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December 21, 1994

Nosocomial Bloodstream Infections in the Critically III-Reply

JAMA. 1994;272(23):1820. doi:10.1001/jama.1994.03520230029023

In Reply.  —Dr Heiselman correctly notes that nosocomial bloodstream infections from IV lines can be associated with significant morbidity and economic burden; he also stresses the fact that appropriate time of replacement or removal of IV lines is essential for preventing secondary bloodstream infection.In our study population, IV lines were responsible for at least 20 (23%) of the 86 episodes of bloodstream infection. The attributable mortality from the infection in this subpopulation was 25% (nine cases vs four controls died). When only matched case-control pairs who survived bloodstream infection (n=11) were considered among patients with infections of IV line origin, cases stayed an additional 6.5 days in the surgical intensive care unit (SICU) (median stay, 15.5 days for cases vs 9 days for controls); extra costs attributable to the infection averaged $28 690 per survivor.Nosocomial bloodstream infection from IV lines occurred on average 8.4 days (median, 6 days)