Kansenshogaku Zasshi
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
Effect of Preventive Measures against Central Venous Catheter-related Infection
Retrospective Study in Our Division for Recent 10 Years
Yuji HANATANISusumu KODAIRAJun-ichi GIBOHiroyuki TOEDASayoko KAWAKAMI
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JOURNAL FREE ACCESS

1999 Volume 73 Issue 10 Pages 1032-1037

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Abstract

A study was made of 2202 central venous catheters (CVC), which were inserted for recent 10 years, to know the effect of preventive measures against CVC-related infection. We divided 10 years in 3 periods: 1987-1990 (the first period), 1991-1993 (the second period), and 1994-1996 (the third period). Preventive measures such as thorough antiseptic precaution, shortening of CVC dwelling time, and prohibition of injection from three-way stopcocks were taken after the second period. In the third period, semiclosed infusion system (I-system) was introduced to our division. A febrile catheterized patient (higher than 38°C) was diagnosed as CVC-related infection when the fever droppe immediately (within 72hours) after removal of CVC, or when the tip of the CVC was positive for culture. The rate of CVC-related infection in the second (9.9%) or the third (7.3%) period was significantly lower than that (14.0%) of the first period (p<0.05 and p<0.001, respectively). The mean dwelling time of CVC was 31.5 days for the first period, 27.0 days for the second period, and 24.8 days for the third period. The rate of long-term dwelling catheters (more than 29 days) in the second (34.5%) or the third (28.7%) period was significantly lower than that (40.5%) in the first period (p<0.01 and p<0.001, respectively). The index of CVC-related infection (incidence of infection per 1, 000 days) was 4. 8 for the first period, 3.7 for the second period, and 2. 9 for the third period. The rate of infection of short-term dwelling CVC (less than 28 days) in the second (9.5%) or the third (6.3%) period was significantly lower than that (16.0%) of the first period (p<0.01 and p<0.001, respectively). As to cultures of CVC and/or blood sample, the isolation rate of fungi decreased significantly (p<0.001), and that of gram-negative rods showed a tendency to increase after the second period.
It was concluded that shortening of CVC dwelling time and application of semiclosed infusion system were effective to reduce the rate of CVC-related infection.

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© The Japansese Association for Infectious Diseases
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