Indian Journal of Microbiology Research


A study on Catheter related bloodstream infections (CRBSI) in Intensive care unit patients in a tertiary care hospital


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Author Details: Abirami E, Preethi Venkatesan, Priyadarshini Shanmugam, Shameem Banu Abdul Sattar

Volume : 4

Issue : 2

Online ISSN : 2394-5478

Print ISSN : 2394-546X

Article First Page : 138

Article End Page : 143


Abstract

Introduction: Catheter related blood stream infections (CRBSI) independently increase hospital costs and length of stay. Knowledge about CRBSIs would help in improving infection control practices and managing nosocomial sepsis.
Objectives:To study the prevalence of central venous catheter related blood stream infections and to identify clinical risk factors & the microbiological profile of organisms causing CRBSI.
Materials & Methods: This was a prospective observational study carried out in the medical ICU of Chettinad Hospital and Research Institute, over a period of one year from March 2014 to February 2015. All adult non-immunocompromised patients admitted to the Intensive care unit(ICU), who had a non-tunnelled Central venous catheter(CVC) insertedwere included. Blood cultures were taken at the time of CVC insertion. At the time of removal, catheters were cultured using semi-quantitative method(SQC) of Makialong with a paired peripheral blood culture. The incidence of BSI was measured per 1000 CVC days.
Results: A total of 82 patients with a cumulative 434 CVC days were included. Of this, 17 catheters (20.73 %) were positive for SQC. 3 patients (17.6%) had developed CRBSI, and the same organism with identical antibiogram pattern was isolated from both the blood and CVC tip. 10 patients (58.8%) had only catheter associated infection without bacteremia. 4 patients(23.5%) had positive blood cultures with different organism growing in CVC tip. CRBSI rate was 6.5/1000CVC days. The risk factors were diabetes mellitus, central line in situ for more than 7 days and emergency insertions. Out of the three definite CRBSIs, two patients grew Klebsiella pneumoniae and one patient grew Staphylococcus epidermidis. Of the 17 CVC tips which yielded positive growth, 53% were CoNS, followed by Klebsiella pneumoniae, E.coli, Enterococcus spp and Candida. CoNS was penicillin resistant and vancomycin sensitive. Majority of Klebsiella pneumoniae isolates were ESBL producers.
Conclusion: The knowledge of incidence of CRBSI and the microbiological spectra will be useful in formulating bundles of care and effective programs to control hospital acquired infections.