Evaluation of the infections due to central venous catheters in intensive care unit patients

Introduction

Central venous catheters (CVC) are responsible for a part of the infections seen in intensive care units (ICU). In our ICU routinely we use CVC for fluid and drug administration as well as CVP measurement. On the ather hand, infection, one of the most important complications of CVC must always he thought. Infections due to CVC are attributed to colonization of microorganisms at the tip of CVC and then their migration to the circulation. In our study, we planned to determine the colonization ratio of microorganisms at the tip of CVC and analyse the agents of infection.

Method

We evaluated the data obtained from 40 CVC that we could send to the laboratory in a year. The insetion sites of CVC were V. basilica (n = 25), V. subclavia (n = 5), V. jugularis interna (n = 4) and V. femoralis (n = 6). CVC were inserted under sterile condition by using sterile gloves and surgical drapes. The duration of catheterization was 8.4 ± 5.1 days (2-23 days). Central venous pressure measurements and fluid administrations were made by the nurses under sterile conditions. Fluid administration sets were changed two times a week. Cannulation sires were cleaned with povidone-iodine (Betadine^®) every day and sterile deesings(Tegaderm^®) were applied. Approximately 2 cm to the tip of each with drawn CVC is sended to the laboratory of microbiology in a sterile tube for culture-antibiogram analysis.

Findings

We determined an agent of infection in 6 of 40 catheters tips that we evaluated (1%5). The agents were: Acinetobacter sp. (n = 2), Coagulase (-) staphylococci (n = 2). Fungi (n = 1), Oxacilline resistant Staphylococci aureus (n = 1). We determined no agent of infection in the others 34 catheters.

Discussion

Infection rate was less compared to previous reports and was similar to the results of the study by Nahidh et al. in which povidine iodine was used in the control group. Then we concluded that the ratio of infections due to colonization at the tip of CVC, may be decreased by daily care of catheters made under sterile conditions.