Decreased mortality among patients with catheter-related bloodstream infections at catalan hospitals (2010-2019)

Background: The incidence of catheter-related bloodstream infections (CRBSI) has fallen over the last decade, especially in intensive care units (ICUs). Aim: to assess the existence of concomitant trends in outcomes and to analyse the current risk factors for mortality. Methods: A multicentre retros...

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Detalles Bibliográficos
Autores: Badia-Cebada, Laia, Peñafiel, Judith, López-Contreras, Joaquín, Pomar, Virginia, Martínez, José Antonio, Santana, Germina, Cuquet, Jordi, Montero, Maria M., Hidalgo-López, Carlota, Andrés, Marta, Gimenez, Montserrat, Quesada, María Dolores, Vaqué, Montserrat, Iftimie, Simona, Gudiol González, Carlota, Perez, Rafel, Coloma, Anna, Marrón, Anna, Barrufet, Pilar, Marimon, Marilo, Lérida, Ana, Clarós, Mercè, Ramírez-Hidalgo, Maria Fernanda, Garcia Pardo, Graciano, Martinez, M. Jesús, Chamarro, Elena Lourdes, Jiménez-Martínez, Emili, Hornero, Ana, Limón, Enrique, López, Maria, Calbo, Esther, Pujol Rojo, Miquel, Gasch, Oriol
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/185883
Acceso en línea:https://hdl.handle.net/2445/185883
Access Level:acceso abierto
Palabra clave:Mortalitat
Catèters
Infeccions
Hospitals
Mortality
Catheters
Infections
Descripción
Sumario:Background: The incidence of catheter-related bloodstream infections (CRBSI) has fallen over the last decade, especially in intensive care units (ICUs). Aim: to assess the existence of concomitant trends in outcomes and to analyse the current risk factors for mortality. Methods: A multicentre retrospective cohort study was conducted at 24 Catalan hospitals participating in the Surveillance of healthcare associated infections in Catalonia (VINCat). All hospital-acquired CRBSI episodes diagnosed from January 2010 to December 2019 were included. A common protocol including epidemiological, clinical and microbiological data was prospectively completed. Mortality at days after bacteraemia onset was analysed using the Cox regression model. Findings: Over the study period, 4,795 episodes of CRBSI were diagnosed. Among them, 75% were acquired in conventional wards and central venous catheters were the most frequently involved (61%). The 30-day mortality rate was 13.8%, presenting a significant downward trend over the study period: from 17.9% in 2010 to 10.6% in 2019 (HR 0.95 [0.92-0.98]). The multivariate analysis identified age (HR 1.03 83 [1.02-1.04]), femoral catheter (HR 1.78 [1.33-2.38]), medical ward acquisition (HR 2.07 [1.62-2.65] and ICU acquisition (HR 3.45 [2.7-4.41]), S. aureus (HR 1.59 [1.27-1.99]) and Candida sp. (HR 2.19 [1.64-2.94]) as risk factors for mortality while the mortality rate associated with episodes originating in peripheral catheters was significantly lower (HR 0.69 [0.54-0.88]). Conclusions: Mortality associated with CRBSI has fallen in recent years but remains high. Intervention programs should focus especially on ICUs and medical wards, where incidence and mortality rates are highest.

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