Central Venous Catheter Related-bloodstream Infection In Surgical Intensive Care Unit:A Retrospective, Case-controlled Study

Objective To analyze the incidence, pathogens distribution and risk factors of central venous catheter related-bloodstream infection in surgical intensive care unit, and provide the evidence of treatment with clinic experience. Methods Patients admitted in surgical intensive care unit of our hospital from January2010-August2011with CVC were enrolled, and divided into CRBSI group and non-CRBSI group on the basis of the outcomes of germiculture of blood samples and hub tips. Then, the incidence and pathogens of CRBSI were analyzed retrospectively. The clinical data of CRBSI group and non-CRBSI group were compared in univariate analysis, and then, a multivariate analysis has been performed with logistic regression to investigate the risk factors. Results Of the249cases with CVC in the study,21cases(8.43%) had CRBSI, and the incidence was8.41cases per1000catheter days.21pathogens were isolated, including4gram-positive bacteria,9gram-negative bacteria and8.fungi, and some were antibiotic-resistance strains. On univariate analysis, significant risk factors were duration of catheterization, duration of PN, The level of blood urea nitrogen when insert CVC, The temperature when remove CVC, chronic health evaluation score (APACHEII) and use of TPN. On Logistic regression analysis, duration of catheterization(OR3.298,95%CI1.070-10.168, P=0.038), APACHEII score(OR1.137,95%CI1.067-1.213, P=0.000), use of TPN (OR1.117,95%CI1.023-1.219, P=0.014) were independent risk factors for CRBSI. Conclusion The major pathogens of CRBSI are gram-negative bacteria, and there was a clear upward trend of fungal infection. Duration of catheterization, APACHEII score and TPN were the independent risk factors.