Temporal Trends and Microbial Distribution of Catheter-Related Bloodstream Infections in Intensive Care Units: An 11-Year Single-Center Study

INTRODUCTION: Catheter-related bloodstream infections (CRBSIs) remain a major cause of morbidity and mortality in intensive care units (ICUs), despite advances in infection control practices. Monitoring long-term trends in infection rates and pathogen distribution is essential for evaluating the effectiveness of preventive strategies and guiding empirical treatment. The present study aimed to evaluate temporal trends in CRBSI incidence and changes in the distribution of causative micro-organisms in an ICU over an 11-year period (2015–2025).
METHODS: This retrospective, single-center study was conducted in the ICUs of Tokat State Hospital, Türkiye, between January 1, 2015, and December 31, 2025. CRBSI rates were calculated as the number of infections per 1,000 catheter-days using aggregated annual surveillance data. Temporal trends in infection rates and microbial distribution were analyzed using joinpoint regression, and annual percent change (APC) values were calculated.
RESULTS: Over the 11-year study period, CRBSI rates demonstrated a statistically significant decreasing trend, with an overall APC of −21.81% (p<0.05). Klebsiella pneumoniae showed a significant decrease during 2015–2017 (APC: −47.83%, p<0.001), followed by an increase during 2017–2022 (APC: +25.01%, p<0.001) and a subsequent decrease during 2022–2025 (APC: −34.21%, p<0.001). Acinetobacter baumannii increased significantly during 2015–2020 (APC: +21.20%, p<0.001) and decreased during 2020–2025 (APC: −31.34%, p<0.001). Candida spp. demonstrated a marked increase during 2015–2021 (APC: +46.10%, p<0.001), followed by a non-significant trend thereafter (APC: −2.50%, p=0.570). Other pathogens, including Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, and enterococci, showed no statistically significant temporal changes.
DISCUSSION AND CONCLUSION: CRBSI rates significantly decreased over the study period, reflecting improvements in infection control practices. However, pathogen-specific trends revealed dynamic and heterogeneous patterns, particularly among Gram-negative bacteria and Candida spp. Continuous surveillance and adaptive infection control strategies are essential to sustain reductions in infection rates and to address evolving microbial patterns.

Keywords: Catheter-related bloodstream infection, intensive care unit, microorganism distribution, temporal trends.