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. 2022 May;27(19):2100610.
doi: 10.2807/1560-7917.ES.2022.27.19.2100610.

Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019

Laia Badia-Cebada  1   2 , Judit Peñafiel  3 , Patrick Saliba  4 , Marta Andrés  5 , Jordi Càmara  6   7   8 , Dolors Domenech  9 , Emili Jiménez-Martínez  10 , Anna Marrón  11 , Encarna Moreno  12 , Virginia Pomar  13 , Montserrat Vaqué  14 , Enric Limón  4 , Úrsula Masats  15 , Miquel Pujol  16   7 , Oriol Gasch  11   17   2 ; VINCat programme (Infection Control Catalan Programme)  18
Affiliations

Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019

Laia Badia-Cebada et al. Euro Surveill. 2022 May.

Abstract

BackgroundCatheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death.AimTo analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat).MethodsA cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000 patient days. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000 patient days and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported.ResultsDuring the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate: 0.20 episodes/1,000 patient days). Patients' median age was 64.1 years; 36.6% (3,403/9,290) were female. In total, 73.7% (n = 6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n = 5,822) were related to central venous catheter (CVC), 24.1% (n = 2,236) to peripheral venous catheters (PVC) and 13.3% (n = 1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR: 0.94; 95%CI: 0.93-0.96), especially in the ICU (IRR: 0.88; 95%CI: 0.87-0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR: 0.88; 95%CI: 0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC: 1.08; 95%CI: 1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05).ConclusionsOver the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards.

Keywords: bundle; catheter-related bloodstream infection; epidemiology; nosocomial infection; peripheral catheter.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Annual incidence rate of catheter-related bloodstream infection adjusted per 1,000 patient days stratified by (A) catheter type and (B) hospital unit type, Catalonia, Spain, 2007–2019 (n = 9,290)
Figure 2
Figure 2
Number of expected catheter-related bloodstream infection per year, stratified by (A) catheter type, (B) catheter use and (C) aetiology, Catalonia, Spain, 2007–2019 (n = 9,290)
Figure 3
Figure 3
Annual incidence rate of catheter-related bloodstream infection adjusted per 1,000 patient days stratified by (A) catheter type and aetiology and (B) catheter type and use, Catalonia, Spain, 2007–2019 (n = 9,290)
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