Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study

Lotte Exterkate; Arne J van Tienhoven; Mark E Haaksma; Micah L A Heldeweg; Lucas Fleuren; Patrick Thoral; Tariq A Dam; Leo M A Heunks; Diederik Gommers; Olaf L Cremer; Rob J Bosman; Sander Rigter; Evert-Jan Wils; Tim Frenzel; Alexander P Vlaar; Dave A Dongelmans; Remko de Jong; Marco Peters; Marlijn J A Kamps; Dharmanand Ramnarain; Ralph Nowitzky; Fleur G C A Nooteboom; Wouter de Ruijter; Louise C Urlings-Strop; Ellen G M Smit; D Jannet Mehagnoul-Schipper; Tom Dormans; Cornelis P C de Jager; Stefaan H A Hendriks; Sefanja Achterberg; Evelien Oostdijk; Auke C Reidinga; Barbara Festen-Spanjer; Gert B Brunnekreef; Alexander D Cornet; Walter van den Tempel; Age D Boelens; Peter Koetsier; Judith Lens; Harald J Faber; A Karakus; Robert Entjes; Paul de Jong; Thijs C D Rettig; Sesmu Arbous; Bas Vonk; Tomas Machado; Armand R J Girbes; Elske Sieswerda; Paul W G Elbers; Pieter R Tuinman

doi:10.1097/SHK.0000000000001994

Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study

Lotte Exterkate
, Arne J van Tienhoven
, Mark E Haaksma
, Micah L A Heldeweg
, Lucas Fleuren
, Patrick Thoral
, Tariq A Dam
, Leo M A Heunks
, Diederik Gommers
, Olaf L Cremer
, Rob J Bosman
, Sander Rigter
, Evert-Jan Wils
, Tim Frenzel
, Alexander P Vlaar
, Dave A Dongelmans
, Remko de Jong
, Marco Peters
, Marlijn J A Kamps
, Dharmanand Ramnarain

Ralph Nowitzky, Fleur G C A Nooteboom, Wouter de Ruijter, Louise C Urlings-Strop, Ellen G M Smit, D Jannet Mehagnoul-Schipper, Tom Dormans, Cornelis P C de Jager, Stefaan H A Hendriks, Sefanja Achterberg, Evelien Oostdijk, Auke C Reidinga, Barbara Festen-Spanjer, Gert B Brunnekreef, Alexander D Cornet, Walter van den Tempel, Age D Boelens, Peter Koetsier, Judith Lens, Harald J Faber, A Karakus, Robert Entjes, Paul de Jong, Thijs C D Rettig, Sesmu Arbous, Bas Vonk, Tomas Machado, Armand R J Girbes, Elske Sieswerda, Paul W G Elbers, Pieter R Tuinman

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Abstract

Background: Aims of this study were to investigate the prevalence and incidence of catheter-related infection, identify risk factors, and determine the relation of catheter-related infection with mortality in critically ill COVID-19 patients. Methods: This was a retrospective cohort study of central venous catheters (CVCs) in critically ill COVID-19 patients. Eligible CVC insertions required an indwelling time of at least 48 hours and were identified using a full-admission electronic health record database. Risk factors were identified using logistic regression. Differences in survival rates at day 28 of follow-up were assessed using a log-rank test and proportional hazard model. Results: In 538 patients, a total of 914 CVCs were included. Prevalence and incidence of suspected catheter-related infection were 7.9% and 9.4 infections per 1,000 catheter indwelling days, respectively. Prone ventilation for more than 5 days was associated with increased risk of suspected catheter-related infection; odds ratio, 5.05 (95% confidence interval 2.12-11.0). Risk of death was significantly higher in patients with suspected catheter-related infection (hazard ratio, 1.78; 95% confidence interval, 1.25-2.53). Conclusions: This study shows that in critically ill patients with COVID-19, prevalence and incidence of suspected catheter-related infection are high, prone ventilation is a risk factor, and mortality is higher in case of catheter-related infection.

Original language	English
Pages (from-to)	358-365
Number of pages	8
Journal	Shock (Augusta, Ga.)
Volume	58
Issue number	5
Early online date	8 Sept 2022
DOIs	https://doi.org/10.1097/SHK.0000000000001994
Publication status	Published - 1 Nov 2022

Keywords

catheter-related infections
Central venous catheters
COVID-19
intensive care

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10.1097/SHK.0000000000001994

INCIDENCE,_RISK_FACTORS,_AND_OUTCOME_OF_SUSPECTED.2Final published version, 403 KBLicence: Taverne

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Exterkate, L., van Tienhoven, A. J., Haaksma, M. E., Heldeweg, M. L. A., Fleuren, L., Thoral, P., Dam, T. A., Heunks, L. M. A., Gommers, D., Cremer, O. L., Bosman, R. J., Rigter, S., Wils, E.-J., Frenzel, T., Vlaar, A. P., Dongelmans, D. A., de Jong, R., Peters, M., Kamps, M. J. A., ... Tuinman, P. R. (2022). Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study. Shock (Augusta, Ga.), 58(5), 358-365. https://doi.org/10.1097/SHK.0000000000001994

