Catheter-related blood stream infections: prevalence, risk factors and antimicrobial resistance pattern

Priyanka Pandit; A K Sahni; Naveen Grover; Vaibhav Dudhat; N K Das; A K Biswas

doi:10.1016/j.mjafi.2019.07.002

Catheter-related blood stream infections: prevalence, risk factors and antimicrobial resistance pattern

Med J Armed Forces India. 2021 Jan;77(1):38-45. doi: 10.1016/j.mjafi.2019.07.002. Epub 2019 Oct 15.

Authors

Priyanka Pandit¹, A K Sahni², Naveen Grover³, Vaibhav Dudhat⁴, N K Das⁵, A K Biswas⁶

Affiliations

¹ Assistant Professor (Microbiology), Command Hospital (Southern Command), Pune 411040, India.
² Brig Med, HQ 15 Corps, C/o 56 APO, India.
³ Col Med, 3 Inf Div, C/o 56 APO, India.
⁴ Junior Consultant (Microbiology), Sahyadri Speciality Hospital, Pune, India.
⁵ Assistant Professor (Microbiology), Dr. DY Patil Medical College, Pune, India.
⁶ Assistant Professor, Department of Transfusion Medicine, Armed Forces Medical College, Pune 411040, India.

Abstract

Background: Intravascular devices have significant potential for producing iatrogenic diseases resulting in catheter-related blood stream infections (CRBSIs). A study was undertaken to find the prevalence of CRBSI among patients in acute wards and to analyze the associated risk factors, causative pathogens with their antibiotic susceptibility (ABST) patterns.

Methods: Randomly ten days per month were chosen, for a period of two years. All the acute wards patients who were on indwelling blood catheters were identified. Those fulfilling the CRBSI criteria were further worked up for confirmation of diagnosis by differential time to positivity. The catheter tip was cultured by Maki's semiquantitative method. ABST of the isolates obtained was performed by Kirby-Bauer disk diffusion method.

Results: The prevalence of CRBSI was found to be 39.25% with the most common organism isolate being Serratia marcescens (23.81%). The immunocompromised status of the patients and catheterisation time were significant risk factors. Methicillin resistance was found to be 33.33% in coagulase-negative staphylococci. The resistance to vancomycin among the Entercoccus faecium isolates was found to be 33.33%. Among the gram negatives, resistance to aminoglycosides, fluoroquinolones and third-generation cephalosporins was high.

Conclusion: The study highlights the importance of regular surveillance programs, an efficient infection control program, strict adherence to antiseptic measures and use of a rational antibiotic policy for the early diagnosis and better management of CRBSI.

Keywords: Antibiotic susceptibility pattern; Catheter related blood stream infections; Central venous catheter; Nosocomial infections; Peripherally inserted central catheter.