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Table 1 Characteristics of ICU activities and patients by study period

From: Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years

Period   A B C D E
  All January 2006 to October 2007 November 2007 to November 2009 December 2009 to May 2011 June 2011 to May 2013 June 2013 to December 2014
Type of disinfectant dressing added to the ongoing catheter bundle*   None CHG sponge on CVC only CHG sponge on all catheters Replacement of CHG sponge by CHG gel in 2 out of 5 ICUs CHG gel on all catheters (five of five ICUs)
ICU activity
 ICU treatment days 91,292 17,185 20,429 15,476 20,726 17,476
 Mean ICU LOS, days (SD) 5.0 (15.6) 4.3 (7.5) 4.4 (7.9) 5.1 (9.2) 5.3 (11.6) 6.3 (17.3)
 Admissions (all ICU stays), n 19,423 4213 4931 3213 4133 2933
 Emergency (%) 13,651 (70.3) 3037 (72.1) 3484 (71.5) 2183 (70.1) 2872 (71.3) 2075 (70.7)
 Surgical admissions, n (%) 13,018 (67.0) 2779 (66.0) 3258 (66.1) 2265 (70.5) 2749 (66.5) 1967 (67.1)
 Scheduled surgery, n (%) 5722 (29.5) 1222 (29.0) 1409 (28.6) 963 (30.0) 1211 (29.3) 917 (31.3)
 Emergency surgery, n (%) 7296 (37.5) 1557 (37.0) 1849 (37.5) 1302 (40.5) 1538 (37.2) 1050 (35.8)
Site of surgery
 Cardiovascular, n (%) 2131 (16.4) 436 (15.7) 536 (16.5) 343 (15.1) 452 (16.4) 364 (18.5)
 Digestive, n (%) 1621 (12.5) 296 (10.7) 432 (13.3) 268 (11.8) 356 (13.0) 269 (13.7)
 Neurosurgery, n (%) 1173 (9.0) 300 (10.8) 313 (9.6) 203 (9.0) 204 (7.4) 153 (7.8)
 Thoracic, n (%) 663 (5.1) 138 (5.0) 163 (5.0) 106 (4.7) 132 (4.8) 124 (6.3)
 Trauma, n (%) 795 (5.9) 174 (6.3) 194 (6.0) 137 (6.1) 145 (5.3) 145 (7.4)
 Workload: NEMS mean (SD) per 12 h shift 30 (25–37) 28 (27–32) 31 (27–37) 31 (27–37) 30 (25–37) 29 (22–36)
ICU treatments
 Patients with ventilation, admissions (%) 7146 (36.8) 1306 (30.1) 1533 (31.1) 1216 (37.9) 1492 (36.1) 1599 (54.5)
 Ventilation-days 50,852 8008 10,901 9445 12,574 9924
 Mechanical ventilation, mean days/months (SD) 471 (108) 364 (76) 436 (80) 525 (77) 524 (116) 522 (79)
 Catheter-days 155,242 27,713 34,363 26,128 36,689 30,349
 CVC (%) 89,489 (57.6) 15,547 (56.1) 19,553 (56.9) 15,024 (57.5) 21,641 (59.0) 17,724 (58.4)
 CVC-jugular (%) 41,684 (46.6) 6618 (42.6) 8365 (42.8) 7128 (47.4) 10,642 (49.2) 8931 (50.4)
 CVC-sub-clavian (%) 16,747 (18.7) 3549 (22.8) 3740 (19.1) 3070 (20.4) 3866 (17.9) 2521 (14.2)
 CVC-femoral (%) 31,058 (34.7) 5380 (34.6) 7448 (38.1) 4826 (32.1) 7132 (33.0) 6272 (35.4)
 Arterial (%) 65,753 (42.3) 12,166 (43.9) 14,810 (43.1) 11,104 (42.5) 15,048 (41.0) 12,625 (41.6)
 Catheter-days per month, mean (SD) 1419 (275) 1161 (189) 1322 (191) 1471 (169) 1545 (295) 1636 (232)
 Patient with extra-renal replacement therapy, admissions, (%) 1621 (8.4) 204 (4.8) 352 (7.1) 250 (7.8) 424 (10.3) 391 (13.3)
 Mean extra-renal replacement therapy, mean hours/month (SD) 1370 (847) 763 (460) 1162 (717) 1037 (437) 1824 (883) 2091 (843)
Patients
 Number 18,286 3981 4607 3022 3901 2775
 Age, year (median, IQR) 63.7 (51.4–73.9) 62.6 (50.3–73.2) 63.6 (50.8–74.4) 65.0 (54.3–74.5) 64.3 (52.3–74.6) 65.2 (52.6–74.5)
 Males, n (%) 12,025 (65.8) 2632 (66.1) 3040 (66.0) 1995 (66.0) 2536 (65.0) 1822 (65.7)
Patient comorbidities
 NYHA IV (%) 1864 (10.2) 396 (9.9) 554 (12.0) 348 (11.5) 335 (8.6) 231 (8.3)
 Chronic dialysis, n (%) 396 (2.2) 80 (2.0) 114 (2.5) 49 (1.6) 67 (1.7) 86 (3.1)
 Severe COPD, n (%) 1383 (7.6) 309 (7.8) 312 (6.8) 215 (7.1) 288 (7.4) 259 (9.3)
 Liver cirrhosis, n (%) 739 (4.0) 128 (3.2) 171 (3.7) 121 (4.0) 182 (4.7) 137 (4.9)
 Metastatic cancer, n (%) 2356 (12.9) 461 (11.6) 581 (12.6) 375 (12.4) 541 (13.9) 398 (14.3)
 Mc Cabe—within 5 years, n (%) 5088 (27.8) 1078 (27.1) 1342 (29.1) 824 (27.3) 1021 (26.2) 823 (29.7)
 Mc Cabe—within 1 year, n (%) 1741 (9.5) 290 (7.3) 415 (9.0) 265 (8.8) 458 (11.7) 313 (11.3)
Major critical illness
 Hemorrhagic shock, n (%) 657 (3.6) 130 (3.3) 100 (2.2) 112 (3.7) 166 (4.3) 149 (5.4)
 Cardiogenic shock, n (%) 726 (4.0) 166 (4.2) 157 (3.4) 126 (4.2) 136 (3.5) 141 (5.1)
 Septic shock, n (%) 1299 (7.1) 207 (5.2) 326 (7.1) 180 (6.0) 331 (8.5) 255 (9.2)
 Pneumonia, n (%) 2511 (13.7) 544 (13.7) 587 (12.7) 382 (12.6) 544 (13.9) 454 (16.4)
 Peritonitis, n (%) 408 (2.2) 87 (2.2) 114 (2.5) 58 (1.9) 81 (2.1) 68 (2.5)
Severity
 SAPS II median (IQR) 38 (27–49) 35 (25–45) 36 (26–47) 38 (29–49) 41 (30–53) 40 (28–51)
 ICU mortality, n (%) 1974 (10.8) 386 (9.7) 441 (9.6) 305 (10.1) 474 (12.2) 368 (13.3)
 Hospital post-ICU mortality, n (%) 539 (2.9) 115 (2.9) 157 (3.4) 100 (3.3) 99 (2.5) 68 (2.5)
  1. CRBSI catheter-related bloodstream infection, CABSI catheter-associated bloodstream infection, i.e., CRBSI + primary bacteremia
  2. *See supplemental Table 2