@article{21f8b38721d7460d87e7fc7af3569833,

title = "Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study",

abstract = "Background: Aims of this study were to investigate the prevalence and incidence of catheter-related infection, identify risk factors, and determine the relation of catheter-related infection with mortality in critically ill COVID-19 patients. Methods: This was a retrospective cohort study of central venous catheters (CVCs) in critically ill COVID-19 patients. Eligible CVC insertions required an indwelling time of at least 48 hours and were identified using a full-admission electronic health record database. Risk factors were identified using logistic regression. Differences in survival rates at day 28 of follow-up were assessed using a log-rank test and proportional hazard model. Results: In 538 patients, a total of 914 CVCs were included. Prevalence and incidence of suspected catheter-related infection were 7.9\% and 9.4 infections per 1,000 catheter indwelling days, respectively. Prone ventilation for more than 5 days was associated with increased risk of suspected catheter-related infection; odds ratio, 5.05 (95\% confidence interval 2.12-11.0). Risk of death was significantly higher in patients with suspected catheter-related infection (hazard ratio, 1.78; 95\% confidence interval, 1.25-2.53). Conclusions: This study shows that in critically ill patients with COVID-19, prevalence and incidence of suspected catheter-related infection are high, prone ventilation is a risk factor, and mortality is higher in case of catheter-related infection.",

keywords = "catheter-related infections, Central venous catheters, COVID-19, intensive care",

author = "Lotte Exterkate and \{van Tienhoven\}, \{Arne J\} and Haaksma, \{Mark E\} and Heldeweg, \{Micah L A\} and Lucas Fleuren and Patrick Thoral and Dam, \{Tariq A\} and Heunks, \{Leo M A\} and Diederik Gommers and Cremer, \{Olaf L\} and Bosman, \{Rob J\} and Sander Rigter and Evert-Jan Wils and Tim Frenzel and Vlaar, \{Alexander P\} and Dongelmans, \{Dave A\} and \{de Jong\}, Remko and Marco Peters and Kamps, \{Marlijn J A\} and Dharmanand Ramnarain and Ralph Nowitzky and Nooteboom, \{Fleur G C A\} and \{de Ruijter\}, Wouter and Urlings-Strop, \{Louise C\} and Smit, \{Ellen G M\} and Mehagnoul-Schipper, \{D Jannet\} and Tom Dormans and \{de Jager\}, \{Cornelis P C\} and Hendriks, \{Stefaan H A\} and Sefanja Achterberg and Evelien Oostdijk and Reidinga, \{Auke C\} and Barbara Festen-Spanjer and Brunnekreef, \{Gert B\} and Cornet, \{Alexander D\} and \{van den Tempel\}, Walter and Boelens, \{Age D\} and Peter Koetsier and Judith Lens and Faber, \{Harald J\} and A Karakus and Robert Entjes and \{de Jong\}, Paul and Rettig, \{Thijs C D\} and Sesmu Arbous and Bas Vonk and Tomas Machado and Girbes, \{Armand R J\} and Elske Sieswerda and Elbers, \{Paul W G\} and Tuinman, \{Pieter R\}",

year = "2022",

month = nov,

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doi = "10.1097/SHK.0000000000001994",

language = "English",

volume = "58",

pages = "358--365",

journal = "Shock (Augusta, Ga.)",

issn = "1073-2322",

publisher = "Lippincott Williams \& Wilkins",

number = "5",

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Exterkate, L, van Tienhoven, AJ, Haaksma, ME, Heldeweg, MLA, Fleuren, L, Thoral, P, Dam, TA, Heunks, LMA, Gommers, D, Cremer, OL, Bosman, RJ, Rigter, S, Wils, E-J, Frenzel, T, Vlaar, AP, Dongelmans, DA, de Jong, R, Peters, M, Kamps, MJA, Ramnarain, D, Nowitzky, R, Nooteboom, FGCA, de Ruijter, W, Urlings-Strop, LC, Smit, EGM, Mehagnoul-Schipper, DJ, Dormans, T, de Jager, CPC, Hendriks, SHA, Achterberg, S, Oostdijk, E, Reidinga, AC, Festen-Spanjer, B, Brunnekreef, GB, Cornet, AD, van den Tempel, W, Boelens, AD, Koetsier, P, Lens, J, Faber, HJ, Karakus, A, Entjes, R, de Jong, P, Rettig, TCD, Arbous, S, Vonk, B, Machado, T, Girbes, ARJ, Sieswerda, E, Elbers, PWG & Tuinman, PR 2022, 'Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study', Shock (Augusta, Ga.), vol. 58, no. 5, pp. 358-365. https://doi.org/10.1097/SHK.0000000000001994

Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study. / Exterkate, Lotte; van Tienhoven, Arne J; Haaksma, Mark E et al.
In: Shock (Augusta, Ga.), Vol. 58, No. 5, 01.11.2022, p. 358-365.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients

