Catheter-related bloodstream infection: burden of disease in a tertiary hospital

Background: Surveillance programmes have become the most effective tool for control ling catheter-related bloodstream infections (CRBSI). However, few studies have investi gated programmes covering all hospital settings. Aim: To describe the results of a control and prevention programme for CRBSI ba...

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Detalhes bibliográficos
Autores: Martínez Morel, Héctor Rolando, Sánchez Payá, José, Molina Gómez, María José, García Shimizu, Patricia, García Román, Vicente, Villanueva Ruiz, César, González Hernández, María, Nolasco Bonmatí, Andreu
Tipo de documento: artigo
Data de publicação:2014
País:España
Recursos:Universidad Católica San Antonio de Murcia (UCAM)
Repositório:RIUCAM. Repositorio Institucional de la Universidad Católica San Antonio de Murcia
OAI Identifier:oai:repositorio.ucam.edu:10952/10891
Acesso em linha:http://hdl.handle.net/10952/10891
Access Level:Acceso aberto
Palavra-chave:Catheter-related bloodstream infection
Central venous catheter
Primary bloodstream infection Surveillance
Infection control
Descrição
Resumo:Background: Surveillance programmes have become the most effective tool for control ling catheter-related bloodstream infections (CRBSI). However, few studies have investi gated programmes covering all hospital settings. Aim: To describe the results of a control and prevention programme for CRBSI based on compliance with recommendations for insertion and maintenance, using annual burden of disease in a tertiary level hospital. Methods: A CRBSI control and prevention programme involving all hospital settings was implemented. The programme consisted of CRBSI surveillance, direct observation of insertion and maintenance of catheters to determine performance, and education for healthcare workers. Findings: In total, 2043 short-term catheters were inserted in 1546 patients for 18,570 catheter-days, and 279 long-term catheters were inserted in 243 patients for 40,440 catheter-days. The annual incidence density was 5.98 (first semester 6.40, second semester 5.64) CRBSI per 1000 catheter-days for short-term catheters, and 0.57 (first semester 0.66, second semester 0.43) CRBSI per 1000 catheter-days for long-term catheters. One hundred and forty insertion procedures were observed, with an average insertion time of 13 (standard deviation 7) min. Compliance with recommendations was as follows: hand hygiene, 86.8%; use of alcoholic chlorhexidine solution for skin disinfection, 35.5%; use of mask, 93.4%; use of gloves, 98.7%; use of gown, 75.0%; use of sterile cloth, 93.8%; use of cap, 92.2%; bandage application, 62.7%; and use of aseptic technique, 89.5%. Forty-five maintenance procedures were observed, and compliance rates were as follows: hand hygiene, 42.1%; use of gloves, 78.1%; and port disinfection with alcoholic chlorhexidine solution, 32.5%. Conclusion: The CRBSI control and prevention programme implemented at the study hospital has decreased the rate of CRBSI, provided important information about the total burden of disease, and revealed possible ways to improve interventions in the future.