Vascular access is one of the most common medical measures in hospitals. Each year, around 300 million intravascular catheters are placed in patients in the United States alone – approximately 3 million of these are central venous catheters (CVCs), which cause 90 per cent of all primary bloodstream infections (BSIs).
Most of these infections occur in patients with short-term CVCs. Depending on the type of ward/surgery, infection rates vary between 1.3 per 1 000 catheter days in inpatient medical/surgical wards to 5.6 per 1 000 catheter days in burn ICUs*.
To ensure consistent diagnosis of primary BSI – for surveillance for instance – the CDC case definitions are used**:
The infection meets at least one of the following criteria:
"B2 Clinical primary BSI" may be used only to report primary BSI in neonates and infants ≤ 1 year of age.
The infection risk is influenced by several factors, for example the patient's immune status. Hence, it is not possible to prevent all intravascular catheter-related primary BSIs. However, compliance with evidence-based recommendations significantly contributes to reducing the infection risk.
Recommendations on preventing primary bloodstream infection
*O'Grady NP, Chertow DS
Managing bloodstream infections in patients who have short-term central venous catheters. Cleveland Clinic Journal of Medicine January, 2011, 78 (1): 10-17.
** 7th edition of the definitions of nosocomial infection (CDC definitions). Robert Koch-Institute, 10 February 2011
