Transcript Incidence of Catheter tip colonization

Dr Weng Chin Oh, Dr Johann Nicholas, Dr D Dobie
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Catheter-associated infections (CAIs) is a serious problem in
haemodialysis patients
In Wolverhampton, we have introduced the following
measures to reduce the incidence of CAI
1. Catheter care bundle
2. Clean hospital policy
This has brought about a significant reduction in bacteraemia
rates (including no MRSA)
In the setting of low bacteraemia rates, the incidence of
catheter tip colonization (CTC) in haemodialysis patients is
unknown
J an-1 1
O ct-10
J ul-10
Apr-10
J an-1 0
O ct-09
J ul-09
Apr-09
J an-0 9
O ct-08
J ul-08
Apr-08
J an-0 8
O ct-07
J ul-07
Apr-07
J an-0 7
O ct-06
J ul-06
Apr-06
J an-0 6
O ct-05
J ul-05
Apr-05
J an-0 5
O ct-04
J ul-04
Apr-04
J an-0 4
G+ H
Heparin
7.0
120
6.0
100
5.0
80
4.0
60
3.0
40
2.0
20
1.0
0
0.0
Infection rate per 1000 catheter days
140
total lines and infections
totals_lines
infections
Catheter use and catheter infections
rates
Month
Citralock
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To determine the incidence of CTC in haemodialysis patients
in the setting of low bacteraemia rates
Methods
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This was a 3 month observational study
All catheter tips from routine catheter removals were
prospectively cultured
Catheter tip data was recorded onto our IT reporting system
and the following characteristics were obtained
1. site of catheter removal
2. no of colonized catheters
3. type of organisms
4. reasons for catheter removal
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There were 11 CAIs (CAI rate 1.1 episode/1000 catheter
days)
86 catheter tips were sent for microbiological analysis
80.3% (n=69) catheter tips were not colonized
The incidence of CTC was 19.7% (n=17). Amongst the group
of colonized tips
1. 41% (n=7) were removed from the femoral vein
2. 59% (n=10) were removed from the right internal
jugular vein
71% of femoral catheter tips were gram negative organisms
(n=5)
80% of right internal jugular tips were gram positive
organisms (n=8)
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We report a CAI rate of 1.1/1000 catheter days
and CTC incidence of 19.7%
This is lower than previous published data
We have successfully shown a low incidence of CTC in the
absence of MRSA bacteraemia