Risk factors for recurrent catheter-related infections after catheter-related bloodstream infections

摘要

Objectives: This study was performed to identify the risk factors for recurrent catheter-related infections (CRIs) following non-tunneled central venous catheter (CVC) reinsertion after catheter-related bloodstream infections (CRBSIs). Methods: A retrospective cohort was constructed from a computer database for patients who underwent reinsertion of a non-tunneled CVC after a CRBSI during the period January 2004 to December 2007. Among these patients, recurrent CRI cases were selected through an electronic chart review, and the risk factors for recurrent CRI were investigated. Results: Fifty-three patients who had had a reinserted non-tunneled CVC after a CRBSI were analyzed and 22 patients were considered as having recurrent CRIs (41.5%). Recurrent/persistent CRBSI after catheter reinsertion was observed in 16 patients, and six patients with systemic inflammatory response syndrome revealed positive results of an identical organism with the initial CRBSI in semi-quantitative reinsertion-catheter tip cultures. In multivariate analysis, fungal CRBSI compared with bacterial infection (adjusted hazard ratio (HR) 7.77, 95% confidence interval (CI) 1.71-35.36) and CRBSI occurrence during intensive care unit (ICU) care (adjusted HR 5.20, 95% CI 1.41-19.18) were revealed as independent risk factors for recurrent CRIs after catheter reinsertion on account of CRBSIs. Conclusions: A substantial proportion of the patients with CRBSIs revealed recurrent CRIs after catheter reinsertion. Fungal CRBSIs when compared with bacterial infections and CRBSI occurrence during ICU care were independent risk factors for recurrent CRIs following catheter reinsertion after a CRBSI.