Objective To investigate the risk factors of central line-associated bloodstream infection (CLABSI) and provide clinical guidance for reducing the incidence of CLABSI. Methods The clinical data of patients with central venous catheter catheterization in Sichuan Provincial People’s Hospital between January 2018 and December 2021 were retrospectively collected. According to whether CLABSI occurred, the patients were divided into CLABSI group and non-CLABSI group. The data of patients were analyzed and the risk factors of CLABIS were discussed. Results A total of 43 987 patients were included. Among them, there were 63 cases in the CLABSI group and 43924 cases in the non-CLABSI group. The incidence of CLABSI was 0.18/1 000 catheter days. Multivariate logistic regression analysis showed that admission to intensive care unit (ICU) [odds ratio (OR)=74.054, 95% confidence interval (CI) (22.661, 242.005), P<0.001], hemodialysis [OR=4.531, 95%CI (1.899, 10.809), P=0.001] and indwelling catheter days [OR=1.017, 95%CI (1.005, 1.029), P=0.005] were independent risk factors for CLABSI. A total of 63 strains of pathogenic bacteria were isolated from the 63 patients with CLABSI. Among them, 28 strains of Gram-positive bacteria, 25 strains of Gram-negative bacteria and 10 strains of Candida. Conclusions Admission to ICU, hemodialysis and long-term indwelling catheter are independent risk factors for CLABSI. The prevention and control measures of CLABSI should be strictly implemented for such patients to reduce the risk of infection.
Objective To evaluate the methodological quality and reporting quality of clinical guidelines and consensus on central venous catheters. Methods The PubMed, EMbase, Web of Science, CBM, WanFang Data, CNKI databases and Guidelines International Network, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Medive.cn websites were searched to collect clinical guidelines and consensus related to central venous catheters. The retrieval time was from the establishment of the database to October 2022. Two researchers independently screened the literature, extracted data and used evaluation tools AGREE Ⅱ and RIGHT to evaluate the quality of the included studies. Results A total of 34 central venous catheter guidelines and consensus were included. The average score for each field of AGREE II was 53.73% for scope and purpose, 39.26% for participants, 39.57% for rigor, 46.76% for clarity, 30.23% for application and 49.18% for editorial independence. Items 1a, 1b, 3, and 4 (100.00%) had the highest reporting rate in the RIGHT evaluation items, followed by items 19a (97.05%), 2/19b (94.11%), 20 (91.17%), 7b/11a (88.23%), and 7a (85.29%). The reporting rate of the remaining items was below 60%. Subgroup analysis results showed that the average score and RIGHT score of the guidance class in the four fields of AGREE Ⅱ (rigor, clarity, application and editorial independence) were higher than those of the consensus class. Guidelines and consensus formulated based on evidence-based medicine methods were higher than those formulated based on expert opinions or reviews in the three fields of AGREE II (rigor, application and editorial independence). The average scores of foreign guidelines and consensus in 6 fields and RIGHT scores of AGREE Ⅱ were higher than those of domestic guidelines and consensus. Conclusion The AGREE Ⅱ of 6 fields average score and RIGHT score in foreign guidelines are higher than those in domestic guidelines.