Predictors of infection clearance rate in intensive care unit patients with catheter-related bloodstream infection

Arjun Patel; A. Reddy; K. Nair

doi:10.5281/zenodo.22812897

Authors

Arjun Patel Division of Clinical Bacteriology, Seine Research Center for Medical Microbiology Author https://orcid.org/8214-0017-0035-6149
A. Reddy Department of Medical Microbiology, Murray Research Center for Medical Microbiology Author https://orcid.org/3527-9696-7426-7078
K. Nair Division of Clinical Bacteriology, Fraser Academy of Medical Microbiology Author https://orcid.org/7230-2035-0146-4475

DOI:

https://doi.org/10.5281/zenodo.22812897

Keywords:

catheter-related bloodstream infection, intensive care unit, microbiological clearance, catheter removal, predictors

Abstract

Graphical abstract

Background: Catheter-related bloodstream infection (CRBSI) is a major preventable cause of morbidity and mortality in intensive care unit (ICU) patients, and clinicians must decide rapidly whether to remove or attempt to salvage an infected catheter [6,1].

Objective: This study aimed to identify independent clinical, microbiological, and catheter-management predictors of seven-day microbiological clearance in ICU patients with CRBSI.

Methods: We performed a retrospective cohort study of 198 CRBSI episodes in 187 ICU patients at a tertiary referral center over five years, defining clearance as two consecutive negative blood cultures within seven days of appropriate therapy, and analyzed predictors using multivariable logistic regression.

Results: Overall, 66.7% of episodes cleared within seven days. Catheter removal within 24 hours (adjusted OR 3.42), coagulase-negative staphylococcal infection (aOR 2.61), timely appropriate empiric therapy (aOR 2.35), and absence of septic shock (aOR 2.18) independently predicted clearance, while Candida infection (aOR 0.44) and immunosuppression (aOR 0.48) independently predicted failure to clear [10,12].

Conclusions: Prompt catheter removal, causative organism, timely appropriate therapy, and illness severity independently determine clearance rate in ICU-associated CRBSI, supporting organism-informed, early source-control decision-making [13,9].

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