Central venous catheter related blood stream infections in an intensive care unit from a tertiary care teaching hospital

Abstract

Introduction – Central venous catheters (CVC) have become essential in the management of critically ill patients and patient who requires long-term medical care. CRBSI (Catheter Related Blood Stream Infection) is one of the most frequent and lethal complication of catheter use. The objective of this study was to determine incidence of CRBSIs and antibiotic susceptibility pattern of isolated bacteria in an ICU set up. Methods – This study was carried out in patients admitted at ICU during a 3 year period (January 2012 to December 2014). A total of 434 samples were received in the laboratory with clinical diagnosis of septicemia after central venous catheterization. Semi quantitative method (roll-plate) was used for catheter tip culture. Peripheral blood cultures were obtained and were processed by standard methods. Results – Out of 434 catheters a total of 256 (59%) catheter tips were colonized. Staphylococcus aureus (42%) were most common colonizers followed by Enterobacteriaceae family, gram negative non-fermenters and Candida albicans. Incidence of CRBSI was 7.8% (33/434) or 9.5 per 1000 catheter days. Staphylococcus aureus was the major (63%) cause of CRBSI followed by Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli. MRSA rate was 76%. All the Acinetobacter baumannii and 33% Pseudomonas aeruginosa were MDR. All the Escherichia coli and Klebsiella pneumoniae were ESBL producers with 33% Klebsiella pneumoniae being MDR. Discussion - Since CVCs are increasingly being used in the critical care and have direct bearing on the mortality and morbidity, regular microbiological surveillance need to be undertaken to prevent complication.