Determinants of Clinical Recovery from Healthcare-Associated Infections in Patients with Central Venous Catheters
Keywords:
Catheter-Associated Infections ; Central Venous Catheter ; Nosocomial Infections ; Factors Risk ; Eradication PathogenAbstract
Background: Catheter-associated infections blood flow (KAIK) remains one from most heavy complications intense therapy , significant way influencing on indicators sick leave mortality and duration hospitalization . Identification clinical and anamnestic factors determining timing and probability complete recovery , critical important for optimization strategies antibacterial therapy and care for central venous catheters .
Objectives: Rate influence clinical , microbiological and demographic factors on dynamics and probability clinical recovery in patients with catheter - associated infections central veins .
Patients and methods : In a prospective observational study 142 patients with confirmed cases were included catheter-associated infections . They assessed character microflora , duration standing catheter , accompanying pathology by scale Charlson comorbidity , as well as indicators systemic inflammatory answer . Statistical analysis was performed using criteria Mann - Whitney , accurate test Fisher and regression models proportional risks Cox For definitions independent predictors recovery .
Results : Complete clinical recovery achieved in 108 patients (76.1%). Detection gram-negative pathogens , mainly Pseudomonas aeruginosa and Acinetobacter baumannii were associated with significant decrease probabilities favorable outcome ( relationship odds 0.38; 95% confidence range 0.18–0.81; p = 0.012). The ratio neutrophils to lymphocytes exceeded 8.5 in patients with protracted current infections (p < 0.001). Timely removal catheter in the first 24 hours from moment demonstrations symptoms increased probability permissions infectious process by 2.4 times (p = 0.004). Severity accompanying pathologies more than 4 points by scale Charleson was independent factor risk slow eradication pathogen .
Conclusions : Early removal central venous catheter and starting etiotropic therapy taking into account risk infection gram-negative strains are key factors that determine success treatment catheter-associated infections .
