13 Catheter-related bloodstream infection (CRBSI) in patients undergoing abdominal surgery: a prospective cohort study

Abstract Aim Postoperative fever is a complex clinical problem which results in prolonged hospital stay interval and increased cost worldwide. The aim of the present study was to investigate the incidence of postoperative fever which is caused by catheter-related bloodstream infection (CRBSI) in patients undergoing abdominal surgery. Methods Patients who underwent abdominal surgery at the 1st Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, and presented postoperative fever were prospectively enrolled from 2018 until 2023. The postoperative fever management included removal of the central catheter and tip culture, blood cultures, urine cultures and chest x-ray. In addition, the day of postoperative fever, blood cultures, urine cultures and central catheter cultures, as well as the reason of postoperative fever were reported. Results In total, 189 patients were included in the present study, 110 of whom were males and 79 females. The cut-off point for postoperative fever associated to CRBSI was 7 days. This point presented 57% sensitivity, 63% specificity, 33% positive predictive value and 82% negative predictive value. Univariable analysis indicated significantly higher rate of CRBSI when postoperative fever was presented after 7th postoperative day (P = 0.02). Moreover, CRBSI was significantly higher in emergent operations (P = 0.003), in patients with more than one pathogens in their blood cultures (P = 0.001) and in patients with positive urine cultures (P = 0.003). Multivariable analysis confirmed the aforementioned correlations except for CRBSI increase in patients with fever after 7 postoperative days. Conclusions Postoperative fever presented before the 7th day after abdominal surgery did not seem to be associated to CRBSI. Therefore, alternative reasons for postoperative fever should be investigated.