Catheter-related infections: A Scandinavian observational study on the impact of a simple hygiene insertion bundle

BACKGROUND: Catheter-related infections (CRIs) and catheter-related bloodstream infections (CRBSIs) are among the most frequent hospital acquired infections. CRI/CRBSI studies in Scandinavian cohorts are scarce. The primary aim of this study was to investigate the CRI/CRBSI incidence and the association between potential risk factors, including the introduction of a simple hygiene insertion bundle and CRIs at a large university hospital in Sweden.

METHODS: We retrospectively included all patients aged 12 and above who received a central venous catheter (CVC) or a central dialysis catheter during a two-year period, one year before and one year after the implementation of a simple hygiene insertion bundle. Microbiological data, including catheter tip cultures and blood cultures, were merged with CVC insertion data.

RESULTS: A total of 1,722 catheter insertions in 1,428 patients were included. CRI and CRBSI incidence were 1.86/1,000 and 0.62/1,000 catheter days, respectively. In a multivariable regression model, the implementation of a simple hygiene insertion bundle was the independent factor most strongly associated with significantly lower CRI-incidence (95% Confidence Interval (CI) of Odds Ratio (OR) 0.23 - 0.92, p = 0.029). Choosing multiple lumen catheters was associated with increasing CRI-incidence (95% CI of OR 1.11-2.39, p = 0.013).

CONCLUSION: The incidence of catheter-related infections and catheter-related bloodstream infections in this Scandinavian cohort was low. The implementation of a simple hygiene insertion bundle seems to be an effective intervention for reducing catheter-related infections. The use of multiple-lumen catheters is associated with increased risk of catheter-related infections.