EVALUATION OF THE INCIDENCE OF CENTRAL VENOUS CATHETER LINE INFECTION IN PATIENTS ADMITTED IN THE INTENSIVE CARE UNITS OF UNTH ENUGU: RISK FACTORS AND MICROBIOLOGY PROFILE
Background: University of Nigeria teaching hospital has two functional intensive care units(ICU), each is a 5 bedded ICU. Patients admitted in the intensive care unit often require the insertion of various invasive devices such as Central venous catheter, and arterial line for monitoring and therapeutic interventions. These devices though indispensable in the management of these patients in ICU but often puts them at risk of various iatrogenic complications and central venous catheter blood stream infection resulting in prolonged hospital stay, increase morbidity, mortality and cost.
Objective: This prospective observational study was aimed at evaluating the incidence of central venous line infection with its risk factors and microbiology profile among patients in UNTH ICUs. The study was conducted over twelve monthsperiod in the two ICUs of UNTH.
Methodology: Patients admitted into these ICUs, who routinely had CVC inserted in them and met the inclusion criteria were recruited for the study. The first blood sample was collected from each patient and sent for full blood count to ascertain blood sterility. The patients whose blood samples had evidence of infection were excluded as the study was aimed at CVC infection acquired in the ICU. A total of 68 patients were recruited but 65patients completed the study. Blood samples were collected aseptically from a peripheral vein 72 hours after insertion of CVC and at removal of CVC for blood culture. The distal 5cm of the CVC was also collected aseptically when disconnected from patient for catheter tip MCS.
Result:A total of 6(9.2%) of the 65 patients had CVC-BSI while 31(48%) had CVC colonization. 1(2.3%) patients whose duration of catheterization was within 5 days had CVC-BSI while 5(22.7%) whose duration of catheterization was beyond 5days had CVC-BSI. Duration of catheterization was the only risk factors and was statistically significant. A total of 37 organisms where isolated and the commonest bacterial isolate was staphylococcus aureus. The bacterial isolates were mostly susceptible to Gentamycin. The organisms showed a high resistance to the antibiotics tested. All the patients were on prophylactic antibiotic.
Conclusion: It was evident in this study that the incidence of central venous catheter blood stream infection and CVC colonization in ICU of UNTH Enugu was 9% and 31% respectively