Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection

Bacterial counts were made of catheter insertion site and of catheter tips to help determine risk factors associated with catheterization of the jugular and subclavian veins. Among the 116 patients included in this study, 69% had central venous catheters (CVC) in the subclavian vein. Seven or more d...

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Main Authors: Sadoyama Geraldo, Gontijo Filho Paulo Pinto
Format: Article
Language:English
Published: Elsevier 2003-01-01
Series:Brazilian Journal of Infectious Diseases
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000200008
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author Sadoyama Geraldo
Gontijo Filho Paulo Pinto
author_facet Sadoyama Geraldo
Gontijo Filho Paulo Pinto
author_sort Sadoyama Geraldo
collection DOAJ
description Bacterial counts were made of catheter insertion site and of catheter tips to help determine risk factors associated with catheterization of the jugular and subclavian veins. Among the 116 patients included in this study, 69% had central venous catheters (CVC) in the subclavian vein. Seven or more days catheterization (p=0.001) and >3 invasive devices (p=0.01) were infection risk factors associated with catheterization of the jugular vein. More than half of the patients presented high colony counts at the insertion site (>200 CFU/20 cm²) and 27% of the catheter tips were contaminated. The risk factors associated with contaminated catheter tips were >14 days hospital stay (p=0.02), >7 days catheterization (p=0.01) and antibiotic therapy (p=0.04). Coagulase-negative staphylococci (CoNS) and Staphylococcus aureus were the most common microorganisms at the insertion site (78%) and in the catheter tip (94%). Five patients presented sepsis (4.1%), four caused by Staphylococci and one by GNB. Twelve patients had the same microorganisms at the insertion site and catheter tip. We found a high prevalence of ORSA (62.5%) and ORCoNS (57.1%) in catheter tips. The high counts of staphylococci, including ORSA and ORCoNS, at the insertion site, and the significant association of this colonization with catheter tip contamination, indicate that the skin is an important reservoir of microorganisms associated with catheter-related bloodstream infection (CR-BSI). Health professionals should be aware of this potential source of infection at the CVC insertion site.
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spelling doaj.art-848277a9eddf4ac0b76a21000c6197012022-12-22T01:13:58ZengElsevierBrazilian Journal of Infectious Diseases1413-86701678-43912003-01-0172142148Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infectionSadoyama GeraldoGontijo Filho Paulo PintoBacterial counts were made of catheter insertion site and of catheter tips to help determine risk factors associated with catheterization of the jugular and subclavian veins. Among the 116 patients included in this study, 69% had central venous catheters (CVC) in the subclavian vein. Seven or more days catheterization (p=0.001) and >3 invasive devices (p=0.01) were infection risk factors associated with catheterization of the jugular vein. More than half of the patients presented high colony counts at the insertion site (>200 CFU/20 cm²) and 27% of the catheter tips were contaminated. The risk factors associated with contaminated catheter tips were >14 days hospital stay (p=0.02), >7 days catheterization (p=0.01) and antibiotic therapy (p=0.04). Coagulase-negative staphylococci (CoNS) and Staphylococcus aureus were the most common microorganisms at the insertion site (78%) and in the catheter tip (94%). Five patients presented sepsis (4.1%), four caused by Staphylococci and one by GNB. Twelve patients had the same microorganisms at the insertion site and catheter tip. We found a high prevalence of ORSA (62.5%) and ORCoNS (57.1%) in catheter tips. The high counts of staphylococci, including ORSA and ORCoNS, at the insertion site, and the significant association of this colonization with catheter tip contamination, indicate that the skin is an important reservoir of microorganisms associated with catheter-related bloodstream infection (CR-BSI). Health professionals should be aware of this potential source of infection at the CVC insertion site.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000200008CVCrisk factorCR-BSIORSAORCoNS
spellingShingle Sadoyama Geraldo
Gontijo Filho Paulo Pinto
Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection
Brazilian Journal of Infectious Diseases
CVC
risk factor
CR-BSI
ORSA
ORCoNS
title Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection
title_full Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection
title_fullStr Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection
title_full_unstemmed Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection
title_short Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection
title_sort comparison between the jugular and subclavian vein as insertion site for central venous catheters microbiological aspects and risk factors for colonization and infection
topic CVC
risk factor
CR-BSI
ORSA
ORCoNS
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000200008
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AT gontijofilhopaulopinto comparisonbetweenthejugularandsubclavianveinasinsertionsiteforcentralvenouscathetersmicrobiologicalaspectsandriskfactorsforcolonizationandinfection