Hostname: page-component-5c6d5d7d68-lvtdw Total loading time: 0 Render date: 2024-08-15T04:27:30.848Z Has data issue: false hasContentIssue false
  • English
  • Français

Cross-Sectional Epidemiology of Phlebitis and Catheter-Related Infections

Published online by Cambridge University Press:  21 June 2016

Javier Ena ,
Emilia Cercenado ,
David Martinez  and
Emilio Bouza
Javier Ena
Affiliation:
Internal Medicine, Hospital Gregorio Maranon, Madrid, Spain
Emilia Cercenado
Affiliation:
Clinical Microbiology Services, Hospital Gregorio Maranon, Madrid, Spain
David Martinez
Affiliation:
Clinical Microbiology Services, Hospital Gregorio Maranon, Madrid, Spain
Emilio Bouza*
Affiliation:
Clinical Microbiology Services, Hospital Gregorio Maranon, Madrid, Spain
*
Servicio de Microbiologia Clinica, Hospital Gregorio Maranon, Dr Esquerdo 46, 28007 Madrid, Spain
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To describe the characteristics and the problems arising from the use of vascular catheterization in a general hospital and to identify avoidable risk factors associated with catheter-related infections.

Design:

Cross-sectional, including the entire hospitalized population.

Setting:

A university-affiliated hospital.

Results:

Three-hundred fifty-three intravascular catheters were implanted in 315 of a total of 1,838 hospitalized patients (17.1%, confidence interval [CI] = 15.7-18.5). Of the 353 intravascular catheters, 26 (7.3%) were intraarterial, 273 (77.3%) were peripheral, and 54 (15.3%) were central. The median (range) duration of the catheterization was 3 (1-1 1) days for arterial catheters, 1 (1-24) for peripheral catheters, and 5 (1- 130) for central catheters. Fifty-three (15%, CI = 11.5-19.5) showed signs of infection. Independent risk factors associated with infection were the presence of infection located elsewhere (odds ratio [OR]=8.7, CI=4.13-18.3, p<.0001), inappropriate catheter care (OR= 5.3, CI = 2.5-11.2, p<.0001), inappropriate length of catheter use (OR= 3.5, CI = 1.4-9.02, p<.01), and duration of hospitalization exceeding 14 days (OR=2.6, CI=O.9-7.83,p=.07).

Conclusion:

