CLABSI rates in critically ill COVID-19 patients
Abstract:
Background: Aims of this study were to investigate the prevalence and incidence of catheter-related infection, identify risk factors and determine the relation of catheter-related infection with mortality in critically ill COVID-19 patients.
Methods: This was a retrospective cohort study of central venous catheters (CVCs) in critically ill COVID-19 patients. Eligible CVC insertions required an indwelling time of at least 48 hours and were identified using a full-admission electronic healthrecord database. Risk factors were identified using logistic regression. Differences in survival rates at day 28 of follow-up were assessed using a log-rank test and proportional hazard model.
Results: In 538 patients, a total of 914 CVCs were included. Prevalence and incidence of suspected catheter-related infection were 7.9% and 9.4 infections per 1000 catheter indwelling days, respectively. Prone ventilation for more than five days was associated with increased risk of suspected catheter-related infection; odds ratio: 5.05 (95 CI: 2.12 – 11.0). Risk of death was significantly higher in patients with suspected catheter-related infection; hazard ratio: 1.78 (95% CI: 1.25 – 2.53).
Conclusion: This study shows that in critically ill patients with COVID-19 prevalence and incidence of suspected catheter-related infection is high, prone ventilation is a risk factor and mortality is higher in case of catheter-related infection.
Reference:
Smit JM, Exterkate L, van Tienhoven AJ, Haaksma ME, Heldeweg MLA, Fleuren L, Thoral P, Dam TA, Heunks LMA, Gommers D, Cremer OL, Bosman RJ, Rigter S, Wils EJ, Frenzel T, Vlaar AP, Dongelmans DA, de Jong R, Peters M, Kamps MJA, Ramnarain D, Nowitzky R, Nooteboom FGCA, de Ruijter W, Urlings-Strop LC, Smit EGM, Mehagnoul-Schipper DJ, Dormans T, de Jager CPC, Hendriks SHA, Achterberg S, Oostdijk E, Reidinga AC, Festen-Spanjer B, Brunnekreef GB, Cornet AD, van den Tempel W, Boelens AD, Koetsier P, Lens J, Faber HJ, Karakus A, Entjes R, de Jong P, Rettig TCD, Arbous S, Vonk B, Machado T, Girbes ARJ, Sieswerda E, Elbers PWG, Tuinman PR. Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study. Shock. 2022 Sep 8. doi: 10.1097/SHK.0000000000001994. Epub ahead of print. PMID: 36155964.