Monitoring Infection Complications Associated with Intravascular Therapy in the Children’s Memorial Health Institute

Abstract

The aim of this study was to monitor the incidence and the aetiology of central venous catheter (CVC) associated infection. The study was conducted from 1 January 2004 through to 31 December 2004 in 12 departments of the Children’s Memorial Health Institute (CMHI) and included children with all types of CVCs. The data from three sources were collected and analysed: 1) the Hospital Infections Registration System – to estimate the frequency of the catheter acquired bloodstream infections (CA-BSIs), 2) the microbiological records – to estimate the type of microorganisms colonising the catheters and the resistance to antibiotics, 3) the ‘Patients with CVCs Observation Cards’ – to analyse the complications associated with the presence of a catheter in the central vein. The rate of the CA-BSIs was 1 sepsis per 1000 catheter-days. The organisms most frequently colonising the catheters were: Staphylococci(69%), Gram-negative bacilli (19%), Enterococci(9%) and Candida spp. (3%). The most active antibiotics against Staphylococci were vancomycin and netilmycin and against Gram-negative bacilli were imipenem, ciprofloxacin and piperacillin/tazobactam. We have analysed the data from 961 of the ‘patients with CVC Observation Cards’. Complications associated with the presence of catheters were observed in 188 patients: pain (119 cases), lack of aspiration (89), oedema (32), pus (19) and induration (17). In 21 patients catheters were removed because of infections. Surveying the intravenously treated patient population allowed us to identified lapses in patient-care and infection-control practices and to improve preventative measures and the care of the patients with CVCs.