• Mandakini Pawar, Yatin Mehta, Pawan Kapoor, Jitendra Sharma, Abhinav Gupta, and Naresh Trehan.
• Department of Microbiology, Escorts Heart Institute and Research Centre, New Delhi, India.
• J. Cardiothorac. Vasc. Anesth. 2004 Jun 1; 18 (3): 304-8.

ObjectiveTo determine the incidence, risk factors, outcome, and pathogens of central venous catheter-related bloodstream infections (CVC-BSIs).DesignProspective study.SettingEscorts Heart Institute and Research Centre, New Delhi, India.ParticipantsOne thousand three hundred fourteen consecutive patients undergoing cardiac operations who were admitted to the intensive care unit with CVC.InterventionsAll patients were assigned into CVC-BSI (n = 35) and non-CVC-BSI (n = 1,279) groups.Measurement And Main ResultsOf the 1,314 patients in the study, 35 (2.6%) had CVC-BSI. On univariate analysis, significant risk factors were use of multilumen catheters, coexistent infections, intra-aortic balloon counterpulsation (IABC), total ventilation hours, emergency surgery, acute physiology, age, chronic health evaluation score (APACHE II), and steroids. On multivariate analysis, duration of catheterization (24.5 +/- 10.9 v 6.1 +/- 3.2; p < 0.001), coexistent infections (57.11% v 2.61%; p < 0.001), IABC (77.1% v 4.1%; p = 0.005), and temperature (38.2 +/- 0.6 v 37.4 +/- 0.3; p < 0.001) were independent predictors of CVC-BSI. Pathogens isolated were Escherichia coli (47%), Acinetobacter species (11.7%), Enterobacter species (5.8%), Proteus species (5.8%), methicillin-resistant Staphylococcus species (11.7%), coagulase-negative Staphylococcus species (5.8%), and Candida (11.7%). The mortality rate in CVC-BSI was 22.9% as compared with 0.2% in non-CVC-BSI cases (p < 0.001).ConclusionBy univariate analysis, the risk factors for CVC-BSI were use of multilumen catheters, duration of catheterization, total ventilation hours, IABC, emergency surgery, APACHE II score, coexistent infections, and steroids. On multivariate analysis, duration of catheterization, IABC, coexistent infections, and temperature were independent predictors of CVC-BSI. The mortality was increased with CVC-BSI.

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