Changing microbiology of indwelling venous catheter related infection

Background: Indwelling venous catheters (IVCs) have become an integral part of managing patients in both inpatient and outpatient settings. Even with advances in technology and techniques, infectious complications remain highly prevalent and result in significant morbidity and mortality. Various patient and catheter related factors have been previously studied to be associated with IVC related infections. Aim: The purpose of this study was to investigate the correlation between the microbiology of IVC related infections and various factors such as patient co morbidities, type of catheter used and the indication for placement. Methods: We retrospectively studied patients admitted to the university-affiliated hospital for IVC related infections from October 2008 to December 2010. Results: Our data show an increase in the incidence of Staphylococcus aureus infections (28%) as compared to the previously reported national data. Staphylococcus aureus was associated with various risk factors, such as catheter use for antibiotic administration (OR = 6.2), PICC line insertion (OR = 2.378), diabetes mellitus (OR = 1.43), hemodialysis (OR = 1.411), and tunneled catheter use (OR=1.4). Individuals with catheters placed for hemodialysis were 2.35 times more likely to have infections with coagulase negative Staphylococci, and 1.397 times more likely to present with other gram-positive organism. Similarly, individuals receiving TPN were 1.188 times more likely to have Candida species as the infecting organism. Conclusion: These correlations are important for choosing initial presumptive antimicrobial therapy, duration of antimicrobial therapy and pursuing catheter removal. Correspondence to: Dr. Lokesh Shahani, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA, Tel: 217-801-1985; E-mail: [email protected]