Abstract
Introduction: Although central venous catheters (CVCs) provide reliable vascular access, there are several risks linked with their use, with the rates of central-line-associated bloodstream infections (CLABSIs) being the most important ones. CLABSIs have a big impact on mortality rates and health care costs. The aim of this study was to investigate the incidence of obesity in the development of central venous catheter infections.
Material and Method: This is a prospective, observational study. The data were collected in the ICUs of three major hospitals in Greece, over a period of 18 months. Totally, 744 patients were included in the study.
Results: The study included 744 ICU patients aged 63.6 ± 16.6 years. The Apache II score and MODS score of patients were 23.3 ± 6.9 and 7.5 ± 3.8, respectively. Totally, 5.426 catheter-days were included in the study. Among the 722 CVCs, 178 (24.7%) were CLABSIs. The incidence rate of CVC-associated CLABSI was 22.48 infections per 1000 catheter-days. CLABSI was significantly predicted by the BMI (p = 0.001), by the diabetes mellitus as comorbidity (p = 0.013), by the doctors’ experience (p = 0.001), by the type of CVC (p = 0.001) and CVC site (p = 0.001), by the number of efforts for CVC insertion (p = 0.009), by the catheterization’s duration (p = 0.001) and by the MODS score (p = 0.001).
Conclusions: Better staff training focused on care bundles preventing infections, better medical training focused on less efforts for CVC insertion, and the use of Ultrasounds during the CVC insertion may be the main factors that can lead to lower CLABSI rates in obese patients. Further research relating CLABSI rates in ICU patients and obesity is needed.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Agency for Healthcare Research and Quality (AHRQ) (2013) Making health care safer II: an updated critical analysis of the evidence for patient safety practices – Executive report. Available at http://www.ahrq.gov/research/findings/evidence-based-reports/ptsafetysum.html
Bianco A, Coscarelli P, Nobile C, Pileggi C, Pavia M (2013) The reduction of risk in central line-associated bloodstream infections: knowledge, attitudes, and evidence-based practices in health care workers. Am J Infect Control 41(2):107–112
CDC (2011) Guidelines for the prevention of intravascular catheter-related infections. Available from: http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf
Dahan M, O’Donnell S, Hebert J, Gonzales M, Lee B, Chandran A, Woolsey S, Escoredo S, Chinnery H, Quach C (2016) CLABSI risk factors in the NICU: potential for prevention: a PICNIC study. Infect Control Hosp Epidemiol 37(12):1446–1452
Furuya E, Dick A, Herzig C, Pogorzelska-Maziarz M, Larson E, Stone P (2016) Central line–associated bloodstream infection reduction and bundle compliance in intensive care units: a National Study. Infect Control Hosp Epidemiol 37(07):805–810
Hallam C, Jackson T, Rajgopal A, Russell B (2018) Establishing catheter-related bloodstream infection surveillance to drive improvement. J Infect Prev 19(4):160–166
Institute of Healthcare Improvement (IHI) (2012) How-to-guide: prevent central line associated bloodstream infections (CLABSI). Retrieved from http://www.ihi.org/knowledge/Pages/Tools/HowtoGuidePreventCentralLineAssociatedBloodstreamInfections.aspx
Kaye K, Marchaim D, Chen T, Baures T, Anderson D, Choi Y, Sloane R, Schmader K (2014) Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults. J Am Geriatr Soc 62(2):306–311
Kim J, Holtom P, Vigen C (2011) Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: epidemiologic and economic consequences. Am J Infect Control 39(8):640–646
Kusek L (2012) Preventing central line-associated bloodstream infections. J Nurs Care Qual 27(4):283–287
Lissauer M, Leekha S, Preas M, Thom K, Johnson S (2012) Risk factors for central line-associated bloodstream infections in the era of best practice. J Trauma Acute Care Surg 72(5):1174–1180
Marra A, Cal R, Durão M, Correa L, Guastelli L, Moura D, Edmond M, dos Santos O (2010) Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era. Am J Infect Control 38(6):434–439
O’Grady N, Alexander M, Burns L, Dellinger E, Garland J, Heard S, Lipsett P, Masur H, Mermel L, Pearson M, Raad I, Randolph A, Rupp M, Saint S (2011) Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 52(9):e162–e193
Pepin C, Thom K, Sorkin J, Leekha S, Masnick M, Preas M, Pineles L, Harris A (2015) Risk factors for central-line–associated bloodstream infections: a focus on comorbid conditions. Infect Control Hosp Epidemiol 36(04):479–481
Tao L, Zhou J, Gong Y, Liu W, Long T, Huang X, Luo G, Peng Y, Wu J (2015) Risk factors for central line-associated bloodstream infection in patients with major burns and the efficacy of the topical application of mupirocin at the central venous catheter exit site. Burns 41(8):1831–1838
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this paper
Cite this paper
Tsolakoglou, I. et al. (2020). Central-Line-Associated Bloodstream Infections (CLABSIs) Incidence and the Role of Obesity: A Prospective, Observational Study in Greece. In: Vlamos, P. (eds) GeNeDis 2018. Advances in Experimental Medicine and Biology, vol 1196. Springer, Cham. https://doi.org/10.1007/978-3-030-32637-1_2
Download citation
DOI: https://doi.org/10.1007/978-3-030-32637-1_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-32636-4
Online ISBN: 978-3-030-32637-1
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)