Impact of Central Venous Catheter Removal on the Recurrence of Catheter-Related Coagulase-Negative Stahylococcal Bacteremia

Raad, Issam; Davis, Steve; Khan, Azim; Tarrand, Jeffrey J.; Elting, Linda S.; Bodey, Gerald P.

doi:10.1086/646512

Cited by 95 publications

(31 citation statements)

References 31 publications

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“…39 Studies using 7 to 21 days of antibiotics infused through the infected line, primarily with BSIs caused by coagulase-negative staphylococci, have shown success rates of 60-91% without catheter removal, 39,47-49 although patient response varied significantly, depending on infecting microorganism; with coagulase-negative staphylococcal BSIs, the risk of recurrent bacteremia has been approximately 20%. 39,50,51 Several studies have reported successful treatment of IVD BSIs due to Candida spp. without device removal using prolonged courses of amphotericin B (AmB) administered through the catheter; 15,52,53 however, this is in contrast to the results of other prospective studies that have found an increased duration of candidemia and mortality in patients who retain their infected IVD.…”

Section: Diagnostic Studiesmentioning

confidence: 99%

“…37,38 Central venous thrombosis can now be diagnosed by venography, 37,38 ultrasonography, 75 MRI, 76 or CT. While there are no prospective data to guide the optimal duration of antimicrobial therapy for IVDR BSIs, most coagulase-negative staphylococcal infections can be cured with only 5 to 7 days of therapy, 1,28,50,78 whereas most infections caused by other microorganisms can be adequately treated with 10 to 14 days of antimicrobial therapy. 28,55,78,79 These recommendations hold only as long as there are no complications related to the infection-endocarditis, septic thrombophlebitis, septic thrombosis, or metastatic infection, such as osteomyelitis-and the BSI clears within 72 hours of initiating therapy.…”

Section: Anti-infective Therapymentioning

confidence: 99%

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Infections in the Neutropenic Patient— New Views of an Old Problem

Donowitz¹,

Maki²,

Crnich³

et al. 2001

Hematology

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Infection in the neutropenic patient has remained a major clinical challenge for over three decades. While diagnostic and therapeutic interventions have improved greatly during this period, increases in the number of patients with neutropenia, changes in the etiologic agents involved, and growing antibiotic resistance have continued to be problematic.The evolving etiology of infections in this patient population is reviewed by Dr. Donowitz. Presently accepted antibiotic regimens and practices are discussed, along with ongoing controversies.In Section II, Drs. Maki and Crnich discuss linerelated infection, which is a major infectious source in the neutropenic. Defining true line-related bloodstream infection remains a challenge despite the fact that various methods to do so exist. Means of prevention of line related infection, diagnosis, and therapy are reviewed.Fungal infection continues to perplex the infectious disease clinician and hematologist/ oncologist. Diagnosis is difficult, and many fungal infections will lead to increased mortality even with rapid diagnosis and therapy. In Section III, Dr. Pappas reviews the major fungal etiologies of infection in the neutropenic patient and the new anti-fungals that are available to treat them.Finally, Dr. Rolston reviews the possibility of outpatient management of neutropenic fever. Recognizing that neutropenics represent a heterogeneous group of patients, identification of who can be treated as an outpatient and with what antibiotics are discussed.

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Section: Diagnostic Studiesmentioning

confidence: 99%

Section: Anti-infective Therapymentioning

confidence: 99%

Infections in the Neutropenic Patient— New Views of an Old Problem

Donowitz¹,

Maki²,

Crnich³

et al. 2001

Hematology

View full text Add to dashboard Cite

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“…Infection is one of the most common causes of catheter failure, as well as the most difficult to manage [11], most often requiring catheter removal [12]. While a variety of microorganisms have been found to cause such infections, CNS, specifically S. epidermidis, represents the leading cause of both intra- [13] and extravascular [14] catheter-associated infections.…”

