American journal of infection control · 2025
The CONSIDER study: Assessing the risk of catheter-associated bloodstream infections beyond the intensive care setting.
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Borgonovo Fabio, Colaneri Marta, Fassio Federico, Scaglione Giovanni, Galli Lucia, Offer Martina, Genovese Camilla, Fattore Rebecca, Schiavini Monica, De Capitani Giovanni, Calloni Maria, Bartoli Arianna, Casella Francesco, Taino Alba, Gidaro Antonio, Cogliati Chiara, Breschi Valentina, Leoni Jessica, Gori Andrea, Foschi Antonella
Аннотация
BACKGROUND: Catheter-associated and related bloodstream infection (CABSI and CRBSI) are major causes of hospital-acquired infections. However, their incidence and risk factors in non-intensive care unit (ICU) patients with vascular access devices (VADs) remain unclear.
METHODS: This retrospective study evaluated CABSI and CRBSI incidence and risk factors in non-ICU hospitalized adults with VADs. Hazard ratios (HR) were estimated with gamma frailty models and random survival forest analysis. Key variables were identified and validated in multivariable models.
RESULTS: Among 2,326 VAD insertions (1,892 patients), 153 with CRBSI or CABSI were identified. The incidence was 1.80 per 1,000 catheter-days for CABSI, 1.24 for CRBSI, and 2.97 overall. Coagulase-negative Staphylococci were the most isolated pathogens (43.9%). Infections were associated with parenteral nutrition (PN) (HR = 4.12) and multilumen catheters (HR = 2.56). Random survival forest models identified PN, intravenous drug use, and in-patient regimen as top variables. CRBSI was strongly associated with PN (HR = 7.42), while CABSI was linked to intravenous drug use (HR = 7.20).
CONCLUSIONS: Our study showed a high incidence of CABSI and CRBSI in non-ICU adult patients. Identifying risk factors highlights the settings where stringent infection prevention strategies are needed.
METHODS: This retrospective study evaluated CABSI and CRBSI incidence and risk factors in non-ICU hospitalized adults with VADs. Hazard ratios (HR) were estimated with gamma frailty models and random survival forest analysis. Key variables were identified and validated in multivariable models.
RESULTS: Among 2,326 VAD insertions (1,892 patients), 153 with CRBSI or CABSI were identified. The incidence was 1.80 per 1,000 catheter-days for CABSI, 1.24 for CRBSI, and 2.97 overall. Coagulase-negative Staphylococci were the most isolated pathogens (43.9%). Infections were associated with parenteral nutrition (PN) (HR = 4.12) and multilumen catheters (HR = 2.56). Random survival forest models identified PN, intravenous drug use, and in-patient regimen as top variables. CRBSI was strongly associated with PN (HR = 7.42), while CABSI was linked to intravenous drug use (HR = 7.20).
CONCLUSIONS: Our study showed a high incidence of CABSI and CRBSI in non-ICU adult patients. Identifying risk factors highlights the settings where stringent infection prevention strategies are needed.