Risk Factors and Clinical Characteristics of Catheter Line-associated Bloodstream Infection in MIMIC IV Database

Background: Central line-associated bloodstream infection (CLABSI) is a common hospital infection. The increasing use of peripherally inserted central catheters and fully implanted venous ports, data on the epidemiological and clinical characteristics of CLABSI in the overall central venous catheter (CVC) population remain limited. The Medical Information Mart for Intensive Care (MIMIC IV) database is a free, open, and public resource research database. The purpose of this study was to describe the risk factors and clinical characteristics of CLABSI in MIMIC IV. Methods: A total of 31,116 patients were included in this study. General information, CVC-related information, comorbidity information, microbiological information, and antibiotic use information were extracted to describe and analyze the clinical characteristics of patients with CLABSI. Results: According to the occurrence of CLABSI, 31,116 patients were divided into the NO CLABSI group (n=30,395) and CLABSI group (n=721). The total indwelling duration of CVC was 439,239.6 days, The incidence of CLABSI is 2.32% and 1.64/1000 catheter days. The risk factors for CLABSI were the number of CVC type, duration of CVC, number of antibiotic type, duration of antibiotics, and femoral vein and internal jugular vein intubation. The in-hospital mortality of the CLABSI group was higher than that of the NO CLABSI group, but no statistical significance was observed (P>0.05). Gram-positive (G+) cocci and Gram-negative (G-) bacilli accounted for 80% and 16.93% of positive bacteria in catheter culture. G+ cocci and G- bacilli accounted for 59.45% and 25.62% of positive bacteria in blood culture. Drugs with the highest resistance rates in catheter culture included penicillin G benzathine, oxacillin, and erythromycin. The most commonly used antibiotics for the treatment of CLABSI included vancomycin, cefepime, piperacillin tazobactam, and cefazolin. Conclusions: This study investigated independent risk factors for CLABSI and their association with in-hospital mortality and described the etiological characteristics, drug sensitivity, and the distribution of antibiotics used for treatment.