1. Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019
- Author
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Badia-Cebada, Laia, Peñafiel, Judit, Saliba, Patrick, Andrés, Marta, Càmara, Jordi, Domènech, Dolors, Jiménez-Martínez, Emili, Marrón, Anna, Moreno, Encarna, Pomar, Virginia, Vaqué, Montserrat, Limón, Enric, Masats, Úrsula, Pujol, Miquel, Gasch Blasi, Oriol, Jover, Alfredo, Castellana, Dolors, Olona, Montserrat, García Pino, Antonia, Rebull Fatsini, Josep, Domènech, Mª France, Hornero, Ana, Ardanuy Tisaire, Carmen, Berbel Palau, Dàmaris, López-Contreras, Joaquín, Fernández, Engracia, Salgado, Xavier, Lérida, Ana, Martin, Lydia, Sopena, Nieves, Casas Garcia, Irma, Pérez, Rafael, Maraver, Encarna, Palau, Eva, Serrats, Pepi, Martínez, José Antonio, Santana, Gemina, Martínez, Ana, Ferrer, Lourdes, Moreno, Mª José, Calbo, Esther, Porta, Carolina, Smithson, Alex, de la Roca Toda, Maria, Aliu, Teresa, Camps, Susana, Ortega, Montserrat, Diaz-Brito, Vicens, Agusti, Carme, Perea Garcia, Miquel, Grau Palafox, Laura, Carrera, Raquel, Besolí, Anna, Horcajada, Juan Pablo, Gonzalez, Cristina, Cuquet, Jordi, Maldonado López, Demelsa Maria, Benítez, Rosa, Duch, Mireia, Blancas, David, Moreno, Esther, Villalba, Naiara, Martínez, Sara, García Flores, Àngels, Ferrer, Roser, Bisbe, Josep, Blascó, Montse, Castro Salom, Antoni, López, Ana Felisa, Espinach Alvarós, Joan, Perez, Àngels, Castander, David, Calaf, Elisabet, Clarós, Mercè, Bosch Ros, Núria, Montardit, Irene, Porta, Roser, De la Cruz Sol, Pilar, Coll Colell, Mª Rosa, García Penche Sanches, Rosa, Tricas, Josep Maria, Redon, Eva, Brugués, Montse, Linares, Laura, Cusco, Maria, Barrufet, Mª Pilar, Vidal, Elena, Barbadillo, Sandra, Marimón, Mariló, Meije, Yolanda, Laplace Enguinados, M.Rosa, Vila, Blanca, Coloma, Ana Guadalupe, López, Lucrecia, Campins Martí, Magda, Almirante Gragera, Benito, Ferrer, Carme, Juan Serra, Natalia, Farguell Carrera, Josep, Garcia Flores, Àngels, Milian Sanz, Marta, Moise, Alexandra, Jiménez Zarate, Ana Mª, Eito Navasal, M. Carmen, Garcia Ramirez, María Gracia, Armario Fernández, Mar, Universitat Autònoma de Barcelona, [Badia-Cebada L] Internal Medicine Department, Hospital Universitari Parc Taulí, Sabadell, Spain. School of Medicine, Universitat Autònoma de Barcelona, Sabadell, Spain. [Peñafiel J] Unit of Statistics, Hospital Universitari de Bellvitge/Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain. [Saliba P] VINCat programme: Infection Control Catalan Programme, Barcelona, Spain. [Andrés M] Infectious Diseases Unit, Departament de Medicina Interna, Hospital de Terrassa, Consorci Sanitari de Terrassa, Spain. [Càmara J] Department of Microbiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain. CIBER de Malalties Respiratòries (CIBERes), ISCIII, Madrid, Spain. [Domenech D] Infermera de control d'infeccions, Hospital Josep Trueta, Girona, Spain, and Consorci Sanitari de Terrassa
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Health Occupations::Medicine::Public Health::Epidemiology [DISCIPLINES AND OCCUPATIONS] ,Male ,Catheterization, Central Venous ,Catheters ,Epidemiology ,profesiones sanitarias::medicina::salud pública::epidemiología [DISCIPLINAS Y OCUPACIONES] ,Bacteremia ,Infections ,Cohort Studies ,Virology ,Sepsis ,Humans ,Prospective Studies ,Espanya ,Epidemiologia ,Polyvinyl Chloride ,Incidence ,infecciones bacterianas y micosis::infección [ENFERMEDADES] ,Public Health, Environmental and Occupational Health ,Fluids and Secretions::Body Fluids::Blood [ANATOMY] ,Catèters ,Middle Aged ,Infeccions ,Bacterial Infections and Mycoses::Infection [DISEASES] ,Spain ,Catheter-Related Infections ,Infecció ,líquidos y secreciones::líquidos corporales::sangre [ANATOMÍA] ,Female - Abstract
Background Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat). Methods A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007–2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000 patient days. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000 patient days and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate: 0.20 episodes/1,000 patient days). Patients’ median age was 64.1 years; 36.6% (3,403/9,290) were female. In total, 73.7% (n = 6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n = 5,822) were related to central venous catheter (CVC), 24.1% (n = 2,236) to peripheral venous catheters (PVC) and 13.3% (n = 1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR: 0.94; 95%CI: 0.93–0.96), especially in the ICU (IRR: 0.88; 95%CI: 0.87–0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR: 0.88; 95%CI: 0.87–0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC: 1.08; 95%CI: 1.05–1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards.
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- 2022