T2 - A Multicenter Retrospective Cohort Study

AU - Exterkate, Lotte

AU - van Tienhoven, Arne J

AU - Haaksma, Mark E

AU - Heldeweg, Micah L A

AU - Fleuren, Lucas

AU - Thoral, Patrick

AU - Dam, Tariq A

AU - Heunks, Leo M A

AU - Gommers, Diederik

AU - Cremer, Olaf L

AU - Bosman, Rob J

AU - Rigter, Sander

AU - Wils, Evert-Jan

AU - Frenzel, Tim

AU - Vlaar, Alexander P

AU - Dongelmans, Dave A

AU - de Jong, Remko

AU - Peters, Marco

AU - Kamps, Marlijn J A

AU - Ramnarain, Dharmanand

AU - Nowitzky, Ralph

AU - Nooteboom, Fleur G C A

AU - de Ruijter, Wouter

AU - Urlings-Strop, Louise C

AU - Smit, Ellen G M

AU - Mehagnoul-Schipper, D Jannet

AU - Dormans, Tom

AU - de Jager, Cornelis P C

AU - Hendriks, Stefaan H A

AU - Achterberg, Sefanja

AU - Oostdijk, Evelien

AU - Reidinga, Auke C

AU - Festen-Spanjer, Barbara

AU - Brunnekreef, Gert B

AU - Cornet, Alexander D

AU - van den Tempel, Walter

AU - Boelens, Age D

AU - Koetsier, Peter

AU - Lens, Judith

AU - Faber, Harald J

AU - Karakus, A

AU - Entjes, Robert

AU - de Jong, Paul

AU - Rettig, Thijs C D

AU - Arbous, Sesmu

AU - Vonk, Bas

AU - Machado, Tomas

AU - Girbes, Armand R J

AU - Sieswerda, Elske

AU - Elbers, Paul W G

AU - Tuinman, Pieter R

PY - 2022/11/1

Y1 - 2022/11/1

N2 - Background: Aims of this study were to investigate the prevalence and incidence of catheter-related infection, identify risk factors, and determine the relation of catheter-related infection with mortality in critically ill COVID-19 patients. Methods: This was a retrospective cohort study of central venous catheters (CVCs) in critically ill COVID-19 patients. Eligible CVC insertions required an indwelling time of at least 48 hours and were identified using a full-admission electronic health record database. Risk factors were identified using logistic regression. Differences in survival rates at day 28 of follow-up were assessed using a log-rank test and proportional hazard model. Results: In 538 patients, a total of 914 CVCs were included. Prevalence and incidence of suspected catheter-related infection were 7.9% and 9.4 infections per 1,000 catheter indwelling days, respectively. Prone ventilation for more than 5 days was associated with increased risk of suspected catheter-related infection; odds ratio, 5.05 (95% confidence interval 2.12-11.0). Risk of death was significantly higher in patients with suspected catheter-related infection (hazard ratio, 1.78; 95% confidence interval, 1.25-2.53). Conclusions: This study shows that in critically ill patients with COVID-19, prevalence and incidence of suspected catheter-related infection are high, prone ventilation is a risk factor, and mortality is higher in case of catheter-related infection.

AB - Background: Aims of this study were to investigate the prevalence and incidence of catheter-related infection, identify risk factors, and determine the relation of catheter-related infection with mortality in critically ill COVID-19 patients. Methods: This was a retrospective cohort study of central venous catheters (CVCs) in critically ill COVID-19 patients. Eligible CVC insertions required an indwelling time of at least 48 hours and were identified using a full-admission electronic health record database. Risk factors were identified using logistic regression. Differences in survival rates at day 28 of follow-up were assessed using a log-rank test and proportional hazard model. Results: In 538 patients, a total of 914 CVCs were included. Prevalence and incidence of suspected catheter-related infection were 7.9% and 9.4 infections per 1,000 catheter indwelling days, respectively. Prone ventilation for more than 5 days was associated with increased risk of suspected catheter-related infection; odds ratio, 5.05 (95% confidence interval 2.12-11.0). Risk of death was significantly higher in patients with suspected catheter-related infection (hazard ratio, 1.78; 95% confidence interval, 1.25-2.53). Conclusions: This study shows that in critically ill patients with COVID-19, prevalence and incidence of suspected catheter-related infection are high, prone ventilation is a risk factor, and mortality is higher in case of catheter-related infection.

KW - catheter-related infections

KW - Central venous catheters

KW - COVID-19

KW - intensive care

UR - https://www.scopus.com/pages/publications/85143088327

U2 - 10.1097/SHK.0000000000001994

DO - 10.1097/SHK.0000000000001994

M3 - Article

C2 - 36155964

SN - 1073-2322

VL - 58

SP - 358

EP - 365

JO - Shock (Augusta, Ga.)

JF - Shock (Augusta, Ga.)

IS - 5

ER -

Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study

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