Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019.
Laia Badia-Cebada, Judit Peñafiel, Patrick Saliba, Marta Andrés, Jordi Càmara, Dolors Domenech, Emili Jiménez-Martínez, Anna Marrón, Encarna Moreno, Virginia Pomar, Montserrat Vaqué, Enric Limón, Úrsula Masats, Miquel Pujol, Oriol Gasch, VINCat programme (Infection Control Catalan Programme)
Author Information
Laia Badia-Cebada: Internal Medicine Department, Hospital Universitari Parc Taulí, Sabadell, Spain.
Judit Peñafiel: Unit of Statistics, Hospital Universitari de Bellvitge/Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain.
Patrick Saliba: VINCat programme: Infection Control Catalan Programme, Barcelona, Spain.
Marta Andrés: Infectious Diseases Unit, Department of Internal Medicine, Hospital Consorci de Terrassa, Spain.
Jordi Càmara: Department of Microbiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
Dolors Domenech: Infection Control Nurse, Hospital Josep Trueta, Girona, Spain.
Emili Jiménez-Martínez: Infection Control Nurse, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain.
BackgroundCatheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death.AimTo analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat).MethodsA cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000 patient days. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000 patient days and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported.ResultsDuring the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate: 0.20 episodes/1,000 patient days). Patients' median age was 64.1 years; 36.6% (3,403/9,290) were female. In total, 73.7% (n = 6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n = 5,822) were related to central venous catheter (CVC), 24.1% (n = 2,236) to peripheral venous catheters (PVC) and 13.3% (n = 1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR: 0.94; 95%CI: 0.93-0.96), especially in the ICU (IRR: 0.88; 95%CI: 0.87-0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR: 0.88; 95%CI: 0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC: 1.08; 95%CI: 1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05).ConclusionsOver the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards.
