Comparisons of infectious complications of central venous catheters used for long and short periods

OBJECTIVES: Risk factors for infectious complications of central venous cat heters (CVC) were compared between CVC used for short and long periods to i dentify patients at risk. PATIENTS AND METHODS: A prospective study was conducted over a 6 month peri od in two general intensive care units (87 patients with short duration CVC ) and in 4 medical units (110 patient with cancer or HIV infection for whom long duration CVC was scheduled). The first CVC inserted was followed to w ithdrawal or for a minimal 3 months. RESULTS: The mean duration of CVC use was 7.5 and 106 days for the short an d long duration groups respectively A CVC-related infection occurred in 6 p atients in the short duration group and in 14 patients in the long duration group giving an incidence of 1.0/100 CVC days (95%Cl: 0.4 - 2.0) for the s hort-duration CVC group and 0.13/100 CVC days (95%Cl: 0.07 - 0.21) for the long-duration CVC group. Intensive care patients with a skin lesion far fro m the CVC insertion point had a higher incidence of CVC-related infection t han patients without a skin infection. Taking into account the indications for CVC, patients with cancer or HIV infection had equivalent risk of infec tion. For both short and long duration CVC use, parenteral nutrition was fo und to be a major risk factor for infectious complications. CONCLUSION: Rigorous regular surveillance of nosocomial infections on centr al catheters should be centered on those inserted for parenteral nutrition.