Incidence and Predictors of Central Venous Catheter Related Infection in Intensive Care Patients

McKinley, S.; Mackenzie, A. Ranald; Finfer, Simon; Ward, R. S.; Penfold, J. B.

doi:10.1177/0310057x9902700206

Cited by 49 publications

(35 citation statements)

References 25 publications

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“…This is consistent with other recent reports. 14,19,22,23 More important perhaps was strict adherence to infection control procedures by participating clinicians. A recent review concluded that these methods are essential when using intravascular catheters.…”

Section: Discussionmentioning

confidence: 99%

“…This definition for bacteraemia has recently been used by other investigators. 1,[18][19][20] Cultures and antimicrobial susceptibility Following catheter removal, the distal tip and a 3-mm intracutaneous segment were aseptically cut from the catheter and placed in individual containers for microbial evaluation. A core laboratory (Esoterix, Inc., San Antonio, TX, USA) was used to ensure consistency when performing and evaluating roll-plate, sonication and blood cultures.…”

Section: Definitionsmentioning

confidence: 99%

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Impact of central venous catheter type and methods on catheter-related colonization and bacteraemia

Moretti

Ofstead

Kristy³

et al. 2005

Journal of Hospital Infection

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A prospective, randomized, controlled, multi-centre clinical trial was performed to test the effectiveness of an antimicrobial central venous catheter (CVC) made of polyurethane integrated with silver, platinum and carbon black (Vantex). Adults expected to require a CVC for more than 60 h were eligible, and were randomized to receive the test or control catheter. All CVCs were inserted with new venipunctures using full aseptic technique. Following catheter removal, the distal tip and an intracutaneous segment were removed and cultured using semiquantitative and quantitative methods. Peripheral blood samples were obtained and cultured to confirm cases of catheter-related bloodstream infection (CRBSI). Bacterial and fungal organisms were identified by standard microbiological methods. Catheter placement was performed primarily in the intensive care unit (50%) or operating theatre (42%). Complete data could be evaluated for 539 patients (77%). The mean duration of CVC placement was 149.3h (six days). There were no significant differences in colonization or bacteraemia rates between the test and control catheters. The overall colonization rate was not particularly low (24.5%), and yet CVC-related bacteraemia occurred in only 1.4% of patients, and CRBSI occurred in only one patient from the control group (0.2%). Insertion site and dressing change frequency were significantly associated with the colonization rate. Although CVCs with antimicrobial features have been associated with a decrease in catheter-related colonization and bacteraemia, this study demonstrated that infection rates may depend more on non-catheter-related factors, such as adherence to infection control standards, selection of insertion site, duration of CVC placement, and dressing change frequency. As microbial resistance increases, clinicians should make maximal use of these processes to reduce catheter-related infections.

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Section: Discussionmentioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

Impact of central venous catheter type and methods on catheter-related colonization and bacteraemia

Moretti

Ofstead

Kristy³

et al. 2005

Journal of Hospital Infection

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“…Potential acute complications of catheter-related thrombosis include increase in the risk of sepsis, life-threatening superior vena cava syndrome, 380 Y. Finkelstein et al and pulmonary embolism [3,5]. The frequency of those complications as well as the optimal therapy in children with symptomatic and asymptomatic thrombosis of the upper venous system thrombosis is currently unknown and awaits future clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with thalassemia major (TM) with severe secondary iron overload, long-term chelation therapy with deferoxamine via a CVL avoids the pain associated with subcutaneous administration, allows for higher doses, and can extend survival and diminish cardiac arrhythmias and failure [1,2]. However, the use of CVLs is being reevaluated owing to their high rate of complications, such as infection and thrombosis [3][4][5]. Some authors have suggested that the majority of venous thromboembolic events in infants and young children with CVLs are associated with the presence of genetic risk factors for thrombophilia [6].…”

Section: Y Finkelstein Et Almentioning

confidence: 99%

Central Venous Line Thrombosis in Children and Young Adults With Thalassemia Major

Finkelstein

Yaniv

Berant

et al. 2004

Pediatric Hematology and Oncology

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High doses of intravenous deferoxamine via central venous line (CVL) has recently been shown to improve survival in patients with noncompliant thalassemia major (TM). The aim of this retrospective study was to evaluate the extent of CVL-related thrombosis and to determine the presence of prothrombotic factors in children and young patients with TM on such a regimen. Twenty-three patients (median age 13, range 5-25 years) with TM in whom a tunneled CVL was inserted for intensification of iron chelation were evaluated for signs and symptoms of thrombosis and for inherited and acquired risk factors of thrombosis. Mean duration of CVL placement was 37 +/- 31 months (range 6-98 months). Eight patients (35%) had CVL-related thrombosis diagnosed clinically or by echocardiography. Nine patients (39%) had prothrombotic factors, but the thrombosis subgroup did not differ from the other group in age, platelet counts, duration of CVL placement, or the presence of predisposing prothrombotic factors. Based on the high rate of CVL-related thrombosis, routine monitoring is suggested for CVL thrombosis in this population.

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“…Several methods have been proposed to prevent infectious complications. Selection of the subclavian site appears to minimize the risk of infectious complications [6,8,9]. Antimicrobialimpregnated catheters and/or catheter hubs were reported to reduce the risks and costs [1,6].…”

Section: Discussionmentioning

confidence: 99%

Infective endocarditis at the tricuspid valve following central venous catheterization

Yamashita¹,

Noma²,

Kuwata³

et al. 2005

J Anesth

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We report a case of infective endocarditis at the tricuspid valve attributed to central venous catheterization. The patient was a 35-year-old woman who had multiple septic emboli in her lung due to tricuspid valve endocarditis after successful treatment of bronchiolitis obliterans organizing pneumonia. She also had right ileosacral arthritis. The case was closely related to catheter-associated Staphylococcus aureus bacteremia. She was treated with intravenous administration of vancomycin and surgical removal of vegetation and tricuspid valvuloplasty. Since infective endocarditis can be a complication of central venous catheterization with high morbidity and mortality, maximal precautions to minimize the risk, early detection, and appropriate treatment of these complications are mandatory to improve patients' outcome.

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Incidence and Predictors of Central Venous Catheter Related Infection in Intensive Care Patients

Cited by 49 publications

References 25 publications

Impact of central venous catheter type and methods on catheter-related colonization and bacteraemia

Impact of central venous catheter type and methods on catheter-related colonization and bacteraemia

Central Venous Line Thrombosis in Children and Young Adults With Thalassemia Major

Infective endocarditis at the tricuspid valve following central venous catheterization

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