Infections Associated with Intravascular Lines and Grafts

Kern, Winfried V.

doi:10.1016/b978-0-7020-6285-8.00048-4

Cited by 4 publications

(5 citation statements)

References 140 publications

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“…Exit-site infection was defined as the finding of purulent secretions at the exit site or two of the three symptoms, namely erythema, tenderness and induration around the exit site. 14 The mean albumin level in this study was found to be 3.05±0.41 in bloodstream infections and 3.13±0.50 in exit-site infections. Albumin levels had no difference against DLC infection based on bloodstream infection and exit-site infection (p>0.05).…”

Section: Grothe Et Al (2010) Found That Diabetes Mellitusmentioning

confidence: 40%

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Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang

2021

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Background. Chronic kidney disease (CKD) is a terminal disease requiring hemodialysis. Hemodialysis requires vascular access using a double lumen catheter (DLC). However, the use of DLC may increase complications mainly infection, either infection of exit site or bloodstream. This study is aimed to seek risk factors contributing to the incidence of central catheter-related infections in CKD patients with DLC undergoing HD at Dr. M. Djamil Hospital, Padang. Methods. This study is a prospective study on patients undergoing HD at Dr. M. Djamil Hospital, Padang. This study using consecutive sampling technique. Data were analyzed using SPSS version 25.0. Results. This study involved 40 CKD patients undergoing HD. Majority of the samples had bloodstream infections (67.5%). Clinical manifestations of purulent secretion, duration of catheter used, and hypoalbuminemia had significant differences in the incidence of DLC infection based on bloodstream infection and exit site infection (p<0.05). The most common bacterial found was Pseudomonas aeruginosa (22.5%) which was sensitive to ceftazidime, cefepime, meropenem, amikacin, gentamicin, ciprofloxacin. Conclusion. Factors contributing to the incidence of DLC-related infections at Dr. M. Djamil Hospital are duration of catheter use and hypoalbuminemia. Pseudomonas aeruginosa is the most common cause of DLC-related infections.

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Section: Grothe Et Al (2010) Found That Diabetes Mellitusmentioning

confidence: 40%

“…increased the risk of bloodstream infection by 1.37 times in CKD patients taking DLC. 14 Theoretically, elderly patients with diabetes mellitus comorbidity are risk factors that can increase the incidence of infection.…”

Section: Grothe Et Al (2010) Found That Diabetes Mellitusmentioning

confidence: 99%

Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang

2021

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“…Additionally, limited concentrations and types of antibiotics can be loaded, which restrains the antimicrobial spectrum . Moreover, the existing guidelines for CRBSI prevention recommend the use of a CSS or a minocycline–rifampicin-impregnated catheter in patients with a catheterization up to 5 days, with no data for pediatric patients. , …”

Section: Release-based Antimicrobial Strategiesmentioning

confidence: 99%

“…72 Moreover, the existing guidelines for CRBSI prevention recommend the use of a CSS or a minocycline−rifampicin-impregnated catheter in patients with a catheterization up to 5 days, with no data for pediatric patients. 60,73 Another possible alternative to prevent catheter-related bloodstream infections is the usage of the Antibiotic Lock Therapy (ALT), which consists of the instillation of a highly concentrated antibiotic solution (100−1000 higher than the minimum inhibitory concentration), usually in association with an anticoagulant, into the lumen of a vascular catheter and is left to settle while the catheter is not being used. 74,75 Additionally, during this procedure, the volume of antibiotic solution must be enough to fill the catheter lumen without spilling into the systemic circulation.…”

