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Background Catheter-related infections(CRI) are highly prevalent and often associated with fatal complications. One year ago, intensive care unit (ICU) of our Hospital implemented a ‘Zero Bacteremia Project.’ Purpose To determine the rate of CRI in hospitalised patients receiving parenteral nutrition (PN) and to determinate whether there is any relationship with the route of administration and place of insertion (hospital ward or operating room). Materials and methods Prospective study conducted in a General Hospital during 13 months. All patients who received PN by central line were included, and The authors registered the Medical Department, insertion date, localisation (peripherally inserted central line, subclavian, jugular, femoral or implanted ports), the place of insertion and, in case of infection, the date and the causal agent. Results 177 central vascular catheters (CVC) were registered in 159 patients, of whom 62% were inserted by the surgery department, 20% by ICU, 12% by internal medicine and 6% by other ones. 71% of the CVC were inserted in the operating room. Subclavian route was mainly used in surgery and digestive departments (62% and 67% respectively), while in internal medicine and ICU there were more jugular vein insertions (76% and 63%). A total of 42 CVC were removed for suspected infection (24%), with positive cultures in 22 of them (12% of total). There were no case of infection in ICU patients, while digestive department had the highest rate (37%) followed by surgery (12%) and internal medicine (11%), probably because CVC were inserted in patients that had been hospitalised longer. Mean time between catheter insertion and infection was 11 days. The genus found in 73% of the cases was Staphylococcus and the most frequent species were Staphylococcus epidermidis (38%) and Staphylococcus hominis (19%). In three cases, polymicrobial infection was found. Conclusions There is no uniformity among departments in using jugular or subclavian route. It was necessary to remove a high percentage of CVC on suspicion of infection, but only half of them had positive cultures. Based on these results, the Hospital Infections Committee has agreed to extend the ‘Zero Bacteremia Project’ to other inpatient Units.

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BackgroundSeveral studies indicate that 96% of patients with symptomatic C. difficile infection had received antibiotics within 14 days prior to the onset of diarrhoea. Complications include dehydration, electrolyte disturbances, toxic megacolon, hypotension, renal failure, systemic inflammatory response syndrome, sepsis and death.PurposeTo analyse patients admitted to our hospital testing positive for toxins A + B of C. difficile over 4½ years and to determine the associated mortality.Material and methodsDescriptive retrospective study conducted between 1 January 2010 and 30 June 2014 that included all hospitalised patients testing positive for C. difficile toxins A + B. Dara recorded were antimicrobial treatments before detection of toxins, condition for which they were prescribed, treatment to eradicate C. difficile and its duration. The percentage of patients who died during that admission or within 10 days of discharge was also determined.ResultsResults were positive in 60 samples from 54 patients, 51.7% women and 48.3% men, with a mean age of 76.2 years. The most common pathologies for which antibiotics were prescribed were respiratory infection (36.4%), urinary tract infection (27.3%), intra-abdominal infection (16.4%), unspecified febrile syndrome (7.3%) and others (12.6%). 35 patients (64.8%) received more than one antimicrobial prior to detection of C. difficile, mainly ß-lactams (63.0%) and fluoroquinolones (27.8%).Treatments prescribed for eradication of C. difficile were:Metronidazole (63.3%): <7 days in 4 isolates, 7–10 days in 18 of them, >10 days for 15 and five patients died during treatment.Oral vancomycin (20%): <7 days in 1 patient, 7–10 days in 3 isolates and >10 days for 8 of them.No treatment: 10 patients (16.7%).Of the patients evaluated, 18 died (32.7%).ConclusionThe number of patients in whom toxins A + B of C. difficile were positively identified was low, probably due to the low degree of clinical suspicion and not too satisfactory sensitivity of the technique. Prescribing for treatments for eradication was not appropriate in 27.8% of patients (10 received no treatment and 5 for insufficient time). The mortality rates found in our study agree with data from the literature (22–40%).References and/or acknowledgementsNo conflict of interest.