TY - JOUR
T1 - Central venous catheter-related infections
T2 - A review
AU - Adal, Karim A.
AU - Barry, M.
N1 - Funding Information:
Supported in part by National Institutes of Health Training Grant T32AI07046.
PY - 1996/3
Y1 - 1996/3
N2 - Catheter-associated bloodstream infections remain an important cause of nosocomial infection, with an estimated 50,000-100,000 cases occurring each year in the United States. Central venous catheters are believed to be responsible for 90% of such infections. The cumulative risk of acquiring a catheter-related bloodstream infection has ranged between 1 and 10% for central venous catheters in general and 6% for total parenteral nutrition catheters. The skin is the most common source of organisms causing catheter- related infections. Recent prospective studies have shown that the incidence density per catheter day does not increase with duration of catheterization and that routine changes, either over a guidewire or by new site puncture, do not appear to lower the risk of infection. Diagnosis of infection can be difficult in intensive care patients but is usually easier in less ill patients with a central venous catheter. Quantitative or semiquantitative laboratory techniques can be used to confirm the diagnosis in the appropriate clinical setting. A variety of preventive measures have been shown to minimize the risk of development of catheter-related bloodstream infection, including use of maximal aseptic technique for insertion, use of special teams for care of the catheter, limiting manipulation of the catheter, use of povidone-iodine ointment and cotton gauze dressings for recently inserted catheters, a silver-impregnated collagen cuff and antiseptic impregnated catheters.
AB - Catheter-associated bloodstream infections remain an important cause of nosocomial infection, with an estimated 50,000-100,000 cases occurring each year in the United States. Central venous catheters are believed to be responsible for 90% of such infections. The cumulative risk of acquiring a catheter-related bloodstream infection has ranged between 1 and 10% for central venous catheters in general and 6% for total parenteral nutrition catheters. The skin is the most common source of organisms causing catheter- related infections. Recent prospective studies have shown that the incidence density per catheter day does not increase with duration of catheterization and that routine changes, either over a guidewire or by new site puncture, do not appear to lower the risk of infection. Diagnosis of infection can be difficult in intensive care patients but is usually easier in less ill patients with a central venous catheter. Quantitative or semiquantitative laboratory techniques can be used to confirm the diagnosis in the appropriate clinical setting. A variety of preventive measures have been shown to minimize the risk of development of catheter-related bloodstream infection, including use of maximal aseptic technique for insertion, use of special teams for care of the catheter, limiting manipulation of the catheter, use of povidone-iodine ointment and cotton gauze dressings for recently inserted catheters, a silver-impregnated collagen cuff and antiseptic impregnated catheters.
KW - central venous catheters
KW - complications
KW - infection
KW - prevention
UR - http://www.scopus.com/inward/record.url?scp=0030111212&partnerID=8YFLogxK
U2 - 10.1016/S0899-9007(96)91126-0
DO - 10.1016/S0899-9007(96)91126-0
M3 - Review article
C2 - 8798227
AN - SCOPUS:0030111212
SN - 0899-9007
VL - 12
SP - 208
EP - 213
JO - Nutrition
JF - Nutrition
IS - 3
ER -