Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center Study

Catheter-associated bloodstream infections (CABSIs) and catheter-related bloodstream infections (CRBSIs) are significant causes of morbidity and mortality worldwide. The current practice favors the removal of vascular access devices (VADs); however, the evidence on this topic remains inconclusive. T...

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Main Authors: Giovanni De Capitani, Marta Colaneri, Claudia Conflitti, Fabio Borgonovo, Lucia Galli, Giovanni Scaglione, Camilla Genovese, Rebecca Fattore, Monica Schiavini, Beatrice Caloni, Daniele Zizzo, Nicola Busatto, Antonio Gidaro, Alba Taino, Maria Calloni, Francesco Casella, Arianna Bartoli, Chiara Cogliati, Emanuele Palomba, Spinello Antinori, Andrea Gori, Antonella Foschi
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/13/5/1085
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author Giovanni De Capitani
Marta Colaneri
Claudia Conflitti
Fabio Borgonovo
Lucia Galli
Giovanni Scaglione
Camilla Genovese
Rebecca Fattore
Monica Schiavini
Beatrice Caloni
Daniele Zizzo
Nicola Busatto
Antonio Gidaro
Alba Taino
Maria Calloni
Francesco Casella
Arianna Bartoli
Chiara Cogliati
Emanuele Palomba
Spinello Antinori
Andrea Gori
Antonella Foschi
author_facet Giovanni De Capitani
Marta Colaneri
Claudia Conflitti
Fabio Borgonovo
Lucia Galli
Giovanni Scaglione
Camilla Genovese
Rebecca Fattore
Monica Schiavini
Beatrice Caloni
Daniele Zizzo
Nicola Busatto
Antonio Gidaro
Alba Taino
Maria Calloni
Francesco Casella
Arianna Bartoli
Chiara Cogliati
Emanuele Palomba
Spinello Antinori
Andrea Gori
Antonella Foschi
author_sort Giovanni De Capitani
collection DOAJ
description Catheter-associated bloodstream infections (CABSIs) and catheter-related bloodstream infections (CRBSIs) are significant causes of morbidity and mortality worldwide. The current practice favors the removal of vascular access devices (VADs); however, the evidence on this topic remains inconclusive. This study evaluates the clinical outcomes in terms of in-hospital mortality and catheter retention vs. removal in CABSI and CRBSI cases. A retrospective, observational, single-center study was conducted at Luigi Sacco Hospital, Milan, Italy (May 2021–December 2023), and it analyzed non-ICU adult patients with VADs diagnosed with CRBSIs or CABSIs. Clinical and microbiological data were collected to assess the outcomes based on catheter management. Among 1874 patients with VADs, 147 were included, with 164 VAD infection events (92 CABSIs and 72 CRBSIs). Overall, 35 (23.8%) patients with CABSIs and CRBSIs died. Out of those who retained the catheter 19 (35.8%) patients died, while among removal patients 16 (17%) died (<i>p</i> = 0.018). A <i>Candida</i> spp. isolation was found to be significantly associated with a higher likelihood of catheter removal (<i>p</i> = 0.04). Our findings suggest that, in non-ICU CRBSI and CABSI cases, VAD removal may be associated with improved outcomes when feasible.
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spelling doaj-art-d021b2bca64f4698ac1f2b98f98429492025-08-20T01:56:42ZengMDPI AGMicroorganisms2076-26072025-05-01135108510.3390/microorganisms13051085Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center StudyGiovanni De Capitani0Marta Colaneri1Claudia Conflitti2Fabio Borgonovo3Lucia Galli4Giovanni Scaglione5Camilla Genovese6Rebecca Fattore7Monica Schiavini8Beatrice Caloni9Daniele Zizzo10Nicola Busatto11Antonio Gidaro12Alba Taino13Maria Calloni14Francesco Casella15Arianna Bartoli16Chiara Cogliati17Emanuele Palomba18Spinello Antinori19Andrea Gori20Antonella Foschi21Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyNational PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Internal Medicine, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Internal Medicine, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Internal Medicine, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Internal Medicine, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Internal Medicine, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyCatheter-associated bloodstream infections (CABSIs) and catheter-related bloodstream infections (CRBSIs) are significant causes of morbidity and mortality worldwide. The current practice favors the removal of vascular access devices (VADs); however, the evidence on this topic remains inconclusive. This study evaluates the clinical outcomes in terms of in-hospital mortality and catheter retention vs. removal in CABSI and CRBSI cases. A retrospective, observational, single-center study was conducted at Luigi Sacco Hospital, Milan, Italy (May 2021–December 2023), and it analyzed non-ICU adult patients with VADs diagnosed with CRBSIs or CABSIs. Clinical and microbiological data were collected to assess the outcomes based on catheter management. Among 1874 patients with VADs, 147 were included, with 164 VAD infection events (92 CABSIs and 72 CRBSIs). Overall, 35 (23.8%) patients with CABSIs and CRBSIs died. Out of those who retained the catheter 19 (35.8%) patients died, while among removal patients 16 (17%) died (<i>p</i> = 0.018). A <i>Candida</i> spp. isolation was found to be significantly associated with a higher likelihood of catheter removal (<i>p</i> = 0.04). Our findings suggest that, in non-ICU CRBSI and CABSI cases, VAD removal may be associated with improved outcomes when feasible.https://www.mdpi.com/2076-2607/13/5/1085catheter-related bloodstream infection (CRBSI)catheter-associated bloodstream infection (CABSI)vascular access device (VAD)removalretention
spellingShingle Giovanni De Capitani
Marta Colaneri
Claudia Conflitti
Fabio Borgonovo
Lucia Galli
Giovanni Scaglione
Camilla Genovese
Rebecca Fattore
Monica Schiavini
Beatrice Caloni
Daniele Zizzo
Nicola Busatto
Antonio Gidaro
Alba Taino
Maria Calloni
Francesco Casella
Arianna Bartoli
Chiara Cogliati
Emanuele Palomba
Spinello Antinori
Andrea Gori
Antonella Foschi
Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center Study
Microorganisms
catheter-related bloodstream infection (CRBSI)
catheter-associated bloodstream infection (CABSI)
vascular access device (VAD)
removal
retention
title Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center Study
title_full Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center Study
title_fullStr Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center Study
title_full_unstemmed Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center Study
title_short Effectiveness of Vascular Catheter Removal Versus Retention in Non-ICU Patients with CRBSI or CABSI in Retrospective, Single-Center Study
title_sort effectiveness of vascular catheter removal versus retention in non icu patients with crbsi or cabsi in retrospective single center study
topic catheter-related bloodstream infection (CRBSI)
catheter-associated bloodstream infection (CABSI)
vascular access device (VAD)
removal
retention
url https://www.mdpi.com/2076-2607/13/5/1085
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