Cruz RP, Rincón ZJ, Mendieta AGG

Language: Spanish
References: 13
Page: 107-115
PDF size: 241.54 Kb.

ABSTRACT

Introduction: Nosocomial infections in hospitalized patients are one of the main concerns of health systems in the twenty-first century, for both the morbidity and mortality caused by them and the economic costs they generate. The catheter-related infections are most severe in patients with a central venous catheter complication. Objectives: To determine the incidence of infections associated with catheters; determine the probability to develop an infection over time in children with central venous catheter; determine the factors associated with the development of infections in children with central catheter at the Hospital for Children, taking into account the time factor. Material and methods: We reviewed the records of patients in the Hospital for Children of IMIEM who were placed central venous catheter between August 1, 2013 to July 31, 2014. The following variables were studied: age in months, gender, service where the catheter placement was made, type of catheter, the use of parenteral nutrition, antibiotics, transfusions, and mechanical ventilation. Descriptive statistics were based on frequencies and percentages. The incidence of bacteremia events was calculated based on the formula accepted by the National Nosocomial Infection Surveillance: number of IR-IVT (infections related to intravascular therapy)/number x 1 000 catheter days. Inferential statistics was done using the χ² test in contingency tables and odds ratio when the comparison was in 2 x 2 boxes. A study of survival analysis was performed using the Kaplan-Meier method. Results: We reviewed 647 records that correspond to 647 catheters inserted, corresponding to a total of 8 042 days-catheter. 19% of the installed catheters were infected and the infection was associated with the intravascular device, ie 123 events of bacteremia out of 647 catheters placed in the span of 8 042 catheter days were presented, giving an incidence rate of 15.29 events bacteremia x 1 000 catheter days. Age in months had a median of 9 with an interquartile deviation of 1-48 months, 60% male and 40% female, the dominant services where catheters were placed was in the emergency room, while the service with more infections was the Intensive Care Unit with 37.7%. The type of catheter used most often was the double lumen at 86.7%. Conclusions: The study allowed us to be aware of a very high incidence of infections associated with central venous catheters in our population, since one of every five catheters in the Hospital for Children presented bacteremia associated. It is necessary to implement measures to reduce the number of infections.

REFERENCES

1. Vaquero SE, Izquierdo GE, Arrizabalaga AM, Gómez PC, Moreno VJM. Incidencia de bacteriemia asociada a catéter en niños hospitalizados que reciben nutrición parenteral, Nutr Hosp, 2011; 26 (1): 236-238.

2. Rosado V, Romanelli RM, Camargos PA. Risk factors and preventive measures for catheter-related bloodstream infections, J Pediatr (Rio J), 2011; 87 (6): 469-477.

3. Ferrer EA, Macías GE, Meza CJ, Cabrera JR, Rodríguez WF, Díaz GE et al. Infecciones relacionadas con catéteres venosos: incidencia y otros factores, Med Int Mex, 2008; 24 (2): 112-119.

4. Pascual A, Bouza E, Liñarez J. Diagnóstico microbiológico de las infecciones asociadas a catéteres intravasculares, 2004. Procedimientos en Microbiología Clínica. SEIMC 2004. ISBN: 84-609-2290-1. Disponible en: https://www.seimc.org/contenidos/documentoscientificos/procedimientosmicrobiologia/seimc-procedimientomicrobiologia15.pdf

5. Vanholder R, Canaud B, Fluck R, Jadoul M, Labriola L, Marti-Monros A et al. Catheter-related blood stream infections (CBRSI): a European view, Nephrol Dial Transplant, 2010; 25 (6): 1753-1756.

6. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by de Infectious Diseases Society of America, Clin Infect Dis, 2009; 49 (1): 1-45.

7. O’Grady NP, Alexander M, Burns LA, Dellinger P, Garland J, Heard SO et al. Guidelines for the prevention of Intravascular Catheter-Related Infections, 2011. Centers for Disease Control and Prevention and Healthcare infection Control Practices Advisory Comitte, 2009, Available in: https://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf

8. Tian LY, Hamvas A. Risk factors for nosocomial bloodstream infections in a neonatal intensive care unit, Zhonqquo Danq Dai Er Ke Za Zhi, 2010; 12 (8): 622-624.

9. Advani S, Reich NG, Sengupta A, Gosey L, Milstone AM. Central line-associated bloodstream infection in hospitalized children with peripherally inserted central venous catheters: extending risk analyses outside the intensive care unit, Clin Infect Dis, 2011; 52 (9): 1108-1115.

10. Vilela R, Jácomo AD, Tresoldi AT. Risk factors for central venous catheter-related infections in pediatric intensive care, Clinics (Sao Paulo), 2007; 62 (5): 537-544.

11. Randolph AG, Brun-Buisson C, Goldmann D. Identification of central venous catheter-related infections in infants and children, Pediatr Crit Care Med, 2005; 17 (3 Suppl): S19-S24.

12. Odetola FO, Moler FW, Dechert RE, VanDerElzen K, Chenoweth C. Nosocomial catheter-related bloodstream infections in a pediatric intensive care unit: risk and rates associated with various intravascular technologies, Pediatr Crit Care Med, 2003; 4 (4): 432-436.

13. Mermel LA, Farr BM, Sherertz RJ, Raad II, O’Grady N, Harris JS et al. Guidelines for the management of intravascular catheter related infections, Clin Infect Dis, 2001; 32 (9): 1249-1272.