Dialysis and central venous catheter infections in critically ill patients: Results of a prospective study

Objective: To determine the incidence of dialysis catheter (DC)-related inf ections in intensive care unit (ICU) patients, and to compare the frequency of DG and central venous catheter (CVC) infections in an ICU setting. Design: Prospective, descriptive survey. Setting: An adult, 10-bed medical/surgical ICU at a university hospital. Patients: A total of 151 DCs and 230 CVCs placed in 170 patients were evalu ated. Interventions: None. Measurements and Main Results: Catheter colonization was defined by a quant itative catheter tip culture yielding greater than or equal to 10(3) colony -forming units/mL, catheter-related bacteremia was defined as catheter colo nization and blood culture positive for the same organism, and site infecti on was defined as the presence of pus at the insertion site. The mean durat ion of catheterization was 6.8 +/- 6 days for DGs and 5.9 +/- 4.6 for CVCs (p = .52). There was no difference between DCs and CVCs in catheter coloniz ation and catheter-related bacteremia incidence rates per 1000 days of cath eter use (24.2 vs. 19.8 [p = .46] and 0.96 vs. 1.5 [p = .60], respectively) . Site infection was observed in one patient (CVC placement). For DCs and C VCs the duration of catheterization was associated with catheter infection (p = .0007 and p = .04, respectively), but when the catheters were examined over 5-day intervals, the incidence of catheter infections did not increas e with duration of catheter use (p = .23 and p = .10, respectively). Conclusions: DG-related infections are associated with DC longevity. As sho wn by the 5-day-interval analysis, the incidence of DG-related infections d id not increase with DG duration, suggesting that the risk for DC-related i nfections remained unchanged with time. The characteristics of DG-related i nfections in ICU patients were comparable to those previously reported for CVC-related infections.