Epidemiological aspects of central vascular catheter-related infections in surgical patients admitted to the Clinical Hospital of the Federal University of Uberlândia

A prospective observational study to investigated nontunneled central venous catheter over a 24-month(set-2000/nov-2002) period in 179 patients at the Clinicai Surgical II Ward in the Uberlândia Federal University Hospital (HC-UFU) was carrried out. The colonization rate of the catheter tips was of 21,2%. The independent risk factors associated with a colonization of the catheter tip was: colonization in the insertion site of CVC ^200UFC/20cm (p—0,01,OR—2,15), hospital stay >14 days (p=0,04; OR=1,97), catheterization >7 days (p=0,038; OR=1,78). The insert in jugular vein was associated the most serious patients with following independent risk factors: internment >14 days (p=0,03; OR=2,37), catheterization £7days(p=0,01; OR=3,65) and use of >3 invasive devices(p=0,04; OR=1,89). The analysis of regression logistics for CR-BSI detected the following independent risk factors: colonization pericatheter >200 UFC/20cm2 (p102UFC (p <0,01; OR=7,95). CoNS was more isolated the skin insertion site (50%) and catheter tip (60%) and Staphylococcus auraus (48%) in the bloodstream followed by CoNS (38%) and BGN (17%). CR-BSI rate caused by S. aureus was 4,9 episodes per 1000 catheter/days. The resistance to the oxacillin was observed in 43,7% strains analysed. Nine patients presented the S. aureus simultaneously in two or three sites (CVC insetion site and/or catheter tip and/or blood) was analyzed by PFGE and Rep-PCR. Nine samples of MRSA belonged to the profile clonal A by PFGE (subclones A1, A2 and A3) and Rep-PCR demonstrated two different clones (A, B). PFGE pattems for MSSA distinguished five types (a,b,c,d and e) and Rep-PCR only three (a,b and c). We can conclude that CR-BSIs caused by policlonal S. aureus had the skin pericateter as source of this microorganism.Tese (Doutorado)Foi realizado um estudo prospectivo observacional em 179 pacientes internados na Unidade de Clinica Cirúrgica II do HC-UFU no período de setembro/2000 a novembro/2002. A taxa de colonização das pontas de cateter foi de 21,2%. Os fatores de risco independentes associados com uma ponta de cateter positiva foram:colonização no SI > 200 UFC/20cm2 (p=0,01;OR=2,15), internação >14 dias(p=0,04; OR=1,97), cateterização >7 dias(p=0,038; OR=1,78). A inserção em veia jugular esteve associada aos pacientes mais graves com seguintes fatores de risco independentes: internação >14 dias(p=0,03; OR=2,37), cateterização> 7 dias(P=0,01, OR=3,65) e uso de >3 dispositivos invasivos(p=0,04; OR=1,89). A análise de regressão logística para CR-BSI detectou os seguintes fatores de risco independentes: colonização pericateter >200UFC/20cm2 (p<0,01; OR=6,89) e ponta do cateter com £1O2UFC (p