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Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments

2017; Elsevier BV; Volume: 97; Issue: 3 Linguagem: Inglês

10.1016/j.jhin.2017.07.008

1532-2939

María Guembe, María Jesús Pérez-Granda, Capdevila Ja, José Barberán, Blanca Pinilla, Pablo Martín‐Rabadán, Emilio Bouza, Jesús Millán, C. Pérez de Oteyza, Adriana Muiño, María Villalba, C. Cuenca, J. García Castaño, Carlos Manterola, Sara Zamorano, Borja Moya-Gómez, Jésica Mansilla Collado, M.T. Salinas, Alejandro Smithson Amat, Javier Ramos Lázaro, Valentín del Villar Sordo, M. del Valle Sánchez, Á.F. Benach, E. Vidal, Laia Albiach, J M Aparicio, Ester Sáez de Adana Arróniz, J. Casademont i Pou, Virginia Pomar Solchaga, F.E. Castellón, T.R. Obanos, María Victoria Egurbide Arberas, Javier Nieto Arana, Eloy Girela-López, A. Zapatero Gaviría, Iván Navas Clemente, Pilar Ruíz, A.C. Salomó, Simona Iftimie, Ana Márcia Chiaradia Mendes-Castillo, Joan Farré, A.O. Lavería, Melissa Chaves Vieira Ribera, Natàlia Pallarès, P CANADAS SUAREZ, F.J. Cepeda Piorno, N.A. Andrés, Raquel Tarazona, M.M. Rodríguez Zapata, M.A. Costa Cerdá,

Nosocomial Infections in ICU

Background The use of peripheral venous catheters (PVCs) has increased outside intensive care units, as has the rate of PVC-associated-bloodstream infection (PVC-BSI). PVCs are widely used in internal medicine departments (IMDs), but data on the incidence of PVC-BSI and its characteristics in IMDs are scarce. Aim To assess the incidence of PVC-BSI episodes detected in IMDs in Spain. Methods A one-year multi-centre prospective observational cohort study in 14 Spanish IMDs was undertaken. Adult patients admitted with at least one PVC and bacteraemia were included in the study. Demographic and clinical data were provided by local coordinators. Findings Seventy episodes of PVC-BSI were recorded, representing an overall rate of 1.64 PVC-BSI episodes/1000 IMD admissions. The mean age of patients was 67.44 (standard deviation 16.72) years. It was estimated that 25.7% of PVCs were no longer necessary. Staphylococcus aureus was the most frequently isolated micro-organism (41.7%). Phlebitis was clinically evident in 44 (62.9%) episodes, and proved to be an independent predictor of catheter insertion in emergency departments (odds ratio 5.44). The crude and attributable mortality rates were 12.9% and 5.7%, respectively. Conclusions PVCs carry a significant risk for bacteraemia in Spanish IMDs. Phlebitis is not always clinically evident in patients with bacteraemia in this population. The study findings support the need for educational and interventional preventive measures in both IMDs and emergency departments to reduce the rate of PVC-BSI and associated comorbidities, and costs.