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Catheter-related bloodstream infections in intensive care units : a systematic review with meta-analysis

Ramritu, Prabha, Halton, Kate A., Cook, David, Whitby, Michael, & Graves, Nicholas (2008) Catheter-related bloodstream infections in intensive care units : a systematic review with meta-analysis. Journal of Advanced Nursing, 62(1), pp. 3-21.

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Abstract

Aim: This paper is a report of a systematic review and meta-analysis of strategies, other than antimicrobial coated catheters, hypothesized to reduce risk of catheter-related bloodstream infections and catheter colonization in the intensive care unit setting.---

Background: Catheter-related bloodstream infections occur at a rate of 5 per 1000 catheter days in the intensive care unit setting and cause substantial mortality and excess cost. Reducing risk of catheter-related bloodstream infections among intensive care unit patients will save costs, reduce length of stay, and improve outcomes.---

Methods: A systematic review of studies published between January 1985 and February 2007 was carried out using the keywords 'catheterization – central venous' with combinations of infection, prevention and bloodstream*. All included studies were screened by two reviewers, a validated data extraction instrument was used and data collection was completed by two blinded independent reviewers. Risk ratios for catheter-related bloodstream infections and catheter colonization were estimated with 95% confidence intervals for each study. Results from studies of similar interventions were pooled using meta-analyses.---

Results: Twenty-three studies were included in the review. The strategies that reduced catheter colonization included insertion of central venous catheters in the subclavian vein rather than other sites, use of alternate skin disinfection solutions before catheter insertion and use of Vitacuff in combination with polymyxin, neomycin and bacitracin ointment. Strategies to reduce catheter-related bloodstream infection included staff education multifaceted infection control programmes and performance feedback.---

Conclusion: A range of interventions may reduce risks of catheter-related bloodstream infection, in addition to antimicrobial catheters.

Impact and interest:

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24 citations in Web of Science®

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ID Code: 19610
Item Type: Journal Article
Additional URLs:
Keywords: Bloodstream infection, Central venous catheters, Intensive care unit, Meta-analysis, Nursing, Prevention, Systematic review
DOI: 10.1111/j.1365-2648.2007.04564.x
ISSN: 0309-2402
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL MICROBIOLOGY (110800) > Medical Infection Agents (incl. Prions) (110802)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Funding:
Deposited On: 17 Apr 2009 13:27
Last Modified: 09 Apr 2014 22:21

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