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Risk of Infection Due to Central Venous Catheters: Effect of Site of Placement and Catheter Type

Published online by Cambridge University Press:  31 March 2016

Angella M. Goetz
Affiliation:
Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania
Marilyn M. Wagener
Affiliation:
Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania
Jean M. Miller
Affiliation:
Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania
Robert R. Muder*
Affiliation:
Veterans' Affairs Medical Center, Pittsburgh, Pennsylvania
*
Infectious Disease Section, VA Medical Center, University Drive C, Pittsburgh, PA 15240

Abstract

OBJECTIVE:

To determine the influence of catheter site and type (single- vs triple-lumen) on infection rates associated with central venous catheterization.

DESIGN:

Prospective observational study of all nontunneled central venous catheters over a 28-month period. Data collected included patient characteristics, insertion site, catheter type, and receipt of parenteral nutrition. End points were clinical infection (bacteremia or site infection) and catheter contamination (clinical infection or colonization with >15 colonies on semiquantitative culture).

SETTING:

Medical-surgical wards of Veterans' Affairs hospital.

RESULTS:

Three hundred catheters were inserted into 204 patients. Seventy percent were inserted into upper-body sites, and 30% were inserted into the femoral vein. Forty-five percent were triple-lumen catheters. Bacteremia occurred in 2.7% of catheter insertions; insertion-site infections developed in 1.3%, and catheter colonization developed in 12%. Catheter contamination was associated with emergent insertion (odds ratio [OR], 6.2; 95% confidence interval [CI95], 1.1-36.7; P=.04) by logistic regression and with femoral location (hazard, 4.2; CI95, 2.0-8.8; P=.0001) and history of transplantation (hazard, 2.8; CI95, 1.1-6.7; P=.024) by Cox regression. Clinical infection was not associated with any of the risk factors evaluated, although there was a trend for association with femoral location by Cox regression (hazard, 4.7; CI95, 0.82-26; P=.08). We did not identify an association between infection and use of triple-lumen catheters or parenteral nutrition.

CONCLUSION:

Our data support an association between intravenous catheter contamination and insertion at a femoral site.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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References

1.Department of Health and Human Resources. Notice of intravenous device-related infections prevention guideline availability. Federal Register 09 27, 1995;60:4997850006.Google Scholar
2.Maki, DG, Weise, CE, Sarafin, HW. A semiquantitative culture method for identifying intravenous catheter-related infection. N Engl J Med 1977;296:13051309.CrossRefGoogle ScholarPubMed
3.Maki, DG. Infections due to infusion therapy. In: Bennet, JV, Brachman, PS, eds. Hospital Infections. 3rd ed. Boston, MA: Little, Brown & Co; 1992.Google Scholar
4.Moncrief, JA. Femoral catheters. Ann Surg 1958;147:166172.CrossRefGoogle Scholar
5.Friedman, B, Kanter, G, Titus, D. Femoral venous catheters: a safe alternative for delivering parenteral alimentation. Nutr Clin Pract 1994;9:6972.CrossRefGoogle ScholarPubMed
6.Williams, JF, Seneff, MG, Friedman, BC, McGrath, BJ, Gregg, R, Sunner, J, et al.Use of femoral venous catheters in critically ill adults: prospective study. Crit Care Med 1991;19:550553.CrossRefGoogle ScholarPubMed
7.Murr, MM, Rosenquist, MD, Lewis, RW, Heinle, JA, Kealy, GP. A prospective safety study of femoral vein versus nonfemoral vein catheterization in patients with burns. J Burn Care Rehabil 1991;12:576578.CrossRefGoogle ScholarPubMed
8.Lazarus, HM, Aeger, RJ, Bloom, AP, Shenk, R. Percutaneous placement of femoral central venous catheters in patients undergoing transplantation of bone marrow. Surg, Gyn, and Obstet 1990;170:403406.Google ScholarPubMed
9.Harden, JL, Kemp, L, Mirtallo, J. Femoral catheters increase risk of infection in total parenteral nutrition patients. Nutr Clin Pract 1995;10:6066.CrossRefGoogle ScholarPubMed
10.Nidus, BD, Speyer, JL, Bottino, J, Green, M, Levin, M, Muggia, FM. Repeated femoral vein cannulation for administration of chemotherapeutic agents. Cancer Treatment Reports 1983;67:185186.Google ScholarPubMed
11.Purdue, GF, Hunt, JL. Vascular access through the femoral vessels: indications and complications. J Burn Care Rehabil 1986;7:498500.CrossRefGoogle ScholarPubMed
12.Kemp, L, Burge, J, Choban, P, Harden, J, Mirtallo, J, Flancbaum, L. The effect of catheter type and site of infection rates in total parenteral nutrition patients. Journal of Parenteral and Enteral Nutrition 1994;18:7174.CrossRefGoogle ScholarPubMed
13.Collignon, P, Soni, N, Pearson, I, Woods, P. Sepsis associated with central vein catheters in critically ill patients. Intensive Care Med 1988;14:227231.CrossRefGoogle ScholarPubMed
14.Clark-Christoff, N, Watters, VA, Sparks, W, Snyder, P, Grant, JP. Use of triple-lumen subclavian catheters for administration of total parenteral nutrition. Journal of Parenteral and Enteral Nutrition 1992;16:403407.CrossRefGoogle ScholarPubMed
15.Hilton, E, Haslett, TA, Bornstein, MT, Tucci, V, Isenberg, HD, Singer, C. Central catheter infections: single-versus triple-lumen catheters. Am J Med 1988;84:667672.CrossRefGoogle ScholarPubMed
16.Yeung, C, May, J, Hughes, R. Infection rate for single lumen v. triple lumen subclavian catheters. Infect Control Hosp Epidemiol 1988;9:154158.CrossRefGoogle ScholarPubMed
17.Pemberton, LB, Lyman, B, Lander, V, Covinsky, J. Sepsis from triple- vs. single-lumen catheters during total parenteral nutrition in surgical or critically ill patients. Arch Surg 1986;121:591594.CrossRefGoogle Scholar
18.McCarthy, MC, Shives, JK, Robison, RJ, Broadie, TA. Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. Journal of Parenteral and Enteral Nutrition 1987;11:259262.CrossRefGoogle Scholar
19.Lee, RB, Buckner, M, Sharp, KW. Do multi-lumen catheters increase central venous catheter sepsis compared to single-lumen catheters? J Trauma 1988;28:14721475.CrossRefGoogle ScholarPubMed
20.Farkas, J-C, Liu, N, Bleriot, J-P, Chevret, S, Goldstein, FW, Carlet, J. Single-versus triple- lumen central catheter-related sepsis: a prospective randomized study in a critically ill population. Am J Med 1992;93:277282.CrossRefGoogle Scholar
21.Miller, JM, Goetz, AM, Squier, C, Muder, RR. Reduction in nosocomial intravenous-device related bacteremias following institution of an intravenous therapy team. J Intravenous Nurs 1996;19:103106.Google Scholar
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