Comparison of hospital- and community-onset central line associated bloodstream infections
2024
Tuğba Yanık Yalçın | Ali Can | Alperen Sümer | Ahmet Habib Mert Satıcı | Ece Ceylan | Mehmet Cüneyt Narin | Ege Can Cılız | Nurefşan Tuba Kurt
BACKGROUND-AIM: Central venous catheters are one of the frequently used interventions in recent years. The aim of this study was to compare community-and hospital-onset central line associated bloodstream infections (CLA-BSI). METHODS: The study design is retrospective observational, and patients were diagnosed with CLA-BSI at Başkent University Ankara Hospital between January 1 and December 31, 2023 were included. RESULTS: Data of 1711 patients with catheter culture growth were reviewed. One hundred thirty-nine CLA-BSI developing in 127 patients were included in the study. Fifty percent of the patients were female, the mean age was 61.4±17.1 years. Fifty-eight percent of the CLA-BSI were reported as hospital-onset. The distribution of catheter types was 56.8% subclavian, 25.2% port and 18% jugular. Fever was significantly higher in community-onset CLA-BSI (41.4% vs. 24.7%, respectively, p=0.03). Coagulase-negative staphylococci were the most common cause of CLA-BSI (34.5%), followed by gram-negative bacilli (32.4%) and fungi (11.5%) (Table1). Fungal pathogens were only detected in hospital-onset CLA-BSI group.Thirty-day mortality was 25.2% for the whole group, 29.6% for hospital-onset CLA-BSI and 19% for community-onset CLA-BSI (p=0.15). CONCLUSIONS: The mortality rate for CLA-BSIs is quite high. Gram-negative bacteria also account for a sizable portion of CLA-BSI cases, even though gram-positive bacteria are still the more frequent cause. Fungal factors were only detected in hospital-onset CLA-BSI. For these reasons, it is very important to adhere to infection control measures when handling and maintaining catheters.
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