Catheter-related infections in burn patients at the Burn Centre of the University Hospital in Ostrava.

Abstract

We need central venous catheters (CVCs) in management of critically ill patients with severe burns, either for the administration of fluids or monitoring hemodynamic status. Central venous catheterization may cause different early or late complications, which depend on the physician's erudition, the quality of the catheters and quality of Intensive Care Unit (ICU) nursing care for insertion. 272 CVCs were inserted in 114 both adult and pediatric patients from 2004 to 2006 in the ICU of the Burn Centre in Ostrava. The average insertion length of the catheter was 10.2 days, and the average total length of catheterization was 24 days. The total number of catheter-days was 2768. All catheter tips removed were routinely cultured. The most frequent infecting pathogens were coagulase-negative Staphylococci. Peripheral blood cultures were examined in case of fever. Bacterial findings from wounds, sputa and urine were monitored in all patients. No exogenous catheter sepsis according to Maki's criteria occurred in our study group. Endogenous catheter colonization with positive peripheral blood culture and bacteraemia occurred in 4 cases, which means an incidence density of 1.44 endogenous colonizations per 1000 catheter-days. The quality of used catheters and particularly the technique of placement and maintenance of catheters are considered crucial for good results in the ICU of Burn centre in Ostrava.