Decreased Mortality among Patients with Catheter-Related Bloodstream Infections at Catalan Hospitals (2010-2019)

Identificador:  imarina:9262337

Handle: https://hdl.handle.net/20.500.11797/imarina9262337

Autors:  Badia-Cebada, L; Peñafiel, J; López-Contreras, J; Pomar,; Martínez, JA; Santana, G; Cuquet, J; Montero, MM; Hidalgo-López, C; Andrés, M; Gimenez, M; Quesada, MD; Vaqué, M; Iftimie, S; Gudiol, C; Pérez, R; Coloma, A; Marron, A; Barrufet, P; Marimon, M; Lérida, A; Clarós, M; Ramírez-Hidalgo, MF; Pardo, GG; Martinez, MJ; Chamarro, EL; Jiménez-Martínez, E; Hornero, A; Limón, E; López, M; Calbo, E; Pujol, M; Gasch, O

Resum:
The incidence of catheter-related bloodstream infections (CRBSI) has fallen over the last decade, especially in intensive care units (ICUs).To assess the existence of concomitant trends in outcomes and to analyse the current risk factors for mortality.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.Over the study period, 4,795 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 (HR 0.95 [0.92-0.98]). The multivariate analysis identified age (HR 1.03 [1.02-1.04]), femoral catheter (HR 1.78 [1.33-2.38]), medical ward acquisition (HR 2.07 [1.62-2.65] and ICU acquisition (HR 3.45 [2.7-4.41]), S. aureus (HR 1.59 [1.27-1.99]) and Candida sp. (HR 2.19 [1.64-2.94]) as risk factors for mortality while the mortality rate associated with episodes originating in peripheral catheters was significantly lower (HR 0.69 [0.54-0.88]).Mortality associated with CRBSI has fallen in recent years but remains high. Intervention programs should focus especially on ICUs and medical wards, where incidence and mortality rates are highest.Copyright © 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.