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Venous central line catheter management in respiratory semi-intensive care unit: The way to zero central line-associated bloodstream infections (CLABSIs) – A randomized controlled trial

Riccardo Inchingolo, Andrea Smargiassi, Giuliana Pasciuto, Giuseppe Corbo, Manuela Cavalletti, Giuliano Montemurro, Daniele Magnini, Giancarlo Scoppettuolo, Riccardo Torelli, Teresa Spanu, Maurizio Sanguinetti, Salvatore Valente
European Respiratory Journal 2014 44: P255; DOI:
Riccardo Inchingolo
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Andrea Smargiassi
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Giuliana Pasciuto
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Giuseppe Corbo
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Manuela Cavalletti
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Giuliano Montemurro
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Daniele Magnini
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Giancarlo Scoppettuolo
2Infectious Diseases, Università Cattolica del Sacro Cuore, Rome, Italy
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Riccardo Torelli
3Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy
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Teresa Spanu
3Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy
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Maurizio Sanguinetti
3Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy
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Salvatore Valente
1Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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Abstract

Aims: 1) efficacy of educational interventions on rate of CLABSIs, 2) effects of port protector, 3) rate of contamination.

9months of observation and 9months of interventional period. We enrolled patients with CVC: 1) placed in RSICU, 2) previously placed without signs of SIRS during 48h before of admittance, 3) previously placed without microbiological evidence of colonization.

During interventional period we randomized patients into two groups: 1) educational intervention plus port protector (Group 1) and 2) educational intervention (Group 2). Patients developing SIRS underwent both peripheral and central blood cultures. We identified 5 conditions: 1) CVC-related sepsis (both blood cultures positive with differential time to CVC positivity at least 2h before); 2) CVC not related sepsis (both blood cultures positive with: a) differential time to CVC positivity less than 2h or b) peripheral positivity precedes CVC one); 3) CVC colonization; 4) contamination of peripheral blood culture; 5) central and peripheral blood cultures negativity.

87 CVC were included during observational period. Catheter dwell time was 1068. CLABSIs rate was 8.4/1000. 10 sepsis (9 CLABSIs), 16 CVC colonization and 6 contamination of blood cultures were observed. 46 CVC were included during interventional period. Catheter dwell time was 707. CLABSIs rate was 1.4/1000. 21/46 CVC were included into Group 1. 5 CVC colonization (2 in Group 1), 3 contamination of blood cultures (only in Group 2) were observed. In Group 1 no CLABSIs were reported.

Both kinds of interventions significantly reduce the rate of CLABSIs.

  • Sepsis
  • Infections
  • Critically ill patients
  • © 2014 ERS
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Venous central line catheter management in respiratory semi-intensive care unit: The way to zero central line-associated bloodstream infections (CLABSIs) – A randomized controlled trial
Riccardo Inchingolo, Andrea Smargiassi, Giuliana Pasciuto, Giuseppe Corbo, Manuela Cavalletti, Giuliano Montemurro, Daniele Magnini, Giancarlo Scoppettuolo, Riccardo Torelli, Teresa Spanu, Maurizio Sanguinetti, Salvatore Valente
European Respiratory Journal Sep 2014, 44 (Suppl 58) P255;

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Venous central line catheter management in respiratory semi-intensive care unit: The way to zero central line-associated bloodstream infections (CLABSIs) – A randomized controlled trial
Riccardo Inchingolo, Andrea Smargiassi, Giuliana Pasciuto, Giuseppe Corbo, Manuela Cavalletti, Giuliano Montemurro, Daniele Magnini, Giancarlo Scoppettuolo, Riccardo Torelli, Teresa Spanu, Maurizio Sanguinetti, Salvatore Valente
European Respiratory Journal Sep 2014, 44 (Suppl 58) P255;
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