Evaluation of catheter blood stream infection in patients admitted to ICU 7 and 8 of Imam Reza Hospital in Tabriz

Abstract

The occurrence of catheter-related blood stream infection, in addition to the adverse effect on patient complications and increasing hospital costs, is an important risk factor for increasing mortality in ICU patients. The aim of this study is the evaluation of catheter blood stream infection in patients admitted to ICU 7 and 8 of Imam Reza Hospital in Tabriz. Materials and Methods: This research was a descriptive-analytical cross-sectional study. In this study, the target population was adult patients admitted to ICU General 7 and 8 of Tabriz Imam Reza Hospital who had a central venous catheter from the date of approval for 9 months in 2022. The sample size was equal to 128 patients. The sampling method in this study was census. Information was collected by a checklist containing information related to age, sex, reason for hospitalization, need for ventilation, indication for catheter installation, duration of catheter maintenance, location of catheter insertion, duration of hospitalization in ICU and hospital, early complications and late complications, and mortality. In case of suspicion of a blood stream infection with the origin of the catheter, blood culture along with the antibiogram was sent twice through the catheter, and if there were clear signs of infection, the catheter was immediately removed and the tip was cultured and the antibiogram was sent, and the results are recorded in the questionnaire. Results: In this study, the highest frequency of indications for catheter installation in the studied subjects was lack of venous access with 68 cases (53.1%) and dialysis with 36 cases (28.1%), respectively. Also, the highest frequency of catheter placement in these people was jugular with 68 cases (53.1%), subcline with 40 cases (31.3%), and femoral with 16 cases (12.5%), respectively. The highest frequency of catheter type in these people was temporary CV-line with 100 cases (78.1%), permanent with 20 cases (15.6%) and temporary dialysis (temporary Chaldon) with 8 cases (6.3%), respectively. Also, the most early complications in these people were, hematoma at the insertion site with 24 cases (18.8%), bleeding at the catheter site with 8 cases (6.3%), and pneumothorax with 4 cases (3.1%), respectively. The most late complications in these people were catheter thrombosis with 32 cases (25.0%), implantation site infection (endocarditis) and septic shock with 8 cases each (6.3%), respectively. Finally, 52 cases (40.6%) of the studied patients died and 76 cases (59.4%) recovered. 44 cases (34.4%) of the studied subjects had blood stream infection, and among these subjects, the most strains isolated from the catheter were Klebsiella pneumoniae in 24 cases (18.8%), Candida albicans and Acinetobacter baumannii with 8 cases each (6.3%) and Staphylococcus epidermidis with 4 cases (3.1%), respectively. The highest antibiotic resistance of the strain isolated from the catheter in the patients was related to Cefepime, Ciprofloxacin and Co-trimoxazole each with 32 cases (50.0%). Also, the highest antibiotic sensitivity of the strain isolated from the catheter in patients was related to Gentamycin with 12 cases (9.4%) and Amikasin with 8 cases (6.3%), respectively. In this study, there was no statistically significant relationship between the catheter blood stream infection variable and the location of the catheter in the study subjects (P>0.05).