Get access

Catheter-related bloodstream infections in intensive care units: a systematic review with meta-analysis

Authors

  • Prabha Ramritu,

    1. Prabha Ramritu MN RN Project Officer The Centre for Healthcare Related Infection Surveillance & Prevention, Princess Alexandra Hospital, Brisbane, Qld, Australia
    Search for more papers by this author
  • Kate Halton,

    1. Kate Halton MSc Project Officer The Centre for Healthcare Related Infection Surveillance & Prevention, Princess Alexandra Hospital, Brisbane, Qld, Australia Institute of Biomedical and Health Innovation, Brisbane, Qld, Australia
    Search for more papers by this author
  • David Cook,

    1. David Cook MBBS PhD Medical Officer Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Qld, Australia
    Search for more papers by this author
  • Michael Whitby,

    1. Michael Whitby FRACP MPH Director of Infectious Diseases The Centre for Healthcare Related Infection Surveillance & Prevention, Princess Alexandra Hospital, Brisbane, Qld, Australia
    Search for more papers by this author
  • Nicholas Graves

    1. Nicholas Graves PhD Senior Research Fellow in Health Economics The Centre for Healthcare Related Infection Surveillance & Prevention, Princess Alexandra Hospital, Brisbane, Qld, Australia
      Institute of Biomedical and Health Innovation, Brisbane, Qld, Australia
    Search for more papers by this author

N. Graves: e-mail: n.graves@qut.edu.au

Abstract

Title. Catheter-related bloodstream infections in intensive care units: a systematic review with meta-analysis

Aim.  This paper is a report of a systematic review and meta-analysis of strategies, other than antimicrobial coated catheters, hypothesized to reduce risk of catheter-related bloodstream infections and catheter colonization in the intensive care unit setting.

Background.  Catheter-related bloodstream infections occur at a rate of 5 per 1000 catheter days in the intensive care unit setting and cause substantial mortality and excess cost. Reducing risk of catheter-related bloodstream infections among intensive care unit patients will save costs, reduce length of stay, and improve outcomes.

Methods.  A systematic review of studies published between January 1985 and February 2007 was carried out using the keywords ‘catheterization – central venous’ with combinations of infection*, prevention* and bloodstream*. All included studies were screened by two reviewers, a validated data extraction instrument was used and data collection was completed by two blinded independent reviewers. Risk ratios for catheter-related bloodstream infections and catheter colonization were estimated with 95% confidence intervals for each study. Results from studies of similar interventions were pooled using meta-analyses.

Results.  Twenty-three studies were included in the review. The strategies that reduced catheter colonization included insertion of central venous catheters in the subclavian vein rather than other sites, use of alternate skin disinfection solutions before catheter insertion and use of Vitacuff in combination with polymyxin, neomycin and bacitracin ointment. Strategies to reduce catheter-related bloodstream infection included staff education multifaceted infection control programmes and performance feedback.

Conclusion.  A range of interventions may reduce risks of catheter-related bloodstream infection, in addition to antimicrobial catheters.

Get access to the full text of this article

Ancillary