Original Article

Epidemiologic analysis of central vein catheter infection in burn patients

Abstract

Background and Objectives: Currently, there are no well-defined guidelines or criteria for catheter-site care in burn patients, and there is little information about the epidemiology of central vein catheter (CVC) infection in such patients. This study aimed at addressing the epidemiological aspect of CVC infection in a sample of Iranian burn patients admitted to the largest referral burn center in Iran, Motahari Burn Center.
Materials and Methods: A total of 191 burn patients were eligible for the study. Catheter related blood stream infection (CRBSI) was diagnosed according to suspected line infection, sepsis or blood culture growing bacteria, which could not have been associated with another site.
Results: Of the 191 patients in this study, 45 males (23.68%) and 19 females (10%) had positive blood culture, confirming CV line infection. Patients who were burned by gas, gasoline ignition or burning Kerosene had the highest incidence of CV line infection. In contrast, patients burned by alcohol, pitch or thinner had the lower rate of CV line infection. Incidence of CV line infection was higher in patients with delay in presentation to the burn center (55.2%) when compared to those who presented without delay (22.8%). Pseudomonas aeruginosa was the most frequent colonizer of the wound culture (52.4%), the dominant strain of the first catheter tip culture (35%) and the dominant strain of the same day blood samples (53.8%). The mortality rate in patients diagnosed with CRBI was 21.9%.
Conclusion: One of the important factors related to CV line infection is delay inpresentation to the burn center. The rate of CV line infection was 20.64 in catheter days.

Olaechea PM, Palomar M, Álvarez-Lerma F, Otal JJ, Insausti J, López-Pueyo MJ. Morbidity and mortality associated with primary and catheter-related bloodstream infections in critically ill patients. Rev Esp Quimioter 2013; 26:21-29.

Chin BS, Han SH, Lee HS, Jeong SJ, Choi H, Kim CO, et al. Risk factors for recurrent catheter-related infections after catheter-related bloodstream infections. Int J Infect Dis 2010; 14(1):e16-21.

Goudie A, Dynan L, Brady PW, Rettiganti M. Attributable cost and length of stay for central line-associated bloodstream infections. Pediatrics 2014;133: e1525-1532.

Cantey JB, Milstone AM. Bloodstream infections: epidemiology and resistance. Clin Perinatol 2015;42(1):1-16.

Bramesfeld A, Wrede S, Richter K, Steen M, Broge B, Pauletzki J, et al. Development of quality indicators and data assessment strategies for the prevention of central venous catheter related bloodstream infections (CRBSI). BMC Infect Dis 2015;15:435.

Nakamura I, Fukushima S, Hayakawa T, Sekiya K, Matsumoto T. The additional costs of catheter-related bloodstream infections in intensive care units. Am J Infect Control 2015; 43:1046-1049.

Blot K, Bergs J, Vogelaers D, Blot S, Vandijck D. Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis. Clin Infect Dis 2014;59:96-105.

Fearonce G, Faraklas I, Saffle JR, Cochran A. Peripherally inserted central venous catheters and central venous catheters in burn patients: a comparative review. J Burn Care Res 2010;31:31-35.

Echevarria-Guanilo ME, Ciofi-Silva CL, Canini SR, Farina JA, Rossi LA. Preventing infections due to intravascular catheters in burn victims. Expert Rev Anti Infect Ther 2009;7:1081-1086.

Bahemia IA, Muganza A, Moore R, Sahid F, Menezes CN. Microbiology and antibiotic resistance in severe burns patients: A 5 year review in an adult burns unit. Burns 2015;41:1536-1542.

O’Mara MS, Reed N L, Palmieri TL, Greenhalgh DG. Central venous catheter infections in burn patients with scheduled catheter exchange and replacement. J Surg Res 2007; 142: 341-350.

Sheridan RL, Weber JM. Mechanical and infectious complications of central venous cannulation in children: lessons learned from a 10-year experience placing more than 1000 catheters. J Burn Care Res 2006; 27:713-718.

Sheridan RL, Weber JM, Peterson HF, Tompkins RG. Central venous catheter sepsis with weekly catheter change in pediatric burn patients: An analysis of 221 catheters. Burns 1995; 21:127-129.

Eyer S, Brummitt C, Crossley K, Siegel R, Cerra F. Catheter-related sepsis: Prospective, randomized study of three methods of long-term catheter maintenance. Crit Care Med 1990; 18:1073-1079.

Austin RE1, Shahrokhi S, Bolourani S, Jeschke MG. Peripherally inserted central venous catheter safety in burn care: a single-center retrospective cohort review. J Burn Care Res 2015; 36:111-117.

Friedman BC1, Mian MA, Mullins RF, Hassan Z, Shaver JR, Johnston KK. Five-lumen antibiotic-impregnated femoral central venous catheters in severely burned patients: an investigation of device utility and catheter-related bloodstream infection rates. J Burn Care Res 2015;36:493-499.

Tymonová J1, Adámková M, Torsová V, Kadlcík M, Jackanin J, Crkvenjas Z. Catheter-related infections in burn patients at the burn centre of the university hospital in Ostrava. Acta Chir Plast 2008;50:23-26.

King B, Schulman CI, Pepe A, Pappas P, Varas R, Namias N. Timing of central venous catheter exchange and frequency of bacteremia in burn patients. J Burn Care Res 2007;28:859-860.

Deshpande KS, Hatem C, Ulrich HL, Currie BP, Aldrich TK, Bryan-Brown CW, et al. The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population. Crit Care Med 2005; 33:13-20.

Goetz A, Wagener M, Miller J, Muder R. Risk of infection due to central venous catheters: Effect of site of placement and catheter type. Infect Control Hosp Epidemiol 1998; 19:842-845.

Durbec O, Viviand X, Potie F, Vialet R, Albanese J, Martin C, et al. A prospective evaluation of the use of femoral venous catheters in critically ill adults. Crit Care Med 1997; 25:1986-1989.

Purdue G, Hunt J. Vascular access through the femoral vessels: indications and complications. J Burn Care Rehabil 1986; 7:498-500.

Kealey GP, Chang P, Heinle J, Rosenquist MD, Lewis RW 2nd. Prospective comparison of two management strategies of central venous catheters in burn patients. J Trauma 1995; 38:334-349.

Ramos GE, Bolgiani AN, Patino O, Prezzavento GE, Guastavino P, Durlach R, et al. Catheter infection risk related to the distance between insertion site and burned area. J Burn Care Rehabil 2002;23:266-271.

Weber JM, Sheridan RL, Pasternack MS, Tompkins RG. Nosocomial infections in pediatric patients with burns. Am J Infect Control 1997; 25:195-201.

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IssueVol 9 No 5 (2017) QRcode
SectionOriginal Article(s)
Keywords
Central Vein Catheter Infection Burn wound

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How to Cite
1.
Roham M, Momeni M, Saberi M, Kheirkhah R, Jafarian A, Rahbar H. Epidemiologic analysis of central vein catheter infection in burn patients. Iran J Microbiol. 2017;9(5):271-276.