Epidemiology
A few organisms are responsible for most cases of CVC-related bacteremia. In general, most of these organisms reside on the skin surface. In fact, coagulase-negative staphylococcus is the most commonly isolated bacterium for most units; however, notice that the predominant pathogen differs in the various ICUs at Vanderbilt, with gram-negative organisms the main culprit in the Burn and Trauma Units. Table 1 outlines the microbial causes of CVC-related BSI by unit at Vanderbilt in 2004.
TABLE 1. Most common pathogens from hospital-acquired CVC-associated bacteremia at Vanderbilt, by unit, 2004
| VUMC Unit | Staph. aureus | Coagulase-negative Staph. | Gram negative rods | Candida spp. | Enterococcus spp. |
| Burn Unit | 21.9% | 9.4% | 53.2% | 3.3% | 9.4% |
| CCU | 0 | 56.3% | 18.9% | 6.3% | 18.8% |
| MICU | 0 | 16.7% | 25.0% | 8.3% | 33.3% |
| NCCU | 7.4% | 40.7% | 11.1% | 14.8% | 22.2% |
| NICU | 6.5% | 67.7% | 6.5% | 6.5% | 9.7% |
| PCCU | 12.0% | 52.0% | 16.0% | 8.0% | 8.0% |
| SICU | 16.7% | 38.1% | 21.5% | 11.9% | 9.5% |
| Trauma | 9.6% | 27.4% | 35.9% | 11.0% | 12.4% |
(source: VUMC Department of Infection Control & Prevention)
Abbreviations
BSI = bloodstream infection
CVC = central venous catheter
ICU = intesive care unit
