Central line-associated bloodstream infection trend in Brazilian adult intensive care units: an ecological study

  • Alexsandra Gomes Resende de Souza da Silva Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
  • Sergiane Bisinoto Alves Municipal Coordination for Patient Safety and Infection Control in Healthcare Services (COMCISS), Municipal Health Department of Goiânia, Goiânia, Brazil
  • Elisângela Eurípedes Resende Guimarães Municipal Coordination for Patient Safety and Infection Control in Healthcare Services (COMCISS), Municipal Health Department of Goiânia, Goiânia, Brazil
  • Jessyca Rodrigues Braga Clinics Hospital, Federal University of Goiás, Goiânia, Brazil
  • Heliny Carneiro Cunha Neves Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil
  • Silvana de Lima Vieira dos Santos Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil
  • Maria Auxiliadora Carmo Moreira Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
Keywords: Bloodstream Infections, Catheter-Associated Infection, Intensive Care Unit, ICU, Antimicrobial Drug Resistance

Abstract

Introduction: Central line-associated bloodstream infections are the second most frequent infection in intensive care units. It represents an adverse event of significant magnitude, thus threatening the patient safety. The aim of this study was to analyze the historical trend of central line-associated bloodstream infections in patients in intensive care units, the rate of infection, central venous catheter utilization ratio, type of pathogen and their antimicrobial resistance pattern.

Methodology: This ecological study was performed at 42 intensive care units from a state capital of the Midwest region of Brazil. Central line-associated bloodstream infections notifications were collected from two databases, the Municipal Coordination for Patient Safety and Infection Control at Healthcare Services, from 2012-2016, and the FormSUS (National Health System Data Processing Company), from 2014-2016.

Results: The incidence of central line-associated bloodstream infections was high and stationary in the period (incidence rate of 2.3 to 3.2 per 1,000 catheter days, central venous catheter utilization ratio average 56,9%). The most frequent microorganisms were coagulase-negative Staphylococcus, Klebsiella pneumoniae, Acinetobacter spp. and Pseudomonas aeruginosa. Resistance to 3rd and 4th generation cephalosporins and carbapenems were detected among Gram-negative bacteria, and resistance to oxacillin among Gram-positive bacteria.

Conclusions: Central line-associated bloodstream infections incidence rates were high, however the historical trend remained stationary in adult intensive care units. Infections were mostly caused by coagulase-negative Staphylococcus, K. pneumoniae, Acinetobacter spp. and Pseudomonas aeruginosa, including multi-drug resistant organisms. These findings point to the need of educational strategies addressing the adherence to established preventive measures and to the rational use of antimicrobials.

Published
2021-11-30
How to Cite
1.
Gomes Resende de Souza da SilvaA, Bisinoto AlvesS, Eurípedes Resende GuimarãesE, Rodrigues BragaJ, Carneiro Cunha NevesH, de Lima Vieira dos SantosS, Carmo MoreiraMA (2021) Central line-associated bloodstream infection trend in Brazilian adult intensive care units: an ecological study. J Infect Dev Ctries 15:1744-1749. doi: 10.3855/jidc.14730
Section
Brief Original Articles