Decreased mortality among patients with catheter-related bloodstream infections at Catalan hospitals (2010–2019). (August 2022)

• Record Type: Journal Article
• Authors: Badia-Cebada, L.; Peñafiel, J.; López-Contreras, J.; Pomar, V.; Martínez, J.A.; Santana, G.; Cuquet, J.; Montero, M.M.; Hidalgo-López, C.; Andrés, M.; Gimenez, M.; Quesada, M.D.; Vaqué, M.; Iftimie, S.; Gudiol, C.; Pérez, R.; Coloma, A.; Marron, A.; Barrufet, P.; Marimon, M.; Lérida, A.; Clarós, M.; Ramírez-Hidalgo, M.F.; Garcia Pardo, G.; Martinez, M.J.; Chamarro, E.L.; Jiménez-Martínez, E.; Hornero, A.; Limón, E.; López, M.; Calbo, E.; Pujol, M.; Gasch, O.;
• Is Part Of: Journal of hospital infection. Volume 126(2022)
• Page Start: 70
• Page End: 77
• Publication Date: 2022-08
• Subjects: Mortality -- Healthcare-associated infection -- Catheter-related bloodstream infection -- Intervention programme; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2022.05.009
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: Background: The incidence of catheter-related bloodstream infections (CRBSIs) 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 30 days after bacteraemia onset was analysed using the Cox regression model. Findings: Over the study period, 4795 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 (hazard ratio (HR): 0.95; 95% confidence interval (CI): 0.92–0.98). The multivariate analysis identified age (HR: 1.03; 95% CI: 1.02–1.04), femoral catheter (1.78; 1.33–2.38), medical ward acquisition (2.07; 1.62–2.65), ICU acquisition (3.45; 2.7–4.41), S. aureus (1.59; 1.27–1.99) and Candida sp. (2.19; 1.64–2.94) as risk factors for mortality, whereas the mortality rate associated with episodes originating in peripheral catheters was significantly lower (0.69; 0.54–0.88). Conclusion: Mortality associated with CRBSI has fallen in recent years but remains high. Intervention programmes should focus especially on ICUs and medical wards, where incidence and mortality rates are highest.