Bacteriemia asociada a catéter venoso central en el paciente crítico: epidemiología y factores de riesgo

Abstract

Introduction

Central venous catheter-related bacteremia is a common nosocomial infection in intensive care units (ICU), the prevalence is worrying. In recent years, due to Covid-19, the number of central venous catether's patients, treated with immunosuppressive drugs, has been increased. Our objective was to determine the prevalence of central catheter bacteremia in ICU, during 2022, as well as to determine associated risk factors.

Method

Descriptive cross-sectional study in ICU of hospita (HGU Dr. Balmis Hospital Alicante, Spain). Were included 466 patients admitted to ICU in 2022. Sociodemographic, clinical, catheter-related data and APACHE-II and q-SOFA scale scores were collected.

Results

The prevalence of bacteriemia was 3.65%. Significant factors associated with bacteriemia were the number of catheters inserted in each patient (p < 0.001) and the use of immunosuppressive drugs (p = 0.002). Patients who had a peripherally inserted catheter (PICC) had a lower probability of develop bacteriemia and patients with conventional catheter and PICC had a higher probability. The rest of the variables, including Covid-19, without significant differences.

Discussion and conclusions

In line with other authors, we can affirm that the administration of immunosuppressive drugs is a risk factor of central venous catheter-related bacteremia; A correct risk-benefit assessment is recommended when prescribing these drugs, in Covid's patients the biological drug tocilizumab could be the recommended one. An increase by one unit in the number of catheters inserted causes a 5-fold increase in probability of developing bacteremia (Odds ratio: 4.984, 95% confidence interval 2.984-9.136). Covid-19, sex, age, comorbidities and q-SOFA and APACHE-II scores do not seem to show a relationship whith bacteremia and PICCs devices do seem to be safer versus conventional CVCs.