Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Nov;50(11):1830-1840.
doi: 10.1007/s00134-024-07615-0. Epub 2024 Sep 17.

Central venous catheter-related infection: does insertion site still matter? A French multicentric cohort study

Vincent Cosme #  1 , Nicolas Massart #  2 , Florian Reizine  3 , Anaïs Machut  4 , Charles-Hervé Vacheron  4   5   6 , Anne Savey  4   6 , Arnaud Friggeri  4   5   6 , Alain Lepape  4   5   6 ; REAREZO study group
Collaborators, Affiliations
Multicenter Study

Central venous catheter-related infection: does insertion site still matter? A French multicentric cohort study

Vincent Cosme et al. Intensive Care Med. 2024 Nov.

Abstract

Purpose: We aim to evaluate the association between central venous catheter (CVC) insertion site and microbiological CVC complications in a nationwide cohort.

Methods: This study was conducted using the healthcare-associated infection surveillance cohort "REA-REZO" involving 193 intensive care units (ICUs). All CVC inserted and removed during the same ICU stay between January 1st 2018 and December 31st 2022 were eligible but only those whose tips were sent for microbiological analysis were included. Primary objective was to describe CVC insertion sites and subsequent catheter-related bloodstream infection (CRBSI).

Results: Out of 126,997 CVCs, 71,314 were not sent for tip culture, and only 55,663 CVCs were included, (30,548 in internal jugular [IJ], 14,423 in femoral and 10,692 in subclavian [SC] sites). The incidence of CRBSI was 0.7 [0.6-0.8] in the IJ site, 0.7 [0.6-0.9] in the femoral site, and 0.6 [0.4-0.7] CRBSI per 1000 CVC days in the SC site (p = 0.248). The multivariable Poisson regression model showed no differences of CRBSI incidence rates between the three insertion sites. Microorganisms observed in CRBSI were coagulase-negative Staphylococci (27.9%), Enterobacterales (27.5%), non-fermenting Gram-negative Bacilli (10.4%), Candida sp. (16.9%), and Staphylococcus aureus (16.9%).

Conclusion: Low CRBSI incidence rates were reported. CRBSI incidences rates were similar in the three insertion sites. Uncertainty remains due to potential selection bias since many CVCs had to be excluded.

Keywords: Acquired infection; Bacteremia; Catheter-related infection; Central venous catheter; Colonization.

PubMed Disclaimer

References

    1. https://rearezo.chu-lyon.fr/resultats/rapport_rearezo_2022.pdf . Accessed 23 Jan 2024
    1. Tabah A, Buetti N, Staiquly Q, Ruckly S, Akova M, Aslan AT, Leone M, Conway Morris A, Bassetti M, Arvaniti K, Lipman J, Ferrer R, Qiu H, Paiva JA, Povoa P, De Bus L, De Waele J, Zand F, Gurjar M, Alsisi A, Abidi K, Bracht H, Hayashi Y, Jeon K, Elhadi M, Barbier F, Timsit JF, EUROBACT-2 Study Group, ESICM, ESCMID ESGCIP and the OUTCOMEREA Network (2023) Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Med 49(2):178–190. https://doi.org/10.1007/s00134-022-06944-2 - DOI - PubMed - PMC
    1. Adrie C, Garrouste-Orgeas M, Ibn Essaied W, Schwebel C, Darmon M, Mourvillier B, Ruckly S, Dumenil AS, Kallel H, Argaud L, Marcotte G, Barbier F, Laurent V, Goldgran-Toledano D, Clec’h C, Azoulay E, Souweine B, Timsit JF, OUTCOMEREA Study Group* (2017) Attributable mortality of ICU-acquired bloodstream infections: Impact of the source, causative micro-organism, resistance profile and antimicrobial therapy. J Infect 74(2):131–141. https://doi.org/10.1016/j.jinf.2016.11.001 - DOI - PubMed
    1. Ziegler MJ, Pellegrini DC, Safdar N (2015) Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis. Infection 43(1):29–36. https://doi.org/10.1007/s15010-014-0689-y - DOI - PubMed
    1. Mimoz O, Lucet JC, Kerforne T, Pascal J, Souweine B, Goudet V, Mercat A, Bouadma L, Lasocki S, Alfandari S, Friggeri A, Wallet F, Allou N, Ruckly S, Balayn D, Lepape A, Timsit JF, CLEAN Trial Investigators (2015) Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet 386(10008):2069–2077. https://doi.org/10.1016/S0140-6736(15)00244-5 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources