Catheter-Related Bloodstream Infection and Antimicrobial Resistance Pattern in a Colombian Tertiary Intensive Care Unit

BACKGROUND/OBJECTIVES: Catheter-related Bloodstream infections (CRBSI) remain an important cause of Nosocomial infection in the ICU (Intensive Care Unit). In addition, Bacterial resistance to commonly used antimicrobial agents is a commonly problem on the ICU. The aim of this study was to determine the rate of CRBI and the antimicrobial resistance pattern for the bacteria responsible for catheter related Nosocomial infections. METHODS: This prospective study was conducted on the ICU of a tertiary care Hospital in Bogotá-Colombia over a period of 11 months. CRBI were identified using the Centers for Disease Control definitions; the CRBI and device-utilization rates were calculated and compared with results of the adult ICU surveillance component of the annual report of the NNIS (National Nosocomial Infections Surveillance) of October 2004. Bacterial identification and the antimicrobial susceptibility were determined by the MicroScan system and were interpreted according to the criteria of the CLSI (Clinical and Laboratory Standards Institute). Results were included in a database and analysed with WHONET 5.3 software. RESULTS: The study included 388 patients. There were 27 episodes of CRBSI, with a rate of 3.55 per 1000 central-line-days and a device-utilization rate of 0.93. Compared with the annual report of the NNIS, our CRBI rate was between the 50th and 75th percentile and the device-utilization rate was higher than 90th percentile. Of these 27 episodes, 13 (48.1%) were due to Gram-negative organisms, 12 (44.4%) were due to Gram-positive organisms, and 2 (7.4%) were fungal. The most common organisms isolated were Acinetobacter baumannii (N = 8, 30%), Staphylococcus aureus (N = 8, 30%) and Klebsiella pneumoniae (N = 3, 11%). The table 1 illustrates the antimicrobial resistance pattern for the most common organism isolated. CONCLUSIONS: The CRBSI rate at our hospital is in a normal rank; even though the high device-utilization rate. Nevertheless, the isolated of multiresistant microorganisms is a threatening problem. Efforts on reducing the use or duration of invasive devices and surveillance of antimicrobial resistance must become a priority in our institution. Table 1 - = not aplicable NT = no tested.