Intravascular device-related primary bacteraemia rates in a general intensive care unit

Abstract

Introduction: the risk of nosocomial infection is greater in an intensive care area than a general ward area. Factors demonstrated as placing intensive care patients at higher risk include the severity of their underlying illness, length of intensive care stay and prolonged exposure to invasive devices. To assess the risk of bloodstream infections associated with intravascular devices we undertook a 6-month survey in a general intensive care unit (ICU). Objective: to prospectively determine, firstly, the intravascular device-related bacteraemia rate and, secondly, the central intravascular device utilisation ratio in the ICU of an Australian tertiary referral teaching hospital. Method: prospective surveillance of all patients admitted to the general ICU from 11/9/95 to 11/3/96 was performed using Centers for Disease Control and Prevention definitions employed in the National Nosocomial Infection Surveillance program. Results: there were 213 patient admissions in the 6-month survey, with an average age of 55.7 years (range 12-94). Mean duration of ICU stay was 6.3 days (range 1-70) and the median ICU length of stay 3 days. Eight episodes of intravascular device-related bacteraemia occurred in this patient group, with four of those burns patients. The intravascular device-related bacteraemia rate was 4.97/1000 device days and the device utilisation ratio for central devices in ICU 0.95. Conclusion: we have established the baseline intravascular device-related bacteraemia rate and utilisation ratio for central devices in the general ICU at an Australian teaching hospital. Knowledge of these rates will help identify problems that lead to an increase in bacteraemia rates and allow comparison with other units that collect data using the same methodology.