Impact of an Anti-infection Double Lumen Bundle on the incidence of central venous catheter-related infections in haematological patients: a retrospective cohort study

抗感染双腔管束对血液病患者中心静脉导管相关感染发生率的影响:一项回顾性队列研究

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Abstract

BACKGROUND: Central venous catheters (CVCs) are commonly used in patients with haematological diseases but are associated with infectious complications. The CVC Anti-infection Double Lumen Bundle was introduced in December 2020 to reduce this risk. The bundle included a double-lumen noble metal alloy-coated CVC and chlorhexidine-impregnated dressings. This study evaluated whether the bundle was associated with a reduction in catheter-related infections. METHODS: Non-tunnelled CVC insertions with a dwell time ≥24 h in adults treated for haematological diseases between May 2013 and June 2024 were included. Data were extracted from the electronic health records. The main objectives of the study were to investigate the proportions of suspected catheter-related infection (sCRI) and catheter-related bloodstream infection (CRBSI). Secondary objectives were catheter tip colonization and incidence of sCRI and CRBSI per 1000 catheter-days. RESULTS: A total of 907 CVC insertions in 690 patients were analysed (471 before and 436 after the bundle implementation date). No differences were observed in the proportions of sCRI (6.4% vs 7.6%), CRBSI (0.4% vs 0.7%) or catheter tip colonization (4.7% vs 4.4%). The incidence per 1000 catheter-days also did not differ (sCRI: 1.67 vs 2.34 and CRBSI: 0.11 vs 0.21). In multi-variable analysis, no variables were associated with a higher risk of sCRI, whereas antibiotic administration at insertion was associated with a lower risk. CONCLUSION: The introduction of the Anti-infection Double Lumen Bundle did not reduce CVC-related infectious complications in patients with haematological diseases.

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