Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China

Abstract Background China has not yet established a national surveillance network such as NHSN from America, so there is still no large-scale investigations on central line-associated bloodstream infection (CLABSI) incidence. Several retrospective studies in China reported that the incidence of CLAB...

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Autores principales:	Cui Zeng, Anhua Wu, Liuyi Li, Huixue Jia
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Central venous catheter Central line associated blood stream infection Intensive care unit Surveillance Epidemiology Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/e4bb2637f27948d98334989a67c608e7
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spelling	oai:doaj.org-article:e4bb2637f27948d98334989a67c608e72021-12-05T12:26:09ZMulti-center prospective study on central line-associated bloodstream infections in 79 ICUs of China10.1186/s12879-021-06871-51471-2334https://doaj.org/article/e4bb2637f27948d98334989a67c608e72021-12-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06871-5https://doaj.org/toc/1471-2334Abstract Background China has not yet established a national surveillance network such as NHSN from America, so there is still no large-scale investigations on central line-associated bloodstream infection (CLABSI) incidence. Several retrospective studies in China reported that the incidence of CLABSI varied due to inconsistent diagnostic criteria. We performed a nationwide survey to investigate the utilization rate of central venous catheters (CVCs) and the incidence of CLABSI in ICUs of different areas of China. Methods This is a prospective multi-center study. Patients admitted to ICUs with the use of CVCs between January 1, 2014 and December 31, 2018 were enrolled in this study. Hospitals were given the definition of catheter-related bloodstream infection as: a laboratory-confirmed bloodstream infection where CVC was in place on the date of event or the day before. The characteristics of patients, information of catheterization, implementation rates of precautions, and CLABSIs were collected. The statistical analysis was performed by SPSS 25.0 software and website of Open Source Epidemiologic Statistics for Public Health. Results A total of 38,212 patients and 466,585 catheter days were involved in surveillance. The average CLABSI incidence in a thousand catheter days was 1.50, the lowest incidence unit was in pediatric ICU (0/1000 catheter days), and the lowest incidence area was in Northeast China (0.77/1000 catheter days), while the highest incidence unit was in cardiac ICU (2.48/1000 catheter days) and the highest incidence area was in Eastern China (1.62/1000 catheter days). The average utilization rate of CVC was 42.85%, the lowest utilization rate was in pediatric ICU (5.85%) and in Central China (38.05%), while the highest utilization rate was in surgical ICU (64.92%) and in Western China (51.57%). Among the 702 CLABSI cases reported, a total of 735 strains of pathogens were cultured. Staphylococcus spp. was the most common organism isolated (27.07%), followed by Enterobacteriaceae (22.31%). The implementation rates of all precautions showed an upward trend during the study period (P ≤ 0.001). Conclusion The average incidence of CLABSI in ICUs in China is 1.5/1000 catheter days, similar to the rates reported in developed countries but lower than previous reports in China. CLABSI incidence showed regional differences in China. It is necessary to implement targeted surveillance of CLABSI cases by using standardized CLABSI surveillance definitions and methodologies.Cui ZengAnhua WuLiuyi LiHuixue JiaBMCarticleCentral venous catheterCentral line associated blood stream infectionIntensive care unitSurveillanceEpidemiologyInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Central venous catheter Central line associated blood stream infection Intensive care unit Surveillance Epidemiology Infectious and parasitic diseases RC109-216
spellingShingle	Central venous catheter Central line associated blood stream infection Intensive care unit Surveillance Epidemiology Infectious and parasitic diseases RC109-216 Cui Zeng Anhua Wu Liuyi Li Huixue Jia Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China
description	Abstract Background China has not yet established a national surveillance network such as NHSN from America, so there is still no large-scale investigations on central line-associated bloodstream infection (CLABSI) incidence. Several retrospective studies in China reported that the incidence of CLABSI varied due to inconsistent diagnostic criteria. We performed a nationwide survey to investigate the utilization rate of central venous catheters (CVCs) and the incidence of CLABSI in ICUs of different areas of China. Methods This is a prospective multi-center study. Patients admitted to ICUs with the use of CVCs between January 1, 2014 and December 31, 2018 were enrolled in this study. Hospitals were given the definition of catheter-related bloodstream infection as: a laboratory-confirmed bloodstream infection where CVC was in place on the date of event or the day before. The characteristics of patients, information of catheterization, implementation rates of precautions, and CLABSIs were collected. The statistical analysis was performed by SPSS 25.0 software and website of Open Source Epidemiologic Statistics for Public Health. Results A total of 38,212 patients and 466,585 catheter days were involved in surveillance. The average CLABSI incidence in a thousand catheter days was 1.50, the lowest incidence unit was in pediatric ICU (0/1000 catheter days), and the lowest incidence area was in Northeast China (0.77/1000 catheter days), while the highest incidence unit was in cardiac ICU (2.48/1000 catheter days) and the highest incidence area was in Eastern China (1.62/1000 catheter days). The average utilization rate of CVC was 42.85%, the lowest utilization rate was in pediatric ICU (5.85%) and in Central China (38.05%), while the highest utilization rate was in surgical ICU (64.92%) and in Western China (51.57%). Among the 702 CLABSI cases reported, a total of 735 strains of pathogens were cultured. Staphylococcus spp. was the most common organism isolated (27.07%), followed by Enterobacteriaceae (22.31%). The implementation rates of all precautions showed an upward trend during the study period (P ≤ 0.001). Conclusion The average incidence of CLABSI in ICUs in China is 1.5/1000 catheter days, similar to the rates reported in developed countries but lower than previous reports in China. CLABSI incidence showed regional differences in China. It is necessary to implement targeted surveillance of CLABSI cases by using standardized CLABSI surveillance definitions and methodologies.
format	article
author	Cui Zeng Anhua Wu Liuyi Li Huixue Jia
author_facet	Cui Zeng Anhua Wu Liuyi Li Huixue Jia
author_sort	Cui Zeng
title	Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China
title_short	Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China
title_full	Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China
title_fullStr	Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China
title_full_unstemmed	Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China
title_sort	multi-center prospective study on central line-associated bloodstream infections in 79 icus of china
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e4bb2637f27948d98334989a67c608e7
work_keys_str_mv	AT cuizeng multicenterprospectivestudyoncentrallineassociatedbloodstreaminfectionsin79icusofchina AT anhuawu multicenterprospectivestudyoncentrallineassociatedbloodstreaminfectionsin79icusofchina AT liuyili multicenterprospectivestudyoncentrallineassociatedbloodstreaminfectionsin79icusofchina AT huixuejia multicenterprospectivestudyoncentrallineassociatedbloodstreaminfectionsin79icusofchina
_version_	1718371931371077632

Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China

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