From catheter to infection: Risk factors for central venous catheter-related infections in the intensive care unit

INTRODUCTION: A substantial proportion of critically ill patients require central venous catheterization, with infection being the most significant complication. Catheter-related infections may increase ICU length of stay, morbidity, and mortality. This study aimed to identify factors contributing to these infections. METHODS: This retrospective observational study included 1985 central venous and hemodialysis catheters meeting predefined inclusion criteria. Catheters were classified by insertion site as femoral, internal jugular, or subclavian. Catheter-related infections were assessed as percentages and as incidence per 1000 catheter-days. Infection risks were compared using relative risk (RR) with 95% confidence intervals (CI). However, incidence analysis accounting for dwell time showed a higher infection incidence in femoral catheters (13.9 per 1000 catheter-days). Compared with subclavian catheters, femoral catheters had a significantly increased infection risk (RR 1.56; 95% CI 1.07-2.28). CONCLUSION: Central venous catheter-related infections are more frequent in femoral sites in a time-dependent manner. Early replacement of femoral catheters is important to reduce infection risk. In clinical practice, prevention strategies should consider not only the insertion site but also expected duration of use, frequency of access, catheter type, patient characteristics, and infection control measures.