Catheter application, insertion vein and length of ICU stay prior to insertion affect the risk of catheter-related bloodstream infection

Summary Background The Dutch PREZIES surveillance scheme for catheter-related bloodstream infection (CR-BSI) collects data on infection rates and related risk factors. Aim To evaluate risk factors for CR-BSI. Methods Hospitals collected data for intensive care units (ICU) or for the entire hospital. All short-term central venous catheters (CVC), including Swan-Ganz catheters, present for ≥48 h were surveyed, except in cases when bacteraemia was present at insertion. CVCs were monitored until infection, removal or death for up to 28 days. Data were collected on 3750 CVCs and 29,003 CVC-days. Findings Of the CVCs surveyed, 1.6% [95% confidence interval (CI) 1.2–2.0] resulted in CR-BSI, representing 2.0/1000 CVC-days (95% CI 1.6–2.6). Multi-variate analysis revealed that the length of ICU stay prior to CVC insertion, insertion in the jugular or femoral vein, and use of the CVC to deliver total parenteral nutrition increased the risk of CR-BSI, whereas use of the CVC to deliver antibiotics decreased the risk of CR-BSI. Conclusion Attention to these risks has the potential to reduce the incidence of CR-BSI.