ABSTRACT
The current work was designed to study the incidence of central venous catheter [CVC] infection and associated septicemia in critically ill patients admitted to the Intensive Care Unit, Armed Forces Hospital, Kuwait. We aimed also at assessing the value of blood culture as a parameter of catheter related sepsis and at determining the risk factors associated with seeding the catheters with micro organisms. Cultures of the tips and subdermal segment of 60 catheters inserted in the internal jugular or the subclavian veins, as well as 80 blood cultures, 80 skin entry site cultures, 100 distant foci of infection cultures, and 70 infusion fluid cultures were studied. CVC colonization rate was 15%, and infection rate was 8.3%. Catheter- related sepsis was primary in 5% and secondary in 3.3% of cases. 47% of positive blood cultures were associated with positive tips. Many factors appeared to affect seeding of our catheters with micro orgnisms, first of all was the existence of the same micro organisms in other body sites as well as contaminated infusion fluids. Staphylococcus epidermidis was the most commonly isolated micro organisms whether from colonized or infected catheters. Catheters inserted in the internal jugular were seeded by micro organisms more readily than those inserted in the subclavian veins. There was a direct proportion between colonization and/or infection of CVCs and the duration of their stay. Positive subdermal catheter segments were found to be a manifestation rather than a cause of positive catheters. We conclude that monitoring of CVC colonization and infection rates provide guidelines for periodic modification of our hospital CVC care protocol and for assessing various risk factors. Blood culture can be considered the only valuable parameter of catheter- related sepsis