Section: Discussionmentioning

confidence: 99%

Microbial colonization of implanted silicone and polyurethane catheters

Baldassarri

Gelosia

Fiscarelli

et al. 1994

J Mater Sci: Mater Med

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Catheters explanted from nephropathic children were tested for microbial colonization, biofilm formation and surface defects chargeable to the implantation into the organism. Infection symptoms were detected in 13.6% of cases, versus 16% of colonization detected in the absence of clinical signs of infection. PU catheters showed slightly higher colonization/ infection rates, perhaps due to the implant location. Biofilm was observed on both silicone and PU catheters, independently of the duration of catheterization; a lower amount of organic deposits was observed on the external catheter surfaces. Surface morphology of the catheters seemed to affect biofilm deposition, cavities and scratches present on both unused and explanted catheters providing preferential sites of deposit formation. Surface characteristics as well as biofilm possibly affected bacterial attachment in an in vitro adherence test. The presence of antibiotic molecules trapped in the biofilm was hypothesized to explain partial inhibition of S. epidermidis and S. aureus adhesion to catheter implanted in patients who underwent antibiotic therapy.

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“…Sin embargo, la probabilidad de éxito de esta terapia combinada dependerá de varios factores, como son el sitio de la infección (si existe tunelitis o infección del reservorio estaría indicada la retirada del catéter, dada la baja probabilidad de erradicación) o el germen implicado en la misma (es más probable que exista respuesta adecuada si la infección está causa por un S. coagulasa-negativo que por un S. aureus). La recurrencia de bacteriemia tras un ciclo de tratamiento antibiótico intravenoso es más probable cuando se deja el mismo catéter que cuando se retira (68). Este hecho refleja la incapacidad de la mayoría de los antibióticos para conseguir una concentración terapéutica necesaria para matar a los microorganismos que componen el biofilm (69,70).…”

Section: Sellado Como Tratamiento De Las Infecciones Relacionadas Conunclassified

Sellado con antibióticos o antisépticos en pacientes pediátricos con nutrición parenteral domiciliaria. Puesta al dí

et al. 2016

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Introduction: Home parenteral nutrition has become the mainstay for the support of patients with severe chronic intestinal failure. Despite the signifi cant advances that have occurred in recent decades in terms of vascular access and parenteral solutions, catheter-related bloodstream infections remain one of the most important complications. Antiseptic lock therapies, as ethanol or taurolidine; and antibiotic lock therapies are used in order to prevent or treat these infections. Objective: The aim of this article is to review the available scientifi c evidence regarding the use of antiseptic and antibiotic lock therapies in the management of pediatric patients with home parenteral nutrition. Material and methods: The use of ethanol or taurolidine lock therapy would be suggested in order to prevent catheter-related bloodstream infections in patients with home parenteral nutrition who have suffered from more than one infection in the previous year or in at-risk patients. Antibiotic locks are used for the treatment of catheter-related bloodstream infections due to S. coagulase negative and gram-negative bacilli in conjunction with systemic antimicrobial therapy, for whom catheter salvage is the goal. Catheter removal is recommended when there are signs of exit site or tunnel infection or the infection is due to S. aureus or Candida species. Conclusion: Despite the fact that evidence based data on the topic is scarce, there are a growing number of publications that support the use of antibiotics or antiseptic locks for the prevention or treatment of catheter-related infections in home parenteral nutrition patients, in whom catheter maintenance is a cornerstone for survival.

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Impact of Central Venous Catheter Removal on the Recurrence of Catheter-Related Coagulase-Negative Stahylococcal Bacteremia

Cited by 95 publications

References 31 publications

Infections in the Neutropenic Patient— New Views of an Old Problem

Infections in the Neutropenic Patient— New Views of an Old Problem

Microbial colonization of implanted silicone and polyurethane catheters

Sellado con antibióticos o antisépticos en pacientes pediátricos con nutrición parenteral domiciliaria. Puesta al dí

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