The risk factors associated with catheter-related infections suggest that many are preventable by improved protocols for management. This hypothesis can easily be tested.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 1 , January 1992 , pp. 15 - 20
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Stamm, WE. Infections related with medical devices. Ann Intern Med. 1978;89:764–769.CrossRefGoogle ScholarPubMed
2. Maki, DG, Goldmann, DA, Rbame, FS. Infection control in intravenous therapy. Ann Intern Med. 1973;79:867–887.CrossRefGoogle ScholarPubMed
3. McCabe, WR, Jackson, GG. Gram-negative bacteremia I. Etiology and ecology. Arch Intern Med. 1962;110:847–855.CrossRefGoogle Scholar
4. Outline for Surveillance and Control of Nosocomial Infections. Atlanta, Ga: Centers for Disease Control; 1970.Google Scholar
5. Simmons, BI? Guidelines for Prevention of Intravascular Inections. Atlanta, Ga: Centers for Disease Control; 1981.Google Scholar
6. Campos-Filho, N, Franco, EL. A microcomputer program for multiple logistic regression by unconditional and conditional maximum likelihood methods. Am J Epidemiol. 1989;129:439–444.CrossRefGoogle ScholarPubMed
7. Bouza, E, Cosin, J, Grupo Cooperativo para el Estudio de la Infeccion. Estudio de prevalencia de infection hospitalaria y consumo de antimicrobianos. Med Clin (Barc). 1986;87:353–358.Google Scholar
8. Grupo de Trabajo EPINCAT. Prevalencia de las infecciones nosocomiales en Cataluna. (I) Infecciones y factores de riesgo. Med Clin (Barc). 1990;95:41–52.Google Scholar
9. Wilkins, EGL, Manning, D, Roberts, C, Davidson, DC. Quantitative bacteriology of peripheral venous cannulae in neonates. J Hosp Infect. 1985;6:209–217.CrossRefGoogle ScholarPubMed
10. Gantz, NM, Presswood, GW, Goldberg, R, Doern, G. Effects of dressing type and change internal on intravenous therapy complications rates. Diagn Microbiol Infect Dis. 1984;2:325–332.CrossRefGoogle Scholar
11. Vaque, J, Rosello, J, Campins, M et al. Prevalencia de infecciones en un hospital quirurgico de tercer nivel (I). Infecciones y factores de riesgo. Med Clin (Barc). 1990;95:41–52.Google Scholar
12. Singh, S, Nelson, N, Acosta, I, Cheek, FE, Puri, VK. Catheter colonization and bacteremia with pulmonary and arterial catheters. Crit Care Med. 1982;10:736–739.CrossRefGoogle ScholarPubMed
13. Russell, JA, Joel, M, Hudson, RJ, Mangano, DT: Schlobhom, RM. Prospective evaluation of radial and femoral artery catheterization sites in critically ill adults. Crit Care Med. 1983; 11:936–939.CrossRefGoogle ScholarPubMed
14. Prager, RL, Silva, J Jr. Colonization of central venous catheters. South Med J 1984;77:458–461.CrossRefGoogle ScholarPubMed
15. Tully, JL, Friendland, GH, Baldini, MA, Goldmann, DA Complications of intravenous therapy with needles and Teflon catheters. Am J Med. 1981;70:702–706.CrossRefGoogle ScholarPubMed
16. Band, JD, Maki, DG. Steel needles used for intravenous therapy. Morbidity in patients with haematologic malignancy. Arch Intern Med. 1980;140:31–34.CrossRefGoogle Scholar
17. Curelaru, I, Bylock, A, Gustavson, E et al. Dynamics of thrombophlebitis in central venous catheterization via basilic and cephalic veins. Acta Chir Scand. 1984;150:285–293.Google ScholarPubMed
18. Ponce de Leon, S, Wenzel, RP. Hospital-acquired infections with Staphylococcus epidermidis . Am J Med. 1984;79:639–644.CrossRefGoogle Scholar
19. Bentley, DE, Lepper, MH. Septicemia related to indwelling venous catheters. JAMA. 1968:206:1749–1752.CrossRefGoogle Scholar
20. Garland, JS, Nelson, DB, Cheah, T, Hennes, HH, Johnanson, TM. Infectious complications during peripheral intravenous therapy with Teflon catheters: a prospective study. Pediatr Infect Dis J. 1987;6:918–921.CrossRefGoogle ScholarPubMed
21. Tomford, JW, Hersey, CO, Maclaren, CE, Porter, DK, Cohen, DI. Intravenous therapy team and peripheral venous catheter associated complications: a prospective controlled study. Arch Intern Med. 1984;144:1191–1194.CrossRefGoogle ScholarPubMed
22. Maki, DC, Weise, CE, Sarafin, HW. A semiquantitative culture method for identifying intravenous catheter-related-infection. N Engl J Med. 1977;296:1305–1309.CrossRefGoogle ScholarPubMed
23. Cleri, DJ, Corrado, ML, Seligman, SJ. Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis. 1980;141:781–786.CrossRefGoogle ScholarPubMed
24. Collins, RN, Braun, PA, Zinner, SH, et al. Risk of local and systemic infection with polyethylene intravenous catheters. N Engl J Med. 1968;279:340–343.CrossRefGoogle ScholarPubMed
25. Norden, C. Application of antibiotic ointment to the, site of intravenous catheterization-a controlled trial. J Infect Dis. 1969;120:611–615.CrossRefGoogle Scholar
26. Zinner, SH, Denny-Brown, BC, Braun, P, et al. Risk of infection with intravenous indwelling catheters: effects of application of antibiotic ointment. J Infect Dis. 1969;120:616–619.CrossRefGoogle ScholarPubMed
27. Maki, DG, Ringer, M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. Ann Intern Med. 1991;114:845–854.CrossRefGoogle ScholarPubMed
28. Corso, JA, Agostinelli, R, Brandriss, MW. Maintenance of venous polyethylene catheters to reduce risk of infection. JAMA. 1969;210:2075–2077.CrossRefGoogle ScholarPubMed
29. Fuchs, PC. Indwelling intravenous polyethylene catheters. JAMA. 1971;216:1447–1450.CrossRefGoogle ScholarPubMed
30. Collin, J, Collin, C, Constable, FL, Johnston, IDA. Infusion thrombophlebitis and infection with various cannulas. Lancet. 1975;ii:150–153.CrossRefGoogle Scholar
31. Nelson, DB, Garland, JS. The natural history of Teflon-associated phlebitis in children. Am J Dis Child. 1987;141:1090–1092.CrossRefGoogle ScholarPubMed
32. Tager, IB, Ginsberg, MB, Ellis, SE et al. An epidemiologic study of the risks associated with peripheral intravenous catheters. Am J Epidemiol. 1983;118:839–851.Google ScholarPubMed