Section: ■ Release-based Antimicrobial Strategiesmentioning

confidence: 99%

A Glance at Antimicrobial Strategies to Prevent Catheter-Associated Medical Infections

et al. 2020

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Urinary and intravascular catheters are two of the most used invasive medical devices; however, microbial colonization of catheter surfaces is responsible for most healthcare-associated infections (HAIs). Several antimicrobial-coated catheters are available, but recurrent antibiotic therapy can decrease their potential activity against resistant bacterial strains. The aim of this Review is to question the actual effectiveness of currently used (coated) catheters and describe the progress and promise of alternative antimicrobial coatings. Different strategies have been reviewed with the common goal of preventing biofilm formation on catheters, including release-based approaches using antibiotics, antiseptics, nitric oxide, 5-fluorouracil, and silver as well as contact-killing approaches employing quaternary ammonium compounds, chitosan, antimicrobial peptides, and enzymes. All of these strategies have given proof of antimicrobial efficacy by modifying the physiology of pathogens or disrupting their structural integrity. The aim for synergistic approaches using multitarget processes and the combination of both antifouling and bactericidal properties holds potential for the near future. Despite intensive research in biofilm preventive strategies, laboratorial studies still present some limitations since experimental conditions usually are not the same and also differ from biological conditions encountered when the catheter is inserted in the human body. Consequently, in most cases, the efficacy data obtained from in vitro studies is not properly reflected in the clinical setting. Thus, further well-designed clinical trials and additional cytotoxicity studies are needed to prove the efficacy and safety of the developed antimicrobial strategies in the prevention of biofilm formation at catheter surfaces.

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“…Two large databases [ 41 , 42 ] including over 77 million patient records will be interrogated for the co-occurrence of CVADs together with signs and symptoms of bacterial or fungal infection, such as fever, rigors, hypotension, lactic acidosis, nausea or vomiting, purulent discharge from the insertion or exit site, leukocytosis, and catheter removal associated with presumption of infection. Infectious disease experts assert that in practically all such cases, blood cultures should be obtained to validate the diagnosis [ 9 , 43 ]. A significant gap between the number of CVAD patient records exhibiting “prima facie” evidence of infection (or lacking sufficient data to assess for infection) and the number of records with concurrently obtained blood cultures would be indicative of the potentially harmful impact of low-quality data and nonstandard diagnostic practices on accurate diagnosis, documentation, and treatment of these high-risk patients.…”

Section: Introductionmentioning

confidence: 99%

Venous Access: National Guideline and Registry Development (VANGUARD): Advancing Patient-Centered Venous Access Care Through the Development of a National Coordinated Registry Network

Iorga¹,

Velezis²,

Marinac‐Dabic³

et al. 2023

J Med Internet Res

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There are over 8 million central venous access devices inserted each year, many in patients with chronic conditions who rely on central access for life-preserving therapies. Central venous access device–related complications can be life-threatening and add tens of billions of dollars to health care costs, while their incidence is most likely grossly mis- or underreported by medical institutions. In this communication, we review the challenges that impair retention, exchange, and analysis of data necessary for a meaningful understanding of critical events and outcomes in this clinical domain. The difficulty is not only with data extraction and harmonization from electronic health records, national surveillance systems, or other health information repositories where data might be stored. The problem is that reliable and appropriate data are not recorded, or falsely recorded, at least in part because policy, payment, penalties, proprietary concerns, and workflow burdens discourage completeness and accuracy. We provide a roadmap for the development of health care information systems and infrastructure that address these challenges, framed within the context of research studies that build a framework of standardized terminology, decision support, data capture, and information exchange necessary for the task. This roadmap is embedded in a broader Coordinated Registry Network Learning Community, and facilitated by the Medical Device Epidemiology Network, a Public-Private Partnership sponsored by the US Food and Drug Administration, with the scope of advancing methods, national and international infrastructure, and partnerships needed for the evaluation of medical devices throughout their total life cycle.

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Infections Associated with Intravascular Lines and Grafts

Cited by 4 publications

References 140 publications

Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang

Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang

A Glance at Antimicrobial Strategies to Prevent Catheter-Associated Medical Infections

Venous Access: National Guideline and Registry Development (VANGUARD): Advancing Patient-Centered Venous Access Care Through the Development of a National Coordinated Registry Network

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