Catheter-related infections: does the spectrum of microbial causes change over time? A nationwide surveillance study.
Niccolò Buetti, Elia Lo Priore, Andrew Atkinson, Andreas F Widmer, Andreas Kronenberg, Jonas Marschall, Swiss Centre for Antibiotic Resistance (ANRESIS)
Author Information
Niccolò Buetti: Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland.
Elia Lo Priore: Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland.
Andrew Atkinson: Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland.
Andreas F Widmer: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
Andreas Kronenberg: Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Jonas Marschall: Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland.
OBJECTIVES: To estimate the incidence and epidemiology of catheter-related bloodstream infections (CRBSIs) on a national scale by using prospective epidemiological data from the Swiss (ANRESIS). DESIGN: Observational study. SETTING: National surveillance from 2008 to 2015 of acute hospitals in Switzerland. PARTICIPANTS: We included acute Swiss hospitals that sent blood cultures and catheter tip culture results on a regular basis during the entire study period to the ANRESIS database. OUTCOME MEASURE: A catheter-related bloodstream infection (termed 'modified CRBSI', mCRBSI) was defined as isolating the same microorganism with identical antibiogram from ≥1 blood cultures (performed ±7 days around the catheter removal) as the one recovered from the catheter tip. Incidence rates of mCRBSI were calculated per 1000 admissions. RESULTS: From 2008 to 2015, the mCRBSI incidence rate decreased from 0.83 to 0.58 episodes/1000 admissions (-6% per year, p<0.001). Coagulase-negative staphylococci, and fungi all exhibited decreasing trends, while rates of enterococci and Gram-negative bacteria remained stable. CONCLUSIONS: The overall incidence of mCRBSI in Switzerland is decreasing; however, the incidence of mCRBSI due to Enterococci and Gram-negative micro-organisms did not change over time. These pathogens may grow in importance in catheter-related infections, which would have clinical implications for the choice of empirical treatment.
