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Catheter-related infection in Irish intensive care units diagnosed with HELICS criteria: a multi-centre surveillance study.

The Journal of Hospital Infection

Adult, Aged, Catheter-Related Infections, diagnosis, epidemiology, Epidemiological Monitoring, Female, Humans, Intensive Care Units, Ireland, Male, Middle Aged, Prevalence

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      Abstract

      Catheter-related infection (CRI) surveillance is advocated as a healthcare quality indicator. However, there is no national CRI surveillance programme or standardized CRI definitions in Irish intensive care units (ICUs). To examine the feasibility of multi-centre CRI surveillance in nine Irish ICUs, using Hospitals in Europe Link for Infection Control through Surveillance (HELICS) definitions (CRI 1, CRI 2 and CRI 3). All non-tunnelled central venous catheters (CVCs) inserted in patients aged >18 years with an ICU stay ≥48 h were included over a three-month study period. Feasibility was demonstrated by the 99.5% return rate for study forms. Data on 1209 CVCs in 614 patients over 7587 CVC-days showed 17 episodes of CRI, representing a national rate of 2.2 per 1000 CVC-days [95% confidence interval (CI) 1.2-3.3]. Rates of CRI 1, CRI 2 and CRI 3 were 0.13 (95% CI 0.00-0.39), 0.79 (95% CI 0.16-1.42) and 1.39 (95% CI 0.60-2.17) per 1000 CVC-days, respectively. CRI was associated with length of ICU stay (P < 0.001), number of CVCs inserted (P < 0.001) and total number of CVC-days per patient (P < 0.001). CRI was higher in CVCs inserted in operating theatres (incident rate ratio 3.9, 95% CI 1.3-11.5; P = 0.02) compared with CVCs inserted in ICUs. Participant feedback reported minimal difficulty with surveillance implementation, and data collection required approximately 1 h per patient per week. The study demonstrated that multi-centre ICU surveillance using HELICS CRI definitions was practical, feasible and provided clinically relevant information. CRI surveillance in ICUs, although labour intensive, is recommended to reduce CRI and allow ongoing evaluation of processes aimed at CRI reduction. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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      23394814
      10.1016/j.jhin.2012.11.020

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