Central venous catheter maintenance practices and exit site infection in blood purification centres: a nationwide survey in China.

BACKGROUND

This nationwide multi-centre cross-sectional study (May 2025) examined central venous catheter (CVC) maintenance practices and exit site infection (ESI) rates across China's 31 regions. Using a questionnaire for nursing managers (2388 valid responses; 97.63% response rate), data covered 60,119 patients undergoing blood purification.

METHODS

A nationwide, multi-centre, cross-sectional study was conducted in May 2025 across all 31 provincial-level regions of mainland China. Nursing managers from blood purification centres were surveyed using a structured questionnaire.

RESULTS

Of the 2446 questionnaires distributed, 2388 were valid, yielding a response rate of 97.63%. Among 60,119 patients using CVCs for blood purification, the overall ESI rate was 3.58%. ESI rates differed significantly by geographic region, hospital grade, and dialysis-centre scale, with higher rates observed in Southeastern China (4.26%), primary hospitals (5.45%), and large-scale dialysis centres (4.21%) (all P < 0.001). Catheter maintenance practices varied substantially across centres. Most hospitals performed dressing changes three times per week (82.50%), predominantly used povidone-iodine as the disinfectant (91.75%), and assigned dedicated supervisory personnel (69.43%). ESI rates were significantly associated with supervision models, dressing and disinfectant selection, dressing change frequency, and patient self-management behaviours during the interdialytic period (all P < 0.001).

CONCLUSION

This nationwide survey demonstrates substantial heterogeneity in CVC maintenance practices and ESI rates across blood purification centres in China. These findings underscore the need for optimized, evidence-based catheter maintenance strategies and targeted infection control measures to reduce catheter-related complications and improve the quality of blood purification care.