take precaution and discharge the patient early for decreasing the catheter contamination and preventing the hospital infections incidence in the ICU patients.

Keywords

References

1.	Emmerson AM, Enstone JE, Griffin M, Kelsey MC, Smyth ET. The second national prevalence survey of infection in hospital-overview of the results. J Hosp Infect 2006;32:175-90.
2.	Weinstein RA. Nosocomial infection update. Emerg Infect Dis 1998;4:416-20.
3.	Donowitz LG, Marsik FJ, Fisher KA, Wenzel RP. High risk of hospital - acquired infection in the ICU patient. Crit Care Med 1982;10:355-7.
4.	Yehia N, Al-Mousa HH, Al-Asar ES. Nosocomial infection in a medical-surgical intensive care unit. Med Prink Pract2008;17:373-7.
5.	Vincent JL, Bihari DJ, Suter PM, Bruinig HA, White J, Nicholas Chanoin MH, et al. The prevalence of Nosocomial infection intensive care unit in Europe. Results of The European prevalence of infection in intensive care study. EPIC International advisory committee. JAMA 1995;274:639-44.
6.	McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med 2003;348:1123-33.
7.	Spengler RF, Greenough WB. Hospital costs and mortality attributed to nosocomial bacteremias. JAMA 1978;240:2455-8.
8.	Collignon PJ. Intravascular catheter associated sepsis: A common problem. The Australian Study on Intravascular Catheter Associated Sepsis. Med J Aust 1994;161:374-8.
9.	Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance(NNISS) System report, data summary from January 1992-hybe 2004m. Am J Infect Control 2004;32:470-85.
10.	Mantese VA, German DS, Kaminski DL, Herrman VM. Colonization and sepsis from triple-lumen catheters in critically ill patient. Am J Surg 1987;154:597-601.
11.	Hilton E, Haslett TM, Borenstein MT, Tucci V, Isenberg HD, Singerc C. Central catheter infection: Single versus triple lumen catheters. Influence of guide wires on infection rates when used for replacement of catheters. AmJ Med 1988;84:667-72.
12.	Mozaffari K, Bakhshandeh H, Khalaj H, Soudi H. Incidence of Catheter-Related Infections in Hospitalized Cardiovascular Patients. Res Cardiovasc Med2013:1:99-103.
13.	Fridkin SK, Pear SM, Williamson TH, Galgiani JN, Jarvis WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996;17:150-8.
14.	Barsanti MC, Woetje KF. Infection prevention in the intensive care unit. Infect Dis Clin N Am 2009;23:703-25.
15.	Moro ML, Vigano EF, Cozzilepri A. Risk factor for central venous catheter-related infections in surgical and intensive care units. The Central Venous Catheter-Related Infections Study Group. Infect Control Hosp Epidemiol 1994;15:253-64.
16.	Egebo K, Toft P, Jakobsen CJ. Contamination of central venous catheters. The skin insertion wound is a major source of contamination. J Hosp Infect 1996;32:99-104.
17.	Bjornson HS, Colley R, Bower RH, Duty VP, Schwartz-Fulton JT, Fischer JE. Association between microorganism growth at the catheter insertion site and colonization of the catheter in patients receiving total parenteral nutrition. Surgery 1982;92:720-7.
18.	CooperGL, HopkinsCC. Rapid diagnosis of intravascular catheter-associated infection by direct Gram's staining of catheter segments. N Engl J Med 1985;312:1142.
19.	Rosenthal VD, Gusman S, Migone O, Crnich CJ. The attributable cost, ength of hospital stay, and mortality of central line-associated bloodlstream infection in intensive care departaments in Argentina: A prospective, matched analysis. Am J Infect Control 2003;31:475-80.
20.	Barsanti MC, Woetje KF. Infection prevention in the intensive care unit. Infect DisClin N Am 2009;23:703-25.
21.	Sharif A, Emami A, Mazouchi T, Mosavi S, Sharif M, Verdi J, et al. Venous catheter infection of patients admitted to ICU and its related factors. KAUMS Journal (FEYZ)2002;6:53-8.
22.	Shirazi M, Farhangnejad M, Golmohammadi R, Ranjbar R. Intra vascular catheter associated bacterial infections in admitted patient. Iranian J Infect Dis 2009;44:31-3.
23.	Grothe C, da Silva Belasco AG, de CássiaBittencourt AR, Vianna LA, de Castro CintraSesso R, Barbosa DA. Incidence of bloodstream infectionamong patients on hemodialysis by central venous catheter. Rev Latino-am Enfermagem 2010;18:73-80.
24.	Andrew G, Kirsteen S, Louise B, Shaun M, Chris J S, Suzanne M, et al. Elimination of central-venous-catheter-related bloodstream infections from the intensive care unit. BMJ QualSaf2011;20:174-80.
25.	Mesiano ER, Merchán-Hamann E. Bloodstream infections among patients using central venous catheters in intensive care units. Rev Lat Am Enfermagem 2007;15:453-9.

Advanced Biomedical Research