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Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

  • Irina Zuschneid (a1), Frank Schwab (a1), Christine Geffers (a1), Henning Rüden (a1) and Petra Gastmeier (a2)...


Background And Objective:

The German Nosocomial Infection Surveillance System (KISS) began in 1997 as a nationwide surveillance project for voluntary registration of nosocomial infections in intensive care units (ICUs). This study investigates trends in the rates of central venous catheter (CVC)–associated primary bloodstream infections (BSIs) in ICUs since participation in KISS.


Eighty-four ICUs that had participated in KISS for at least 24 months were considered for more detailed analysis. Monthly rates of primary BSI for the 84 ICUs were pooled for the 24 months. The best model for describing the curve of reduction was sought. Additionally, incidence densities were compared using the z test.


For the 212 ICUs participating, a relative 25.7% decrease (from 2.1 to 1.6 primary BSIs per 1,000 CVC-days) was observed from January 1997 to June 2001. The 84 ICUs that participated in KISS for a minimum of 24 months accumulated 552,359 patient-days and 404,897 CVC-days during their 24 months. A linear regression model was selected to explain the curve of primary BSI reduction in the 84 ICUs. It showed a decrease from 2.1 to 1.5 primary BSIs per 1,000 CVC-days, meaning an overall relative reduction of 28.6% during the 2-year observation period. These results were significant (Student's t test for the monthly reduction coefficient; P = .04). The reduction of primary BSIs was shown for both clinical sepsis and laboratory-confirmed, CVC-associated primary BSIs.


Performing surveillance with KISS was associated with a reduction of the rates of CVC-associated primary BSIs in ICU patients (Infect Control Hosp Epidemiol 2003;24:501-505).


Corresponding author

Institute of Hygiene, Free University Berlin, Heubnerweg 6, 14059 Berlin, Germany


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1.Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182205.
2.Gaynes, R, Richards, C, Edwards, J, et al. Feeding back surveillance data to prevent hospital-acquired infections. Emerg Infect Dis 2001;7:295298.
3.Emori, TG, Culver, DH, Horan, TC, et al. National Nosocomial Infections Surveillance System (NNIS): description of surveillance methods. Am J Infect Control 1991;19:1935.
4.Gastmeier, P, Sohr, D, Geffers, C, Nassauer, A, Daschner, F, Ruden, H. Are nosocomial infection rates in intensive care units useful benchmark parameters? Infection 2000;28:346350.
5.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.
6.Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen. Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen. Berlin: Nationales Referenzzentrum fur Surveillance von nosokomialen Infektionen; 2002. Available at
7.National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992-April 2000, issued June 2000. Am J Infect Control 2000;28:429448.
8.Haley, RW, Culver, DH, Morgan, WM, White, JW, Emori, TG, Hooton, TM. Increased recognition of infectious diseases in US hospitals through increased use of diagnostic tests, 1970-1976. Am J Epidemiol 1985;121:168181.
9.Geffers, C, Gastmeier, P, Brauer, H, Daschner, F, Ruden, H. Surveillance of nosocomial infections in ICUs: is postdischarge surveillance indispensable? Infect Control Hosp Epidemiol 2001;22:157159.
10.Eckmanns, T, Rath, A, Ruden, H, Gastmeier, P, Daschner, F. Outbreak of Enterobacter cloacae related to understaffing, overcrowding, and poor hygiene practices. Infect Control Hosp Epidemiol 2000;21:305307.
11. Anonymous. Monitoring hospital-acquired infections to promote patient safety: United States, 1990-1999. MMWR 2000;49:149153.
12.Zuschneid, I, Sohr, D, Kohlhase, C, et al. Accuracy of nosocomial infection (NI) data from Intensive Care Units (ICUs) within the German Nosocomial Infections Surveillance System. Presented at the Fifth International Conference of the Hospital Infection Society; September 15-18, 2002; Edinburgh, Scotland.
13.Veenstra, DL, Saint, S, Saha, S, Lumley, T, Sullivan, SD. Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis. JAMA 1999;281:261267.
14.Marin, MG, Lee, JC, Skurnick, JH. Prevention of nosocomial bloodstream infections: effectiveness of antimicrobial-impregnated and heparin-bonded central venous catheters. Crit Care Med 2000;28:33323338.
15.Mermel, LA. Prevention of intravascular catheter-related infections. Ann Intern Med 2000;132:391402.
16.Civetta, JM, Hudson-Civetta, J, Ball, S. Decreasing catheter-related infection and hospital costs by continuous quality improvement. Crit Care Med 1996;24:16601665.
17.Bishop-Kurylo, D. The clinical experience of continuous quality improvement in the neonatal intensive care unit. Journal of Perinatal and Neonatal Nursing 1998;12:5157.
18.Eggimann, P, Harbarth, S, Constantin, MN, Touveneau, S, Chevrolet, JC, Pittet, D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000;355:18641868.
19.Sherertz, RJ, Ely, EW, Westbrook, DM, et al. Education of physicians-in-training can decrease the risk for vascular catheter infection. Ann Intern Med 2000;132:641648.

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Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

  • Irina Zuschneid (a1), Frank Schwab (a1), Christine Geffers (a1), Henning Rüden (a1) and Petra Gastmeier (a2)...


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