Trends of central line-associated bloodstream infections in the intensive care unit in the Kingdom of Bahrain: Four years’ experience

Table 1 Univariate analysis of risk factors for central line-associated bloodstream infections

Potential risk factor		CLABSI cases, n = 34, n (%)	Control, n = 1600, n (%)	P value1
Age	< 50 yr	11 (32)	672 (42)	0.13
	> 50 yr	23 (68)	928 (58)
Gender	Male	20 (59)	880 (55)	0.32
	Female	14 (41)	720 (45)
Primary clinical diagnosis	Medical	24 (71)	1056 (66)	2.88
	Surgical	10 (29)	544 (34)
Catheter insertion site	Subclavian	4 (11)	496 (31)	< 0.05
	Jugular	10 (30)	464 (29)
	Femoral	20 (59)	640 (40)
ICU time interval from ICU admission till line insertion	< 5 d	19 (56)	1408 (88)	< 0.05
	> 5 d	15 (44)	192 (12)
Location of central line insertion	ICU	20 (59)	1216 (76)	< 0.05
	Non-ICU	14 (41)	384 (24)
Length of duration central line	< 1 wk	11 (32)	1438 (90)	< 0.001
	> 1 wk	23 (68)	162 (10)
Death		15 (44)	432 (27)	< 0.01
A live discharge		19 (54)	1168 (73)	< 0.01

¹Using Chi-squared test.

ICU: Intensive care unit; CLABSI: Central line-associated bloodstream infections.

Table 2 The microbiological causes of central line-associated bloodstream infections

Organism	Number (percentage out of total 34), n (%)	MDR organism, n (%)
Gram negative bacteria
Acinetobacter	5 (15)	3 MDR1 (60)
Escherichia coli	4 (12)	1 ESBL (25) 2 CRE (50)
Pseudomonas	4 (12)	2 CRP (50)
Klebsiella	3 (8)	2 CRE (66)
Morganella	1 (3)
Serratia	1 (3)
Stenotrophomonas maltophilia	1 (3)
Total gram negative	19 (56)	10 (53)
Gram positive bacteria
Enterococcus	5 (15)	3 VRE (60)
Coagulase negative Staphylococcus	6 (18)	6 MRCONS (100)
Staphylococcus aureus	2 (5)	1MRSA (50)
Streptococcus viridans	1 (3)
Total gram positive	14 (41)	10 (71)
Candida species	1 (3)
Total	34 (100)	20/34 (59)

¹Multi-drug resistance: Resistant to > 3 classes of antimicrobial.

CRE: Carbapenem resistant enterobacteriasae; ESBL: Extended spectrum B lactamase producer; CRP: Carbapenem resistant pseudomonas; VRE: Vancomycin resistant enterococcus; MRCONS: Methicillin resistant coagulase negative staphylococcus; MRSA: Methicillin resistant staphylococcus aureus; MDR: Multi-drug resistance.

Table 3 Antibiotics sensitivity percentage of the common gram-positive causative organisms for central line-associated bloodstream infections in our study

Antibiotic	Staphylococcus aureus, n (%) = 2 (5)	Coagulase negative Staphylococcus,n (%) = 6 (18)	Enterococcus, n (%) = 5 (15)
Penicillin	0/2 (0)	0/6 (0)	1/5 (20)
Ampicillin			1/5 (20)
Erythromycin	1/2 (50)	0/6 (0)	0/5 (0)
Clinamycin	1/2 (50)	3/6 (50)
Trimethoprim sulphamethoxazole	1/2 (50)	1/6 (16)
Vancomycin	2/2 (100)	6/6 (100)	2/5 (40)
Cloxacillin	1/2 (50)	0/6 (0)
Tetracycline	1/2 (50)	3/6 (50)
Linazolid	2/2 (100)	6/6 (100)	5/5 (100)
Daptomycin	2/2 (100)	6/6 (100)	5/5 (100)

Table 4 Antibiotics sensitivity percentage of the common gram-negative causative organisms for central line-associated bloodstream infections in our study

Antimicrobial agent	Acinetobacter baumanii	Pseudomonas aeruginosa	Escherichia coli	Klebsiella
	n (%) = 5 (15)	n (%) = 4 (12)	n (%) = 4 (12)	n (%) = 3 (9)
Piperacillin tazobactam	2/5 (40)	4/4 (100)
Ceftriaxone			1/4 (25)	1/3 (33)
Ceftazidime	2/5 (40)	4/4 (100)	1/4 (25)	1/3 (33)
Cefipime	2/5 (40)	4/4 (100)	1/4 (25)	1/3 (33)
Merpenem	2/5 (40)	4/4 (100)	2/4 (50)	1/3 (33)
Imipenem	2/5 (40)	2/4 (50)	2/4 (50)	1/3 (33)
Ciprofloxacin	2/5 (40)	4/4 (100)	1/4 (25)	1/3 (33)
Gentamicin	2/5 (40)	4/4 (100)	1/4 (25)	1/3 (33)
Amikacin	2/5 (40)	4/4 (100)	1/4 (25)	1/3 (33)
Colistin	5/5 (100)	4/4 (100)	4/4 (100)	3/3 (100)