Diagnosis of central venous catheter related infection in adult patients

Worthington, Tony; Elliott, Tom

doi:10.1016/j.jinf.2005.06.007

Cited by 21 publications

(19 citation statements)

References 80 publications

(91 reference statements)

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“…The use of central vascular catheter (CVC) was introduced into hospitals in the 1940's and become essential to the modern medical practice [1]. Although this intravascular device allows a rapid access into the bloodstream, its use has been associated to nosocomial bacteremias and candidemias, with significant rates of both morbidity and mortality, as well as high hospital costs [2].…”

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confidence: 99%

Etiology and pathogenesis of bloodstream infections associated with the use of long-term central vascular catheter (CVC) in patients who undergone gastrointestinal surgery

Brito¹,

Gondim²,

Filho³

et al. 2007

Braz J Infect Dis

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CVC is the main factor of risk of bloodstream infections. This study purpose was determining both etiology and pathogenesis of these infections in 80 patients who undergone gastrointestinal surgery and who worn long lasting CVC, in the institution HC-UFU. Cultures were made in nostril, skin of the insertion site, tip and catheter hub, in addition to hemoculture in those suspects of sepsis. The colonization incidence rate of the catheter tip was 12.5/ 1,000 catheter days and the CVC associate infection rate was 3.1/1,000 catheter days. Frequencies of skin, hub and catheter tip colonization were 13.8%, 8.9% and 13.3%, respectively. Coagulase-negative Staphylococci were the most found microorganisms in nostril (74%), skin (45.4%) and hub (75%) and Gram-negative bacilli (50%), followed by S. aureus (25%) the most common ones in catheter tip. Approximately 51% of patients received antibiotics and most of them (53.7%) had therapeutic purpose. The frequency of patients with clinical sepsis was 27.5%. Three cases of bacteremia associated with the use of CVC were detected (3.8%), with S. aureus in two of them and K. pneumoniae in the third one. There was not seen any association of skin and hub colonization with their presence in the catheter tip and in the blood of these patients, but S. aureus was recovered from nostril of those with sepsis by this pathogenic agent. A greater concern is suggested over preventive measures and control of these primary and secondary bloodstream, as well as catheter tip colonization.

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confidence: 99%

Etiology and pathogenesis of bloodstream infections associated with the use of long-term central vascular catheter (CVC) in patients who undergone gastrointestinal surgery

Brito¹,

Gondim²,

Filho³

et al. 2007

Braz J Infect Dis

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“…Introdução os dispositivos intravasculares foram introduzidos na prática clínica em meados de 1940 e atualmente são indispensáveis na assistência à saúde de inúmeros pacientes, particularmente aqueles internados em unidades de terapia intensiva (UTI) ou sob quimioterapia (10,28,30) . Esses acessos intravasculares são utilizados para monitoramento hemodinâmico, realização de hemodiálise, nutrição parenteral, administração de hemoderivados e medicamentos.…”

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“…Estima-se que nos EUA ocorram de 200 a 400 mil ICSs por ano e a maioria está relacionada com o uso de acessos intravasculares. Acredita-se que as IRCs sejam responsáveis por 10% a 20% das infecções hospitalares (8,16,30) .…”

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“…As complicações associadas a essas infecções são importantes, uma vez que a mortalidade relacionada com a IRC varia de 12% a 30% (8,13,19,24,30) . Além disso, a literatura relata que, por ano, nos EUA, aproximadamente 80 mil CVCs são infectados, trazendo custo adicional para a saúde de U$ 60 a 460 milhões, uma vez que esses pacientes permanecem mais tempo internados e necessitam de procedimentos adicionais (cerca de 10 a 40 dias) (4,9,13,20) .…”

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“…Atualmente, a metodologia mais utilizada para avaliar ICSRC é a cultura semiquantitativa de ponta de cateter (15) associada à hemocultura qualitativa periférica. Dados da literatura utilizando essa metodologia apontam, no entanto, para uma remoção desnecessária de 75% a 85% dos cateteres em pacientes febris, dos quais somente 15% a 25% dos dispositivos provam realmente estar infectados (4,21,30) . Dos métodos diagnósticos disponíveis de rotina para ICSRC que preservam o cateter, a diferença de tempo de positividade (DTP) e a hemocultura pareada quantitativa de sangue periférico e sangue de cateter são descritas, porém pouco aplicadas na rotina (5,6,24) .…”

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Diferença de tempo de positividade: método útil no diagnóstico de infecção de corrente sanguínea relacionada com cateter?

Correa

Almeida²,

Júnior³

et al. 2012

J. Bras. Patol. Med. Lab.

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Introdução: As infecções de corrente sanguínea relacionadas com cateter (ICSRCs) apresentam impacto significativo na morbidade e na mortalidade de pacientes internados, além de elevar custos hospitalares. A utilização de equipamentos automatizados no processamento de hemoculturas gerou uma alternativa para diagnóstico de ICSRC por meio da análise da diferença de tempo de positividade (DTP) entre hemoculturas pareadas (coletadas simultaneamente) de sangue periférico e sangue de cateter. Um diagnóstico acurado e rápido dessas infecções pode otimizar as condutas clínicas e terapêuticas, poupando a retirada precoce dos cateteres. Objetivos: Avaliar na rotina a DTP como ferramenta auxiliar no diagnóstico de ICSRC e determinar os principais microrganismos isolados.

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Skin antisepsis during catheter insertion for reducing central venous catheter related infections

Lai

O'Riordan

et al. 2012

Cochrane Database of Systematic Reviews

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Diagnosis of central venous catheter related infection in adult patients

Cited by 21 publications

References 80 publications

Etiology and pathogenesis of bloodstream infections associated with the use of long-term central vascular catheter (CVC) in patients who undergone gastrointestinal surgery

Etiology and pathogenesis of bloodstream infections associated with the use of long-term central vascular catheter (CVC) in patients who undergone gastrointestinal surgery

Diferença de tempo de positividade: método útil no diagnóstico de infecção de corrente sanguínea relacionada com cateter?

Skin antisepsis during catheter insertion for reducing central venous catheter related infections

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