• Michael Climo, Dan Diekema, David K Warren, Loreen A Herwaldt, Trish M Perl, Lance Peterson, Theresa Plaskett, Connie Price, Kent Sepkowitz, Steve Solomon, Jerry Tokars, Victoria J Fraser, and Edward Wong.
• Hunter Holmes McGuire Veteran Affairs Medical Center, Richmond, Virginia 23249, USA.
• Infect Control Hosp Epidemiol. 2003 Dec 1;24(12):942-5.

ObjectiveTo determine the prevalence of central venous catheter (CVC) use among patients both within and outside the ICU setting.DesignA 1-day prevalence survey of CVC use among adult inpatients at six medical centers participating in the Prevention Epicenter Program of the CDC. Using a standardized form, observers at each Epicenter performed a hospital-wide survey, collecting data on CVC use.SettingInpatient wards and ICUs of six large urban teaching hospitals.ResultsAt the six medical centers, 2,459 patients were surveyed; 29% had CVCs. Among the hospitals, from 43% to 80% (mean, 59.3%) of ICU patients and from 7% to 39% (mean, 23.7%) of non-ICU patients had CVCs. Despite the lower rate of CVC use on non-ICU wards, the actual number of CVCs outside the ICUs exceeded that of the ICUs. Most catheters were inserted in the subclavian (55%) or jugular (22%) site, with femoral (6%) and peripheral (15%) sites less commonly used. The jugular (33.0% vs 16.6%; P < .001) and femoral (13.8% vs 2.7%; P < .001) sites were more frequently used in ICU patients, whereas peripherally inserted (19.9% vs 5.9%; P < .001) and subclavian (60.7% vs 47.3%; P < .001) catheters were more commonly used in non-ICU patients.ConclusionsCurrent surveillance and infection control efforts to reduce morbidity and mortality associated with bloodstream infections concentrate on the high-risk ICU patients with CVCs. Our survey demonstrated that two-thirds of identified CVCs were not in ICU patients and suggests that more efforts should be directed to patients with CVCs who are outside the ICU.

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