Prevalence of the Use of Central Venous Access Devices Within and Outside of the Intensive Care Unit: Results of a Survey Among Hospitals in the Prevention Epicenter Program of the Centers for Disease Control and Prevention

Climo, Michael W.; Diekema, Daniel J.; Warren, David K.; Herwaldt, Loreen A.; Perl, Trish M.; Peterson, Lance R.; Plaskett, Theresa; Price, Connie S.; Sepkowitz, Kent A.; Solomon, Steve; Tokars, Jerry; Fraser, Victoria J.; Wong, Edward S.

doi:10.1086/502163

Cited by 126 publications

(100 citation statements)

References 26 publications

(22 reference statements)

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“…ost hospitalized patients have an intravenous catheter, and up to 30% have a central venous catheter for hemodynamic support, for infusion of medications that require instillation into a central vein, or for long-term venous access (1). These catheters are a major source of health care-associated infections.…”

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Microbial Biofilms on Needleless Connectors for Central Venous Catheters: Comparison of Standard and Silver-Coated Devices Collected from Patients in an Acute Care Hospital

et al. 2014

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e Microorganisms may colonize needleless connectors (NCs) on intravascular catheters, forming biofilms and predisposing patients to catheter-associated infection (CAI). Standard and silver-coated NCs were collected from catheterized intensive care unit patients to characterize biofilm formation using culture-dependent and culture-independent methods and to investigate the associations between NC usage and biofilm characteristics. Viable microorganisms were detected by plate counts from 46% of standard NCs and 59% of silver-coated NCs (P ‫؍‬ 0.11). There were no significant associations (P > 0.05, chi-square test) between catheter type, side of catheter placement, number of catheter lumens, site of catheter placement, or NC placement duration and positive NC findings. There was an association (P ‫؍‬ 0.04, chi-square test) between infusion type and positive findings for standard NCs. Viable microorganisms exhibiting intracellular esterase activity were detected on >90% of both NC types (P ‫؍‬ 0.751), suggesting that a large percentage of organisms were not culturable using the conditions provided in this study. Amplification of the 16S rRNA gene from selected NCs provided a substantially larger number of operational taxonomic units per NC than did plate counts (26 to 43 versus 1 to 4 operational taxonomic units/NC, respectively), suggesting that culture-dependent methods may substantially underestimate microbial diversity on NCs. NC bacterial communities were clustered by patient and venous access type and may reflect the composition of the patient's local microbiome but also may contain organisms from the health care environment. NCs provide a portal of entry for a wide diversity of opportunistic pathogens to colonize the catheter lumen, forming a biofilm and increasing the potential for CAI, highlighting the importance of catheter maintenance practices to reduce microbial contamination.

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Microbial Biofilms on Needleless Connectors for Central Venous Catheters: Comparison of Standard and Silver-Coated Devices Collected from Patients in an Acute Care Hospital

et al. 2014

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“…3,4 Furthermore, in many hospitals there may actually be more patients with catheters outside the ICU than in it. 5 The lower utilization rates of central lines outside the ICU and the larger, more widely distributed population exacerbate the effort required for adequate surveillance of CLABSI by means of the traditional manual methods. The increasing availability of patient and laboratory data offer the potential for automating the process.…”

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confidence: 99%

Electronic Surveillance for Healthcare-Associated Central Line—Associated Bloodstream Infections Outside the Intensive Care Unit

Woeltje

McMullen

Butler

et al. 2011

Infect. Control Hosp. Epidemiol.

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"Electronic surveillance for healthcare-associated central line-associated bloodstream infections outside the intensive care unit." Infection Control and Hospital Epidemiology.32,11. 1086-1090. (2011 http://www.jstor.org/page/info/about/policies/terms.jsp JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. The University of Chicago Press and The Society for Healthcare Epidemiology of America are collaborating with JSTOR to digitize, preserve and extend access to Infection Control and Hospital Epidemiology.http://www.jstor.org infection control and hospital epidemiology november 2011, vol. 32, no. 11 o r i g i n a l a r t i c l e background. Manual surveillance for central line-associated bloodstream infections (CLABSIs) by infection prevention practitioners is time-consuming and often limited to intensive care units (ICUs). An automated surveillance system using existing databases with patientlevel variables and microbiology data was investigated.

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“…The majority of CLABSIs now occur outside ICUs. 1,31,34 We were able to include all central lines inside and outside of ICUs, and we used a previously validated methodology to calculate the number of central-line days outside the ICUs.…”

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confidence: 99%

Comparison of a Silver-Coated Needleless Connector and a Standard Needleless Connector for the Prevention of Central Line-Associated Bloodstream Infections

Jacob

Tejedor

Reyes

et al. 2014

Infect. Control Hosp. Epidemiol.

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objective. To assess the impact of a novel, silver-coated needleless connectors (NCs) on central-line-associated bloodstream infection (CLABSI) rates compared with a mechanically identical NCs without a silver coating. conclusions. The use of silver-coated NCs decreased the CLABSI rate by 32%. CLABSI reduction efforts should include efforts to minimize contamination of NCs. Infect Control Hosp Epidemiol 2015;36(3):294-301Central-line-associated bloodstream infection (CLABSI) is a major cause of patient harm, and prevention of such infections has received much attention over the past decade. A national effort to prevent CLABSIs has been undertaken through optimization of central-line insertion practices. With this and other strategies, including economic disincentives through payment reform and public reporting of infection rates, the incidence of CLABSI has decreased in U.S. hospitals; however, in 2009,~41,000 CLABSIs were reported. 1 The persistence of CLABSIs and their high associated mortality underscore the need for novel prevention efforts.CLABSIs occur through two major routes. Infection can occur via an extraluminal pathway when microorganisms, often from the skin surface, gain access to the bloodstream via the external catheter surface. This contamination of the catheter surface can occur at the time of catheter insertion, particularly if proper insertion practices are not used. Intraluminal colonization of the catheter with seeding of the bloodstream typically occurs following contamination of the catheter hub, which is frequently manipulated in the process of injecting medications or fluids. Molecular typing of blood, skin, and catheter hub isolates suggests that most CLABSIs occurring early after line insertion originate from the skin (and are likely insertion-related events), whereas many CLABSIs occurring after the first 1-2 weeks of line placement are related to catheter hub contamination. [2][3][4][5][6][7][8]

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Prevalence of the Use of Central Venous Access Devices Within and Outside of the Intensive Care Unit: Results of a Survey Among Hospitals in the Prevention Epicenter Program of the Centers for Disease Control and Prevention

Cited by 126 publications

References 26 publications

Microbial Biofilms on Needleless Connectors for Central Venous Catheters: Comparison of Standard and Silver-Coated Devices Collected from Patients in an Acute Care Hospital

Microbial Biofilms on Needleless Connectors for Central Venous Catheters: Comparison of Standard and Silver-Coated Devices Collected from Patients in an Acute Care Hospital

Electronic Surveillance for Healthcare-Associated Central Line—Associated Bloodstream Infections Outside the Intensive Care Unit

Comparison of a Silver-Coated Needleless Connector and a Standard Needleless Connector for the Prevention of Central Line-Associated Bloodstream Infections

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