A Prospective Study of the Catheter Hub as the Portal of Entry for Microorganisms Causing Catheter-Related Sepsis in Neonates

Salzman, Mark B.; Isenberg, Henry D.; Shapiro, Jeffrey D.; Lipsitz, Philip J.; Rubin, Lorry G.

doi:10.1093/infdis/167.2.487

Cited by 195 publications

(81 citation statements)

References 12 publications

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“…In our study, catheters were in place for no longer than 3 days, and the positive S. aureus culture from the hub occurred in only one case, and this was obtained on the same day as the blood sample from which S. aureus was cultured (Table 2). Hub colonization plays an important role in catheter-related bloodstream infection (23,40,42). The detection of hub colonization with the same microorganism recovered from the blood shows that hub contamination is important in the pathogenesis of catheter related infections (40).…”

Section: Resultsmentioning

confidence: 99%

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Stpahylococcus aureus biofilms on central venous haemodialysis catheters

Aoki¹,

Pizzolitto²,

Garcia³

et al. 2005

Braz. J. Microbiol.

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Biofilm bacterial infections are common in patients undergoing treatment with haemodialysis. This study involved 16 patients (7 males, 9 females; ages from 22 to 81 with an average age of 50) who had had a total of 25 temporary haemodialysis polyurethane catheter insertions into the subclavian vein (22 dual-lumen and 3 triple-lumen). The catheters remained in place from 3 to 91 days, on an average of 47 days. The reasons for catheter removal were: bad functioning (44%), suspicion of catheter-related infection (20%), availability of permanent access (16%), accidental removal (12%), signs and symptoms of infection at the site of catheter insertion (4%), and exogenous contamination (4%). Positive tip cultures were observed on seven of the catheters (28%), showing three positive blood cultures. The Staphylococcus aureus were identified in 12% of the blood cultures and isolated from one of the hubs, and biofilms were observed on all catheter tips. The S. aureus retrieved from both blood and catheters (tips and hubs) were resistant to penicillin and susceptible to azithromycin, ciprofloxacin, clindamycin, chloramphenicol, gentamicin, oxacillin, rifampin, sulfamethoxazole, tetracycline, and vancomycin. The S. aureus strains isolated from both blood and catheters (tips and hubs) were considered to be identical based on antibiotic susceptibility patterns and genetic similarity assessed using an automated ribotyping system.

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Section: Resultsmentioning

confidence: 99%

“…Hub colonization plays an important role in catheter-related bloodstream infection (23,40,42). The detection of hub colonization with the same microorganism recovered from the blood shows that hub contamination is important in the pathogenesis of catheter related infections (40).…”

Section: Resultsmentioning

confidence: 99%

Stpahylococcus aureus biofilms on central venous haemodialysis catheters

Aoki¹,

Pizzolitto²,

Garcia³

et al. 2005

Braz. J. Microbiol.

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“…However, invasion from the catheter occurs less frequently through the use of contaminated intravenous fluids, from fungemia and from the central portion of the catheter (13).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Candida species in umbilical catheters implanted in newborns in Natal, Brazil

Fernandes¹,

Júnior²,

Oliveira³

et al. 2007

Braz. J. Microbiol.

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All the newborns with umbilical venous catheters, hospitalized in the neonatal intensive care unit at Januário Cicco Maternity Hospital in Natal, Brazil, between January, 2003 and December, 2004 were studied. The prevalence of Candida species in the tips of intra-venous catheters was assessed, as well as the coexisting exposures that the patients were subjected to. Catheter tips were cultivated in blood agar and when yeast culture occurred, the colony was subcultivated for species identification through morphologic and biochemical assays. From a total of 240 catheters, 41 were positive for yeasts, and 34 were submitted to identification. The following agents were isolated: 13 C. albicans (38%), 10 Candida parapsilosis (29%), 8 C. tropicalis (20%), one C. guilliermondii (3%), one C. famata (3%) and one Trichosporon spp. (3%). Three patients among those with positive catheter tip fungal cultures were also hemoculture positive, with the same fungal species at both sites. Among the coexisting exposures, it should be pointed out that all the patients underwent broad spectrum antibiotic therapy, used a nasogastric probe, in addition to undergoing other invasive procedures such as mechanical ventilation and umbilical catheter implantation.

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“…1 Bloodstream infections caused by normal skin flora result in catheter colonization, bacteremia and prolonged hospitalization. [2][3][4][5][6] Coagulase-negative-staphylococcal (CoNS) bacteremia accounts for 80% of all CVL-related bacteremia. 1,7,8 Other organisms associated with central catheters are Klebsiella, Enterobacter, Escherichia coli, Serratia, Citrobacter and Candida species.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

et al. 2008

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Objective: To evaluate the efficacy of prophylactic antibiotics in preventing infection associated with central venous catheters in preterm neonates.Study Design: The search strategy of the Cochrane Neonatal Review Group was used. The following databases were searched: Medline, Cochrane Central Register of Controlled Trials, CINAHL and EMBASE. In addition, we hand-searched abstracts of Pediatric Academic Societies annual meetings published in Pediatric Research (1990 to July 2007 and Canadian Pediatric Society annual meeting proceedings (1990( to July 2007. No language restrictions were applied. Included were randomized controlled trials of antibiotics given prophylactically to prevent infection in preterm infants (<37 completed weeks) less than 1-month old admitted to neonatal intensive care units. Both centrally or peripherally inserted central venous catheters were included. Assessment of methodological quality and extraction of data for included trials was undertaken independently by two authors. When suitable, data from trials were combined in a meta-analysis.Result: A total of three studies were found which addressed the role of prophylactic antibiotics to prevent catheter-related infection in neonates. Two studies used vancomycin as the prophylactic antibiotic and one study used amoxicillin. The meta-analysis of studies that used vancomycin had shown an absolute risk reduction of infection from 23 to 2.4%, which yields a number needed to treat equal to 5 (P ¼ 0.0001). Total duration of catheter stay and mortality, were both similar in the vancomycin and control groups. In the amoxicillin study, catheter-related sepsis was not significantly different between the treatment and control groups (P ¼ 0.40). The rate of colonization, however, was significantly higher in the control group (relative risk 0.48; 95% CI 0.12, 1.35). The incidence of necrotizing enterocolitis, intracranial hemorrhage, thrombosis and deaths were not statistically significant between groups.Conclusion: Prophylactic vancomycin appeared to be effective in preventing catheter-related sepsis in preterm neonates. The potential risks, however, of the emergence of resistance because of prophylactic antibiotics, and their continued effectiveness, need further evaluation, before routine use can be recommended.

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A Prospective Study of the Catheter Hub as the Portal of Entry for Microorganisms Causing Catheter-Related Sepsis in Neonates

Cited by 195 publications

References 12 publications

Stpahylococcus aureus biofilms on central venous haemodialysis catheters

Stpahylococcus aureus biofilms on central venous haemodialysis catheters

Prevalence of Candida species in umbilical catheters implanted in newborns in Natal, Brazil

Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

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