CVC RELATED BACTEREMIA

MICROBIOLOGICALLY CONFIRMED, CENTRAL VENOUS CATHETER RELATED BACTEREMIA IN INTENSIVE CARE UNIT PEDIATRIC PATIENTS.

Abstract

Objectives: To characterize clinically, epidemically and microbiologically the episodes of
confirmed bacteremia associated with intravascular catheters of patients in the pediatric intensive care
unit. Study Design: An analytical, prospective study. Setting: Intensive care unit of Pediatric Hospital
José Luis Miranda”. Period: January 2003 to December 2007. Methods: 453 patients. Rates, density
of incidence, risk factors, static’s and mortality were determined and analyzed. Results: 96 patients
developed bacteremia episodes and 90 (74%) had microbiological criteria. The risk factors associate were:
to have multiple catheters, permanency with the catheter more than 7 days, parenteral feeding, prolonged
mechanical ventilation, previous transfusions and surgical interventions. The isolations of coagulase
negative staphylococci prevailed in 33 patients (36, 7%). The previous demurrage to the insert of the
catheter was of 4,0 ± 9,4 days for the healthy ones and 11, 6 ± 24,6 days in the sick persons (p = 0,000);
the definitive demurrage was of 56,1 ± 62,4 days in the sick persons versus 24,6 ± 31,7 days in the healthy
ones (p = 0,000). The mortality of the second group was superior (26%). Conclusions: Multiple dependent
and independent factors exist on which actions should be focused to prevent and to diminish the mortality
by bacteremias associated with catheters in children admitted in intensive care units.