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Cross-Sectional Epidemiology of Phlebitis and Catheter-Related Infections

Published online by Cambridge University Press:  21 June 2016

Javier Ena
Affiliation:
Internal Medicine, Hospital Gregorio Maranon, Madrid, Spain
Emilia Cercenado
Affiliation:
Clinical Microbiology Services, Hospital Gregorio Maranon, Madrid, Spain
David Martinez
Affiliation:
Clinical Microbiology Services, Hospital Gregorio Maranon, Madrid, Spain
Emilio Bouza*
Affiliation:
Clinical Microbiology Services, Hospital Gregorio Maranon, Madrid, Spain
*
Servicio de Microbiologia Clinica, Hospital Gregorio Maranon, Dr Esquerdo 46, 28007 Madrid, Spain

Abstract

Objectives:

To describe the characteristics and the problems arising from the use of vascular catheterization in a general hospital and to identify avoidable risk factors associated with catheter-related infections.

Design:

Cross-sectional, including the entire hospitalized population.

Setting:

A university-affiliated hospital.

Results:

Three-hundred fifty-three intravascular catheters were implanted in 315 of a total of 1,838 hospitalized patients (17.1%, confidence interval [CI] = 15.7-18.5). Of the 353 intravascular catheters, 26 (7.3%) were intraarterial, 273 (77.3%) were peripheral, and 54 (15.3%) were central. The median (range) duration of the catheterization was 3 (1-1 1) days for arterial catheters, 1 (1-24) for peripheral catheters, and 5 (1- 130) for central catheters. Fifty-three (15%, CI = 11.5-19.5) showed signs of infection. Independent risk factors associated with infection were the presence of infection located elsewhere (odds ratio [OR]=8.7, CI=4.13-18.3, p<.0001), inappropriate catheter care (OR= 5.3, CI = 2.5-11.2, p<.0001), inappropriate length of catheter use (OR= 3.5, CI = 1.4-9.02, p<.01), and duration of hospitalization exceeding 14 days (OR=2.6, CI=O.9-7.83,p=.07).

Conclusion:

The risk factors associated with catheter-related infections suggest that many are preventable by improved protocols for management. This hypothesis can easily be tested.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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References

