Central line-associated bloodstream infection: is the hospital epidemiology of methicillin-resistant Staphylococcus aureus relevant?

Abstract We aimed to evaluate the risk factors, including the hospital epidemiology of methicillin-resistant Staphylococcus aureus (MRSA), for central venous line-associated and laboratory-confirmed bloodstream infections (CLA-BSI and LC-BSI, respectively). The risk factors examined included the age...

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Bibliographic Details
Published in:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2010-02, Vol.16 (1), p.33-37
Main Authors: Yoshida, Junichi, Ishimaru, Toshiyuki, Kikuchi, Tetsuya, Matsubara, Nobuo, Ueno, Takako, Hirata, Noriko, Koyanagi, Nobuhiro
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia - epidemiology
Bacteremia - microbiology
Bloodstream infection
Catheterization, Central Venous - adverse effects
Central venous catheter
Child
Child, Preschool
Cross Infection - epidemiology
Cross Infection - microbiology
Epidemiology
Female
Hematology, Oncology and Palliative Medicine
Humans
Infant
Infant, Newborn
Infectious Diseases
Male
Medical Microbiology
Medicine
Medicine & Public Health
Methicillin-Resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus (MRSA)
Middle Aged
Original Article
Risk Factors
Staphylococcal Infections - epidemiology
Staphylococcal Infections - microbiology
Staphylococcus aureus
Virology
Young Adult
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Summary:Abstract We aimed to evaluate the risk factors, including the hospital epidemiology of methicillin-resistant Staphylococcus aureus (MRSA), for central venous line-associated and laboratory-confirmed bloodstream infections (CLA-BSI and LC-BSI, respectively). The risk factors examined included the age and sex of patients, whether or not they were in the surgery service, the number of days of central line (CL) placement, the monthly number of inpatients and those positive for MRSA, and whether the standard or maximal barrier precautions were observed at CL insertion. As the outcome factors, we selected CLA-BSI and LC-BSI, while precluding repeated isolation within 28 days. Of a total of 22 723 device days in 927 patients with CL placement, we observed 81 CLA-BSIs and 40 LC-BSIs, rates of 3.56 and 1.76 (/1000 device-days), respectively. Logistic regression analysis revealed a single significant factor, CL placement of more than 30 days, with odds ratios of 3.038 [95% confidence interval (CI) 1.733–5.326; P < 0.001] for CLA-BSI and 3.227 (95% CI 1.427–7.299; P = 0.005) for LC-BSI. Both BSIs included MRSA in seven events without temporal clusters. We conclude that the factor of long CL placement outweighs other risk factors, including the hospital epidemiology of MRSA.
ISSN:1341-321X
1437-7780
DOI:10.1007/s10156-009-0018-Z