Multilumen Central Venous Catheters Increase Risk for Catheter-Related Bloodstream Infection: Prospective Surveillance Study

Templeton, Alison; Schlegel, Matthias; Fleisch, Felix; Rettenmund, G.; Schöbi, Barbara; Henz, Samuel; Eich, Gerhard

doi:10.1007/s15010-008-7314-x

Cited by 75 publications

(45 citation statements)

References 30 publications

(23 reference statements)

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“…Several studies have suggested that S. aureus infections may be harder to eradicate and more likely to cause complications [10,11]. In our case we found three types of strains (Klebsiella, Pseudomonas and Candida albicans).…”

Section: Hemodialysis Catheter-related Bloodstream Infection (Hc-rbsisupporting

confidence: 48%

Endocarditis with Permanent Hemodialysis Tunneled Catheter: A Severe and Multidisciplinary Situation

Maaoui¹,

M²,

Gaied³

et al. 2017

Int J Neurorehabilitation Eng

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Tunnelled catheter endocarditis is a frequent and sever situation among hemodialysis patients. The management should be fast and multidisciplinary.Case report: We report the case of a 36 year old woman with a history of systemic erythematous lupus, discovered at the age of twenty. She profited from a tunneled catheter because of exhaustion of her venous capital. One year later, the patient had an endocarditis of the tricuspid valve. An echocardiogram demonstrated mobile and friable 8 mm vegetation in the tricuspid valve. Blood cultures were positive for pseudomonas and klebsiella. The catheter was removed at the fifth day of the infection. The patient received antibiotic treatment which was changed on several occasions in front of multiresistant strains. Ten days later, the blood culture showed Candida albicans. The echocardiogram demonstrated an increase of the size of the vegetation to 15 mm. A chest CT carried out in front of a respiratory distress showed pulmonary septic emboli. Tricuspid valve replacement was performed. Culture of native valve was positive for multiresistant candida famata. The patient developed a pulmonary embolism causing her death.Discussion: Endocarditis with permanent catheter is a severe situation with high mortality and poor prognosis among hemodialysis patients. Immune suppression due to a renal failure and auto immune disease can support the development of multiresistant strains difficult to treat. Conclusion:Endocarditis on tunneled catheter is a serious infection. Nephrologists, cardiologists and infectiologists must collaborate in order to provide adequate therapy.

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Section: Hemodialysis Catheter-related Bloodstream Infection (Hc-rbsisupporting

confidence: 48%

Endocarditis with Permanent Hemodialysis Tunneled Catheter: A Severe and Multidisciplinary Situation

Maaoui¹,

M²,

Gaied³

et al. 2017

Int J Neurorehabilitation Eng

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“…Catheters with multiple lumens have been associated with a higher rate of infections because they are usually inserted in patients with high-intensity treatment who require a great number of catheter manipulations for prolonged periods [5,34]. A recent meta-analysis found that multilumen CVCs had a greater risk of CRBIs than single-lumen CVCs, although this difference was not statistically significant when only high-quality studies were considered [11].…”

Section: Discussionmentioning

confidence: 99%

A prospective 7-year survey on central venous catheter-related complications at a single pediatric hospital

et al. 2009

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The aims of this study were to assess the incidence and risk factors of major central venous catheter (CVC)-related complications in a large cohort of children affected by oncological, hematological, or immunological diseases in a 7-year prospective observational study at a single center. Nine hundred fifteen CVCs were inserted in 748 children for a total period of 307,846 CVC-days. Overall, 298 complications were documented with a complication rate of 0.97/1,000 CVC-days: 105 mechanical complications (dislocations 0.30/1,000 CVC-days, ruptures 0.04/1,000 CVC-days), 174 infections (bloodstream infections 0.46/1,000 CVC-days, tunnel infections 0.10/1,000 CVC-days), and 19 thrombosis (0.06/1,000 CVC-days). Significant risk factors were: diagnosis of acute lymphoblastic leukemia (ALL) and age

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“…35 We found that 5-lumen CVCs had a higher risk for colonization than did 4-or 3-lumen CVCs. Antimicrobial-coated CVCs had lower rates of microbial colonization than did non-antimicrobial-coated 4-or 5-lumen CVCs but still had colonization rates marginally higher than did non-antimicrobial-coated 3-lumen CVCs.…”

Section: Discussionmentioning

confidence: 54%

Density of Microbial Colonization on External and Internal Surfaces of Concurrently Placed Intravascular Devices

Koh

Robertson

Watts

et al. 2012

American Journal of Critical Care

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Background Intravascular devices provide essential vascular access for management of critically ill patients but can be associated with bloodstream infections. Objectives To determine colonization rates in segments of concurrently placed peripheral arterial, nontunnelled short-term central venous catheters and peripherally inserted central catheters and the pattern of heaviest colonization when the catheters are removed. Methods A prospective study was conducted on inpatients with intravascular devices in place for 9 days or more. At removal, each catheter was cut into 3 segments, and each segment was cultured separately. The density of colonization on external and internal surfaces of each segment was compared by estimating odds ratios by repeated-measures ordinal logistic regression. Results A total of 48 peripheral arterial, 135 central venous, and 106 peripherally inserted central catheters were obtained from 289 patients. Colonization was greatest at the proximal external segment of all catheters. On the external surface, colonization was lower on the middle (odds ratio, 0.70; P < .001) and distal (odds ratio, 0.56; P < .001) segments than on the proximal segments. On the internal surface, colonization was lower on the proximal (odds ratio, 0.39; P < .001), middle (odds ratio, 0.30; P < .001), and distal (odds ratio, 0.31; P < .001) segments than on the external proximal segments. This trend was similar for all catheter types. Conclusion Colonization of intravascular devices was heaviest on proximal segments.

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Multilumen Central Venous Catheters Increase Risk for Catheter-Related Bloodstream Infection: Prospective Surveillance Study

Abstract: Number of lumens and site of access were independent risk factors for CRBSI. The use of catheters with multiple lumens should therefore be restricted as far as possible. If a catheter cannot be removed, the permanent closure of unneeded lumens may reduce the risk of CRBSI.

Cited by 75 publications

References 30 publications

Endocarditis with Permanent Hemodialysis Tunneled Catheter: A Severe and Multidisciplinary Situation

Endocarditis with Permanent Hemodialysis Tunneled Catheter: A Severe and Multidisciplinary Situation

A prospective 7-year survey on central venous catheter-related complications at a single pediatric hospital

Density of Microbial Colonization on External and Internal Surfaces of Concurrently Placed Intravascular Devices

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