1. Stamm, WE. Infections related with medical devices. Ann Intern Med. 1978;89:764769.CrossRefGoogle ScholarPubMed
2. Maki, DG, Goldmann, DA, Rbame, FS. Infection control in intravenous therapy. Ann Intern Med. 1973;79:867887.CrossRefGoogle ScholarPubMed
3. McCabe, WR, Jackson, GG. Gram-negative bacteremia I. Etiology and ecology. Arch Intern Med. 1962;110:847855.CrossRefGoogle Scholar
4. Outline for Surveillance and Control of Nosocomial Infections. Atlanta, Ga: Centers for Disease Control; 1970.Google Scholar
5. Simmons, BI? Guidelines for Prevention of Intravascular Inections. Atlanta, Ga: Centers for Disease Control; 1981.Google Scholar
6. Campos-Filho, N, Franco, EL. A microcomputer program for multiple logistic regression by unconditional and conditional maximum likelihood methods. Am J Epidemiol. 1989;129:439444.CrossRefGoogle ScholarPubMed
7. Bouza, E, Cosin, J, Grupo Cooperativo para el Estudio de la Infeccion. Estudio de prevalencia de infection hospitalaria y consumo de antimicrobianos. Med Clin (Barc). 1986;87:353358.Google Scholar
8. Grupo de Trabajo EPINCAT. Prevalencia de las infecciones nosocomiales en Cataluna. (I) Infecciones y factores de riesgo. Med Clin (Barc). 1990;95:4152.Google Scholar
9. Wilkins, EGL, Manning, D, Roberts, C, Davidson, DC. Quantitative bacteriology of peripheral venous cannulae in neonates. J Hosp Infect. 1985;6:209217.CrossRefGoogle ScholarPubMed
10. Gantz, NM, Presswood, GW, Goldberg, R, Doern, G. Effects of dressing type and change internal on intravenous therapy complications rates. Diagn Microbiol Infect Dis. 1984;2:325332.CrossRefGoogle Scholar
11. Vaque, J, Rosello, J, Campins, M et al. Prevalencia de infecciones en un hospital quirurgico de tercer nivel (I). Infecciones y factores de riesgo. Med Clin (Barc). 1990;95:4152.Google Scholar
12. Singh, S, Nelson, N, Acosta, I, Cheek, FE, Puri, VK. Catheter colonization and bacteremia with pulmonary and arterial catheters. Crit Care Med. 1982;10:736739.CrossRefGoogle ScholarPubMed
13. Russell, JA, Joel, M, Hudson, RJ, Mangano, DT: Schlobhom, RM. Prospective evaluation of radial and femoral artery catheterization sites in critically ill adults. Crit Care Med. 1983; 11:936939.CrossRefGoogle ScholarPubMed
14. Prager, RL, Silva, J Jr. Colonization of central venous catheters. South Med J 1984;77:458461.CrossRefGoogle ScholarPubMed
15. Tully, JL, Friendland, GH, Baldini, MA, Goldmann, DA Complications of intravenous therapy with needles and Teflon catheters. Am J Med. 1981;70:702706.CrossRefGoogle ScholarPubMed
16. Band, JD, Maki, DG. Steel needles used for intravenous therapy. Morbidity in patients with haematologic malignancy. Arch Intern Med. 1980;140:3134.CrossRefGoogle Scholar
17. Curelaru, I, Bylock, A, Gustavson, E et al. Dynamics of thrombophlebitis in central venous catheterization via basilic and cephalic veins. Acta Chir Scand. 1984;150:285293.Google ScholarPubMed
18. Ponce de Leon, S, Wenzel, RP. Hospital-acquired infections with Staphylococcus epidermidis . Am J Med. 1984;79:639644.CrossRefGoogle Scholar
19. Bentley, DE, Lepper, MH. Septicemia related to indwelling venous catheters. JAMA. 1968:206:17491752.CrossRefGoogle Scholar
20. Garland, JS, Nelson, DB, Cheah, T, Hennes, HH, Johnanson, TM. Infectious complications during peripheral intravenous therapy with Teflon catheters: a prospective study. Pediatr Infect Dis J. 1987;6:918921.CrossRefGoogle ScholarPubMed
21. Tomford, JW, Hersey, CO, Maclaren, CE, Porter, DK, Cohen, DI. Intravenous therapy team and peripheral venous catheter associated complications: a prospective controlled study. Arch Intern Med. 1984;144:11911194.CrossRefGoogle ScholarPubMed
22. Maki, DC, Weise, CE, Sarafin, HW. A semiquantitative culture method for identifying intravenous catheter-related-infection. N Engl J Med. 1977;296:13051309.CrossRefGoogle ScholarPubMed
23. Cleri, DJ, Corrado, ML, Seligman, SJ. Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis. 1980;141:781786.CrossRefGoogle ScholarPubMed
24. Collins, RN, Braun, PA, Zinner, SH, et al. Risk of local and systemic infection with polyethylene intravenous catheters. N Engl J Med. 1968;279:340343.CrossRefGoogle ScholarPubMed
25. Norden, C. Application of antibiotic ointment to the, site of intravenous catheterization-a controlled trial. J Infect Dis. 1969;120:611615.CrossRefGoogle Scholar
26. Zinner, SH, Denny-Brown, BC, Braun, P, et al. Risk of infection with intravenous indwelling catheters: effects of application of antibiotic ointment. J Infect Dis. 1969;120:616619.CrossRefGoogle ScholarPubMed
27. Maki, DG, Ringer, M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. Ann Intern Med. 1991;114:845854.CrossRefGoogle ScholarPubMed
28. Corso, JA, Agostinelli, R, Brandriss, MW. Maintenance of venous polyethylene catheters to reduce risk of infection. JAMA. 1969;210:20752077.CrossRefGoogle ScholarPubMed
29. Fuchs, PC. Indwelling intravenous polyethylene catheters. JAMA. 1971;216:14471450.CrossRefGoogle ScholarPubMed
30. Collin, J, Collin, C, Constable, FL, Johnston, IDA. Infusion thrombophlebitis and infection with various cannulas. Lancet. 1975;ii:150153.CrossRefGoogle Scholar
31. Nelson, DB, Garland, JS. The natural history of Teflon-associated phlebitis in children. Am J Dis Child. 1987;141:10901092.CrossRefGoogle ScholarPubMed
32. Tager, IB, Ginsberg, MB, Ellis, SE et al. An epidemiologic study of the risks associated with peripheral intravenous catheters. Am J Epidemiol. 1983;118:839851.Google ScholarPubMed