Arterial catheter-related bloodstream infections: results of an 8-year survey in a surgical intensive care unit.

Objectives: To determine whether a policy based on provisional replacement of catheters every 5 days had an impact on the incidence of arterial catheter-related bloodstream infections in a population of adult surgical intensive care unit patients.
Design: Prepost study in which all patients with an arterial catheter who were admitted between 1997 and 2004 were observed. Scheduled replacement of arterial catheters every 5 days during period A (before 2000) was compared to nonscheduled replacement during period B (after 2000).
Setting: A 20-bed surgical intensive care unit at a French university hospital.
Patients: All intensive care unit patients requiring an arterial catheter.
Interventions: Modification to the catheter maintenance policies between period A and period B.
Measurements and Main Results: A total of 1,672 consecutive patients were included, and 3,247 arterial catheters were analyzed, yielding an average number of 1.9 (sd, 1.7) arterial catheters per patient. The rate of colonization (14.2% before 2000 vs. 16.4% after 2000; p = .10) and the incidence density of arterial catheter colonization (31.32 [95% confidence interval] 27.07-36.25 per 1,000 catheter-days before 2000 vs. 29.79 [95% confidence interval, 26.72-33.21] per 1,000 catheter-days after 2000; p = .11) did not differ significantly between the two periods. However, the rate of arterial catheter-related bloodstream infections (1.4% before 2000 vs. 0.6% after 2000; p = .01) and the arterial catheter-related bloodstream infections incidence density (3.13 [95% confidence interval, 1.97-4.97] before 2000 vs. 1.01 [95% confidence interval, 0.56-1.82] per 1,000 catheter-days after 2000; p < .0001) was significantly higher before 2000.
Conclusion: Discontinuation of scheduled replacement of arterial catheters every 5 days did not increase the risk of colonization but decreased the risk of bloodstream infections.