Local signs at insertion site and catheter-related bloodstream infections: an observational post hoc analysis using individual data of four RCTs
Open Access
- 14 December 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Critical Care
- Vol. 24 (1), 1-9
- https://doi.org/10.1186/s13054-020-03425-0
Abstract
BackgroundLittle is known on the association between local signs and intravascular catheter infections. This study aimed to evaluate the association between local signs at removal and catheter-related bloodstream infections (CRBSI), and which clinical conditions may predict CRBSIs if inflammation at insertion site is present.MethodsWe used individual data from four multicenter randomized controlled trials in intensive care units (ICUs) that evaluated various prevention strategies for arterial and central venous catheters. We used multivariate logistic regressions in order to evaluate the association between >= 1 local sign, redness, pain, non-purulent discharge and purulent discharge, and CRBSI. Moreover, we assessed the probability for each local sign to observe CRBSI in subgroups of clinically relevant conditions.ResultsA total of 6976 patients and 14,590 catheters (101,182 catheter-days) and 114 CRBSI from 25 ICUs with described local signs were included. More than one local sign, redness, pain, non-purulent discharge, and purulent discharge at removal were observed in 1938 (13.3%), 1633 (11.2%), 59 (0.4%), 251 (1.7%), and 102 (0.7%) episodes, respectively. After adjusting on confounders,>= 1 local sign, redness, non-purulent discharge, and purulent discharge were associated with CRBSI. The presence of >= 1 local sign increased the probability to observe CRBSI in the first 7 days of catheter maintenance (OR 6.30 vs. 2.61 [>7 catheter-days], p(heterogeneity)=0.02).ConclusionsLocal signs were significantly associated with CRBSI in the ICU. In the first 7 days of catheter maintenance, local signs increased the probability to observe CRBSI.Funding Information
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (P400PM_183865)
- Gottfried und Julia Bangerter-Rhyner-Stiftung
This publication has 32 references indexed in Scilit:
- CONSORT GuidelinesPublished by Springer Science and Business Media LLC ,2013
- Randomized Controlled Trial of Chlorhexidine Dressing and Highly Adhesive Dressing for Preventing Catheter-related Infections in Critically Ill AdultsAmerican Journal of Respiratory and Critical Care Medicine, 2012
- Guidelines for the Prevention of Intravascular Catheter-related InfectionsClinical Infectious Diseases, 2011
- What Is The Predominant Source of Intravascular Catheter Infections?Clinical Infectious Diseases, 2010
- Infectious risk associated with arterial catheters compared with central venous catheters*Critical Care Medicine, 2010
- Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of AmericaClinical Infectious Diseases, 2009
- Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studiesBMJ, 2007
- Réactualisation de la douzième conférence de consensus de la Société de réanimation de langue française (SRLF) : infections liées aux cathéters veineux centraux en réanimation: Updating of the 12th consensus conference of the Société de Réanimation de langue française (SRLF): catheter related infections in Intensive Care unitAnnales Françaises dʼAnesthésie et de Réanimation, 2005
- Inflammation at the insertion site is not predictive of catheter-related bloodstream infection with short-term, noncuffed central venous catheters*Critical Care Medicine, 2002
- New Technologies and Infection Control Practices to Prevent Intravascular Catheter-related InfectionsAmerican Journal of Respiratory and Critical Care Medicine, 2001