Central line-associated blood stream infections: characteristics and risk factors for mortality over a 5.5-year period

Abstract

Background/aim: Central line-associated bloodstream infections (CLABSIs) are associated with substantial morbidity and mortality and the infection rates vary in a wide range (high: 62.5%; low: 20%) in developing countries. We aimed to investigate the characteristics and the risk factors for mortality in patients with CLABSIs in intensive care units (ICUs) and provide the relevant data. Materials and methods: The electronic medical records database and file records obtained through active surveillance by an infection control committee of a hospital were screened to identify patients with CLABSIs hospitalized from January 2008 through July 2013. Results: A total of 166 CLABSI episodes in 158 patients out of 17,553 on 38,562 catheter and 94,512 hospitalization days were evaluated. The infection developed in catheterized patients at a median of 14 days (range 2-88), and the highest infection rate with 13.4% (n = 20) was the femoral region among the places where the catheter was inserted. Of the patients catheterized, 54.4% survived whereas 45.6% died. In patients having Candida infection, the mortality was significantly higher. High APACHE II scores and Candida infections were found to be significant risk factors associated with mortality. Conclusion: APACHE II scores and bloodstream infection with Candida species were the most powerful predictors of mortality. In ICU practice, health-care givers must consider the emerging role of Candida for both invasiveness and mortality.