Risk Factors for Central Line Associated Bloodstream Infection in Patients with Inflammatory Bowel Disease

Parenteral nutrition using central venous catheter (CVC) is common in patients with inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD). We investigated the risk factors for central line-associated blood stream infections (CLABSI) in patients admitted on the ward of digestive tract internal medicine. Patients with home parenteral nutrition were excluded. In addition to 13 factors related to the host and 3 factors for the management of CVC, disease activity (UC, Mayo score; CD, CD activity index) was evaluated. A total of 562 patients were included (UC 562, CD 334). The incidences of CLABSI were 9.6% in total, 8.3% in patients with UC, and 10.5% in patients with CD, and rates per 1,000 device days were 4.9, 4.4, and 5.3, respectively. Independent risk factors for CLABSI were the use of biological product (odds ratio: 4.98, 95% confidence interval: 1.81-13.69) in patients with UC and men (5.38, 1.85-15.64) and moderate/severe disease activity (2.54, 1.20-5.38) in patients with CD. Routine bath/shower during the CVC use decreased the risk (UC: 0.17, 0.06-0.44; CD: 0.33, 0.15-0.72). In conclusion, the identified risk factors for CLABSI in IBD were different from the common risk factors reported previously. Routine hygiene management with bath/shower was required to prevent CLABSI.