Dialysis and central venous catheter infections in critically ill patients: Results of a prospective study

Abstract

To determine the incidence of dialysis catheter (DC)-related infections in intensive care unit (ICU) patients, and to compare the frequency of DC and central venous catheter (CVC) infections in an ICU setting. Prospective, descriptive survey. An adult, 10-bed medical/surgical ICU at a university hospital. A total of 151 DCs and 230 CVCs placed in 170 patients were evaluated. None. Catheter colonization was defined by a quantitative catheter tip culture yielding ≥103 colony-forming units/mL, catheter-related bacteremia was defined as catheter colonization and blood culture positive for the same organism, and site infection was defined as the presence of pus at the insertion site. The mean duration of catheterization was 6.8 ± 6 days for DCs and 5.9 ± 4.6 for CVCs (p = .52). There was no difference between DCs and CVCs in catheter colonization and catheter-related bacteremia incidence rates per 1000 days of catheter use (24.2 vs. 19.8 [p = .46] and 0.96 vs. 1.5 [p = .60], respectively). Site infection was observed in one patient (CVC placement). For DCs and CVCs the duration of catheterization was associated with catheter infection (p = .0007 and p = .04, respectively), but when the catheters were examined over 5-day intervals, the incidence of catheter infections did not increase with duration of catheter use (p = .23 and p = .10, respectively). DC-related infections are associated with DC longevity. As shown by the 5-day-interval analysis, the incidence of DC-related infections did not increase with DC duration, suggesting that the risk for DC-related infections remained unchanged with time. The characteristics of DC-related infections in ICU patients were comparable to those previously reported for CVC-related infections.