Japanese Society for Infection Prevention and Control-Online Journal

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Risk Factors for Central Line Associated Bloodstream Infection in Patients with Inflammatory Bowel Disease

Kaori ISHIKAWA¹⁾, Yoshio TAKESUE¹⁾, Kaoru ICHIKI¹⁾, Toshie TSUCHIDA²⁾, Kazuhiko NAKAJIMA¹⁾, Takashi UEDA¹⁾, Kumiko YAMADA¹⁾ and Yoshiko TAKAHASHI³⁾
¹⁾Department of Infection Prevention and Control, Hospital of Hyogo College of Medicine, ²⁾School of Nursing, Graduate School of Nursing, Hyogo University of Health Sciences, ³⁾Department of Pharmacy, Hospital of Hyogo College of Medicine

Parenteral nutrition using central venous catheter (CVC) is common in patients with inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn's disease (CD). We investigated the risk factors for central line-associated blood stream infections (CLABSI) in patients admitted on the ward of digestive tract internal medicine. Patients with home parenteral nutrition were excluded. In addition to 13 factors related to the host and 3 factors for the management of CVC, disease activity (UC, Mayo score; CD, CD activity index) was evaluated. A total of 562 patients were included (UC 562, CD 334). The incidences of CLABSI were 9.6% in total, 8.3% in patients with UC, and 10.5% in patients with CD, and rates per 1,000 device days were 4.9, 4.4, and 5.3, respectively. Independent risk factors for CLABSI were the use of biological product (odds ratio: 4.98, 95% confidence interval: 1.81-13.69) in patients with UC and men (5.38, 1.85-15.64) and moderate/severe disease activity (2.54, 1.20-5.38) in patients with CD. Routine bath/shower during the CVC use decreased the risk (UC: 0.17, 0.06-0.44; CD: 0.33, 0.15-0.72). In conclusion, the identified risk factors for CLABSI in IBD were different from the common risk factors reported previously. Routine hygiene management with bath/shower was required to prevent CLABSI.

Key words：inflammatory bowel disease, Crohn's disease, ulcerative colitis, central line-associated bloodstream infection, risk factor

e-mail: i-kaori＠hyo-med.ac.jp

Received: May 23, 2019
Accepted: September 5, 2019

34 (6)：296─301,2019