Investigation of the Factors Associated with Mortality in Catheter-Related Bloodstream Infections: Five-Year Observation

Abstract

Aim: Intravenous catheter use can cause various infections ranging from infection at the site of catheter entry to bacteremia and colonization. The purpose of this study was to identify the causative micro-organisms, and effects on morbidity-mortality of catheter-related bloodstream infections developing over the last five years. Material and Methods: Data for 194 patients who underwent central intravenous catheter insertion in our hospital’s intensive care unit and other departments between November 2014 and August 2019 were analyzed retrospectively. Blood samples taken from the catheter or the catheter tip, and blood samples collected simultaneously from the peripheral vein were included in the study, and culture results were recorded. Patients’ demographic data and the effects of the factors identified on morbidity and mortality were subjected to statistical analysis. Results: Ninety-two (47.4%) of the 194 patients included in the study were female and 102 (52.6%) were male, and mortality rate was 62.4% (n=121). The frequency of underlying medical conditions such as asthma, congestive heart failure, and cerebrovascular event, and receiving treatments such as immunosuppression, transfusion, tracheostomy, nasogastric tube, and mechanical ventilation were higher in mortal cases than non-mortal cases. A total of two hundred and forty microorganisms were detected in 194 patients, 121 (50.4%) of which were Gram negative bacteria, while 68 (28.3%) were Gram positive bacteria, and 51 (21.3%) were Candida species. Conclusion: As a result, it was observed that the advanced age, underlying diseases and presence of resistant microorganisms were higher in mortal cases.

Keywords

• Catheter-related bloodstream infections
• mortality
• advanced age

Kateter İlişkili Kan Dolaşımı Enfeksiyonlarında Mortalite ile İlişkili Faktörlerin Araştırılması: Beş Yıllık Gözlem

Abstract

Amaç: İntravenöz kateter kullanımı hastalarda kateter girişindeki enfeksiyondan bakteriyemi ve kolonizasyona kadar çeşitli enfeksiyonlara neden olabilir. Bu çalışmanın amacı, son beş yılda gelişen kateter ilişkili kan dolaşımı enfeksiyonlarının etken mikroorganizmalarını tanımlamak ve morbidite-mortalite üzerine etkisini ortaya koymaktır. Gereç ve Yöntemler: Kasım 2014 ve Ağustos 2019 tarihleri arasında hastanemizin yoğun bakım ünitesinde ve hastanemizin diğer bölümlerinde santral intravenöz kateter yerleştirilen 194 hastanın verileri geriye dönük olarak incelendi. Kateterden veya kateter ucundan alınan kan örnekleri ve periferik venden aynı anda toplanan kan örnekleri çalışmaya dahil edildi ve alınan kan örneklerinin kültür sonuçları kaydedildi. Hastaların demografik verileri ile saptanan faktörlerin morbidite ve mortalite üzerine olan etkileri istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 194 hastanın 92’si (%47,4) kadın, 102'si (%52,6) erkek cinsiyette idi ve mortalite oranı %62,4 (n=121) idi. Astım, konjestif kalp yetmezliği ve serebrovasküler olay gibi altta yatan tıbbi durumların sıklığı ve immünosupresyon, transfüzyon, trakeostomi, nazogastrik tüp ve mekanik ventilatör uygulanması gibi tedavilerin sıklığı mortal olgularda mortal olmayan olgulardan daha fazla idi. Yüz doksan dört hastada toplam 240 adet mikroorganizma üremesi saptanmış olup bunların 121 (%50,4)'i Gram negatif bakteri, 68 (%28,3)'i Gram pozitif bakteri ve 51 (%21,3)'i Candida spp idi. Sonuç: Sonuç olarak ileri yaş, altta yatan hastalıklar ve dirençli mikroorganizma varlığının mortal olgularda daha fazla olduğu görülmüştür.

Keywords

• Kateter ilişkili kan dolaşımı enfeksiyonu
• mortalite
• ileri yaş

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