Diagnosis of Central Venous Catheter-Related Sepsis

Brun-Buison, C.; Abrouk, Fekri; Legrand, Patrick; Huet, Y.; Larabi, Salah; Rapin, M

doi:10.1097/00132586-198712000-00043

Cited by 13 publications

(17 citation statements)

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“…Studies were included if a definition of CRBSI was provided that required the isolation of the same organism from the culture of a catheter segment and peripheral blood cultures. Catheter colonization results were reported if the study used a recognized definition of a positive catheter colonization of either ‡15 colony forming units (CFU) by semi-quantitative culture (Maki et al 1977) or ‡10 3 CFU/ mL by quantitative technique from culture of the distal end of the catheter (Brun-Buisson et al 1987).…”

Section: Search Methodsmentioning

confidence: 99%

Catheter‐related bloodstream infections in intensive care units: a systematic review with meta‐analysis

Ramritu

Halton

Cook

et al. 2008

Journal of Advanced Nursing

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Title. Catheter-related bloodstream infections in intensive care units: a systematic review with meta-analysis. Aim. This paper is a report of a systematic review and meta-analysis of strategies, other than antimicrobial coated catheters, hypothesized to reduce risk of catheterrelated bloodstream infections and catheter colonization in the intensive care unit setting. Background. Catheter-related bloodstream infections occur at a rate of 5 per 1000 catheter days in the intensive care unit setting and cause substantial mortality and excess cost. Reducing risk of catheter-related bloodstream infections among intensive care unit patients will save costs, reduce length of stay, and improve outcomes. Methods. A systematic review of studies published between January 1985 and February 2007 was carried out using the keywords 'catheterization -central venous' with combinations of infection*, prevention* and bloodstream*. All included studies were screened by two reviewers, a validated data extraction instrument was used and data collection was completed by two blinded independent reviewers. Risk ratios for catheter-related bloodstream infections and catheter colonization were estimated with 95% confidence intervals for each study. Results from studies of similar interventions were pooled using meta-analyses. Results. Twenty-three studies were included in the review. The strategies that reduced catheter colonization included insertion of central venous catheters in the subclavian vein rather than other sites, use of alternate skin disinfection solutions before catheter insertion and use of Vitacuff in combination with polymyxin, neomycin and bacitracin ointment. Strategies to reduce catheter-related bloodstream infection included staff education multifaceted infection control programmes and performance feedback. Conclusion. A range of interventions may reduce risks of catheter-related bloodstream infection, in addition to antimicrobial catheters.

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Section: Search Methodsmentioning

confidence: 99%

Catheter‐related bloodstream infections in intensive care units: a systematic review with meta‐analysis

Ramritu

Halton

Cook

et al. 2008

Journal of Advanced Nursing

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“…Although useful, these methods are time-consuming; they depend on the skill of the observer and may not be routinely used [68]. Importantly, cut-off for the diagnosis of CRI varies according to the technique used: in particular, quantitative culture techniques using sonication (!1000 CFUs) [16], vortex (!100 CFUs) [14]; and roll-plate semiquantitative technique (>15 CFUs) [15].…”

Section: Diagnosismentioning

confidence: 99%

Overview of catheter-related infections with special emphasis on prevention based on educational programs

Eggimann

Pittet

2002

Clinical Microbiology and Infection

110

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Intra-vascular access is an unavoidable tool in sophisticated modern medical practice, and catheter-related infection remains a leading cause of nosocomial infections, particularly in intensive care units where it is associated with significant patient morbidity, mortality, and additional hospital costs. The incidence of catheter-related bloodstream infection ranges from 2 to 14 episodes per 1000 catheter-days. On average, microbiologically documented, device-related bloodstream infections complicate the use of a central venous line in three to five per 100 cases. But this represents only the visible part of the iceberg and most episodes of clinical sepsis are nowadays considered to be catheter-related. We briefly review the pathophysiology of these infections, highlighting the importance of the skin insertion site and the intravenous line hub as principal sources of colonization and infection. Principles of therapy are briefly addressed. A large proportion of these infections are preventable and this has been the objective of creating precise guidelines. It was recently suggested that the situation may evolve with the introduction of antibiotic/antiseptic-coated devices, whose impact on the epidemiology of antibiotic resistance remains to be determined. Recently, educational programs and/or a global preventive strategy based on the strict application of specific preventive measures and careful control of all factors associated with infection proved to be even more effective than coated devices in reducing rates of infection. Practical aspects regarding educational approaches will help clinicians to adapt and incorporate educational programs into clinical practice.

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“…Colony counts of less than 10 3 CFU are considered intermediate, possible contamination, or the early stages of colonization. 91,92 For quantitative cultures based on sonication, a cut-off point of >10 2 CFU was established to discriminate between catheter infection and catheter colonization. 93 In general, semiquantitative and quantitative cultures give comparable results, although the semiquantitative procedure is easier and faster in practice.…”

Section: How Should the Results Of Catheter Cultures Be Interpreted?mentioning

confidence: 99%

Executive summary: Diagnosis and Treatment of Catheter-Related Bloodstream Infection: Clinical Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) and the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC)

Cháves

Garnacho-Montero

Pozo

et al. 2018

Enfermedades Infecciosas y Microbiología Clínica

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Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias). Short-term peripheral venous catheters, non-tunneled and long-term central venous catheters, tunneled catheters and hemodialysis catheters are covered by these guidelines. The panel identified 39 key topics that were formulated in accordance with the PICO format. The strength of the recommendations and quality of the evidence were graded in accordance with ESCMID guidelines. Recommendations are made for the diagnosis of CRBSI with and without catheter removal and of tunnel infection. The document establishes the clinical situations in which a conservative diagnosis of CRBSI (diagnosis without catheter removal) is feasible. Recommendations are also made regarding empirical therapy, pathogen-specific treatment (coagulase-negative staphylococci, Sthaphylococcus aureus, Enterococcus spp, Gram-negative bacilli, and Candida spp), antibiotic lock therapy, diagnosis and management of suppurative thrombophlebitis and local complications.

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Diagnosis of Central Venous Catheter-Related Sepsis

Cited by 13 publications

References 0 publications

Catheter‐related bloodstream infections in intensive care units: a systematic review with meta‐analysis

Catheter‐related bloodstream infections in intensive care units: a systematic review with meta‐analysis

Overview of catheter-related infections with special emphasis on prevention based on educational programs

Executive summary: Diagnosis and Treatment of Catheter-Related Bloodstream Infection: Clinical Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) and the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC)

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