Sporadic bacteremia complicating central venous catheter use in a community hospital: a model to predict frequency and aid in decision-making for initiation of investigation.

Sporadic bacteremia complicating single-lumen central venous catheter (CVC) use was prospectively recorded in a community hospital in 1981 and 1982. Sixty-four of 1258 (5.1%) patients had definite bacteremia. A nested case-control study was then undertaken to identify predictive risk factors. Fifteen statistically significant factors found in the 1981 cohort were tested in the 1982 cohort, and four remained significant for both years. Univariate and multiple logistic regression analysis on both years' findings, separately and together, identified two independently associated factors: diagnosed respiratory colonization/infection (p less than 0.0001) and serum albumin level (p less than 0.001). Based on these factors, an equation was developed to express the probability of bacteremia. Solving this equation provides an infection control practitioner with an expected rate of bacteremia that complicates CVC use and provides an aid for decision-making for investigation in the absence of clusters.