التفاصيل البيبلوغرافية
| العنوان: |
Decreased mortality among patients with catheter-related bloodstream infections at Catalan hospitals (2010-2019). |
| المؤلفون: |
Badia-Cebada, L., Peñafiel, J., López-Contreras, J., Pomar, V., Martínez, J.A., Santana, G., Cuquet, J., Montero, M.M., Hidalgo-López, C., Andrés, M., Gimenez, M., Quesada, M.D., Vaqué, M., Iftimie, S., Gudiol, C., Pérez, R., Coloma, A., Marron, A., Barrufet, P., Marimon, M. |
| المصدر: |
Journal of Hospital Infection; Aug2022, Vol. 126, p70-77, 8p |
| مستخلص: |
Background: The incidence of catheter-related bloodstream infections (CRBSIs) has fallen over the last decade, especially in intensive care units (ICUs).Aim: To assess the existence of concomitant trends in outcomes and to analyse the current risk factors for mortality.Methods: A multicentre retrospective cohort study was conducted at 24 Catalan hospitals participating in the Surveillance of healthcare-associated infections in Catalonia (VINCat). All hospital-acquired CRBSI episodes diagnosed from January 2010 to December 2019 were included. A common protocol including epidemiological, clinical, and microbiological data was prospectively completed. Mortality at 30 days after bacteraemia onset was analysed using the Cox regression model.Findings: Over the study period, 4795 episodes of CRBSI were diagnosed. Among them, 75% were acquired in conventional wards and central venous catheters were the most frequently involved (61%). The 30-day mortality rate was 13.8%, presenting a significant downward trend over the study period: from 17.9% in 2010 to 10.6% in 2019 (hazard ratio (HR): 0.95; 95% confidence interval (CI): 0.92-0.98). The multivariate analysis identified age (HR: 1.03; 95% CI: 1.02-1.04), femoral catheter (1.78; 1.33-2.38), medical ward acquisition (2.07; 1.62-2.65), ICU acquisition (3.45; 2.7-4.41), S. aureus (1.59; 1.27-1.99) and Candida sp. (2.19; 1.64-2.94) as risk factors for mortality, whereas the mortality rate associated with episodes originating in peripheral catheters was significantly lower (0.69; 0.54-0.88).Conclusion: Mortality associated with CRBSI has fallen in recent years but remains high. Intervention programmes should focus especially on ICUs and medical wards, where incidence and mortality rates are highest. [ABSTRACT FROM AUTHOR] |
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