Prevention of catheter sepsis: The hub

Sitges‐Serra, Antonio; Hernández, R Sánchez; Maestro, Sandra; Pi-Suñer, T.; Garcés, José M.; Segura, M.

doi:10.1016/s0899-9007(97)00220-7

Cited by 51 publications

(21 citation statements)

References 33 publications

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“…Microorganisms gain access by one of three mechanisms: 1) skin organisms invade the percutaneous tract, probably facilitated by capillary action, at the time of insertion or in the days following; 2) microorganisms contaminate the catheter hub and lumen when the catheter is inserted over a percutaneous guidewire or later manipulated [29]; or 3) organisms are carried hematogenously to the implanted IVD from remote sources of local infection, such as a pneumonia.…”

Section: Pathogenesis Of Intravascular Device-related Bloodstream Infmentioning

confidence: 99%

Nosocomial infections in the intensive care unit associated with invasive medical devices

Safdar¹,

Crnich²,

Maki

2001

Curr Infect Dis Rep

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Modern day health care has become synonymous with cutting-edge, high-tech medicine, which includes a large and growing number of invasive medical devices, especially in intensive care units. The most widely used of these devices--intravascular catheters of many types and urinary catheters--account for more than one half of all institutionally acquired infections. Growing knowledge of the pathogenesis and epidemiology of these infections has given birth to novel and more effective control measures, the most promising of which are technologically based.

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Section: Pathogenesis Of Intravascular Device-related Bloodstream Infmentioning

confidence: 99%

Nosocomial infections in the intensive care unit associated with invasive medical devices

Safdar¹,

Crnich²,

Maki

2001

Curr Infect Dis Rep

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“…This suggests that the health-care provider's hands may transfer skin flora to the inner surface of the catheter hub during hub manipulation and replacement of the infusion set and emphasizes the importance of good hand hygiene. [44][45][46][47] The design of line setups can influence the risk of infection and reducing the number of ports, decreasing the use of three-way stopcocks, and limiting the number of catheter lumens may decrease the occurrence of line sepsis. 46,47 Strategies that reduce the likelihood of line sepsis include: minimizing blood sampling by batching laboratory specimen draws; 48 prepping of hubs with disinfectants; 44,49 use of an alternative hub design with an antiseptic chamber; [50][51][52] and use of better hub connectors with needleless systems.…”

Section: Reducing Intravascular Line-related Infectionsmentioning

confidence: 99%

Prevention and Treatment of Nosocomial Sepsis in the NICU

et al. 2004

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Nosocomial sepsis is a serious problem for neonates who are admitted for intensive care. It is associated with an increase in mortality, morbidity, and prolonged length of hospital stay. Thus, both the human and fiscal costs of these infections are high. Although the rate of nosocomial sepsis increases with the degree of both prematurity and low birth weight, no specific lab test has been shown to be very useful in improving our ability to predict who has a ''real'' blood-stream infection and, therefore, who needs to be treated with a full course of antibiotics. As a result, antibiotic use is double the rate of ''proven'' sepsis and we are facilitating the growth of resistant organisms in the neonatal intensive care unit. The purpose of this article is to describe simple changes in process, which when implemented, can reduce nosocomial infection rates in neonates and improve outcomes.

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“…Evidence derived from electron microscopic examination of catheter surfaces [22] and data coming from series of CBIs in which hubs were cultured [23] indicate that the longer the catheters remain in place the more likely they are to become contaminated by the endoluminal route.…”

Section: Pathogenesismentioning

confidence: 99%

Catheter‐related Bloodstream Infections

Sitges‐Serra¹,

Girvent²

1999

World j. surg.

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Catheter-related bloodstream infections (CBIs) rank among the most frequent and potentially lethal nosocomial infections. Intravascular devices become contaminated on the outer surface during nonaseptic insertion or maintenance of the catheter exit site or endoluminally during hub manipulation. CBI is heralded by spiking fever, malaise and rigors and should be promptly diagnosed to prevent endocarditis and septic metastasis. In about two-thirds of the cases the offending organisms are coagulase-negative staphylococci; Staphylococcus aureus, gram-negative bacilli, and Candida sp. are responsible for one-third of these infections and carry a worse prognosis. Diagnosis of CBI relies on proper bacteriologic techniques, some of which can be performed in situ avoiding withdrawal of the device. Prevention strategies should aim at avoiding extra- and endoluminal contamination and should be based on three main pillars: maximal aseptic barriers at insertion, appropriate site maintenance, and junctional (hub) care and protection. Treatment includes catheter withdrawal and appropriate antibiotic coverage. For long-term cuffed catheters, local treatment with intraluminal administration of antibiotics is effective and can save a significant number of catheters, particularly those colonized by coagulase-negative staphylococci.

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Prevention of catheter sepsis: The hub

Cited by 51 publications

References 33 publications

Nosocomial infections in the intensive care unit associated with invasive medical devices

Nosocomial infections in the intensive care unit associated with invasive medical devices

Prevention and Treatment of Nosocomial Sepsis in the NICU

Catheter‐related Bloodstream Infections

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