Table 2: Odds ratios for duration of device use, determined by univariate logistic regression and 95% confidence intervals. Device use Duration of device use 1‐4 days 5‐9 days (95% CI) ≥ 10 days (95% CI) ventilation 1 1.9* (1.4‐2.6) 1.6* (1.1‐2.2) central venous catheterization 1 4.3* (1.7‐10.7) 8.4* (3.4‐20.4) urinary catheterization 1 1.6* (1.0‐2.4) 3.3* (2.2‐4.9) * p< 0.05 antibiotics. Acute admission had no proportional hazard over time, indicating that the effect of this risk factor changed over time. To account for this an interaction term with time at risk was included in the analysis. The effect of acute admission was highest at the start of the urinary catheterization and decreased with continuing ICU stay/catheterization at a factor of 10% per day. Mortality Developing VAP was not associated with a higher crude mortality (26.0% and 23.2% in patients with and without infection, respectively). Developing a CR‐BSI or a CA‐UTI was associated with a (nearly) significantly higher crude mortality: 30.9% versus 20.2% (p=0.06) in patients with a CVC and 26.7% versus 16.7% (p=0.002) in patients with a CAD. In multivariate regression developing a device‐associated infection was not associated with mortality (Table 4). Micro‐organisms Only the culture of the first infection of its kind is given here. During the first 4 days of ventilation 37% of the isolates for VAP were flora associated with early‐onset VAP: Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae. In pneumonia patients ventilated for 5 days or more less H. influenzae was isolated and more Pseudomonas aeruginosa and Enterobacteriaceae. In CA‐UTI patients intestinal flora contributed 69% in the first 4 days. This decreased to 44%, whereas P. aeruginosa and Klebsiella pneumoniae increased in frequency. Staphylococci were found in 60% of the isolates of CR‐BSI patients in the first 2 weeks. After 2 weeks they were only found in 41% of the isolates whereas Enterobacteriaceae were more frequently found with increasing duration of CVC. 28 Chapter 2
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