Reducing the Risk for Catheter-Related Infections: A New Strategy (1997)

Editorials15 August 1997Reducing the Risk for Catheter-Related Infections: A New StrategyMichele L. Pearson, MD and Elias Abrutyn, MDMichele L. Pearson, MDCenters for Disease Control and Prevention; Atlanta, GA 30333Allegheny University of the Health Sciences; Philadelphia, PA 19102Search for more papers by this author and Elias Abrutyn, MDCenters for Disease Control and Prevention; Atlanta, GA 30333Allegheny University of the Health Sciences; Philadelphia, PA 19102Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-4-199708150-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Intravascular catheters are integral to the practice of modern medicine. These devices are used to deliver life-sustaining fluids, such as antimicrobial agents, parenteral nutrition, and blood or blood products, and to monitor the hemodynamic status of critically ill patients. However, a potentially life-threatening complication-infection, particularly bloodstream infection-is associated with the use of intravascular catheters. Several types of catheters are available for clinical use, including short peripheral catheters, midline catheters, peripherally inserted central venous catheters, nontunneled central venous catheters used for the short term, and tunneled central venous catheters used for the long term (for example, Hickman and port catheters). The ...References1. Maki DG. Infections due to infusion therapy. In: Bennett JV, Brachman PS, eds. Hospital Infections. 3d ed. Boston: Little, Brown; 1992. Google Scholar2. Yeung C, May J, Hughes R. Infection rate for single-lumen v triple lumen subclavian catheters. Infect Control Hosp Epidemiol. 1988; 9:154-8. Google Scholar3. McCarthy MC, Shives JK, Robison RJ, Broadie TA. Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. JPEN J Parenter Enteral Nutr. 1987; 11:259-62. Google Scholar4. Clark-Christoff N, Watters VA, Sparks W, Snyder P, Grant JP. Use of triple-lumen subclavian catheters for administration of total parenteral nutrition. JPEN J Parenter Enteral Nutr. 1992; 16:403-7. Google Scholar5. Farkas JC, Liu N, Bleriot JP, Chevret S, Goldstein FW, Carlet J. Single-versus triple-lumen central catheter-related sepsis: a prospective randomized study in a critically ill population. Am J Med. 1992; 93:277-82. Google Scholar6. Pearson ML. Guideline for prevention of intravascular device-related infections. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1996; 17:438-73. Google Scholar7. Pearson ML. Guidelines for prevention of intravascular device-related infections. Part I. Intravascular device-related infections: an overview. The Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1996; 24:262-93. Google Scholar8. Maki DG, Stolz SM, Wheeler S, Mermel LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Ann Intern Med. 1997; 127:257-66. Google Scholar9. Raad I, Darouiche R, Dupuis J, Abi-Said D, Gabrielli A, Hachem R, et al. Central venous catheters coated with minocycline and rifampin for the orevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. Ann Intern Med. 1997; 127:267-74. Google Scholar10. Bach A, Bohrer H, Motsch J, Martin E, Geiss HK, Sonntag HG. Prevention of bacterial colonization of intravenous catheters by antiseptic impregnation of polyurethane polymers. J Antimicrob Chemother. 1994; 33:969-78. Google Scholar11. Greenfeld JI, Sampath L, Popilskis SJ, Brunnert SR, Stylianos S, Modak S. Decreased bacterial adherence and biofilm formation on chlorhexidine and silver sulfad azine-impregnated central venous catheters implanted in swine. Crit Care Med. 1995; 23:894-900. Google Scholar12. Sherertz RJ, Carruth WA, Hampton AA, Byron MP, Solomon DD. Efficacy of antibiotic-coated catheters in preventing subcutaneous Staphylococcus aureus infection in rabbits. J Infect Dis. 1993; 167:98-106. Google Scholar13. Maki DG, Cobb L, Garman JK, Shapiro JM, Ringer M, Helgerson RB. An attachable silver-impregnated cuff for prevention of infection with central venous catheters: a prospective randomized multicenter trial. Am J Med. 1988; 85:307-14. Google Scholar14. Kamal GD, Pfaller MA, Rempe LE, Jebson PJ. Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. JAMA. 1991; 265:2364-8. Google Scholar15. Ciresi DL, Albrecht RM, Volkers PA, Scholten DJ. Failure of antiseptic bonding to prevent central venous catheter-related infection and sepsis. Am Surg. 1996; 62:641-65. Google Scholar16. Pemberton LB, Ross V, Cuddy P, Kremer H, Fessler T, McGurk E. No difference in catheter sepsis between standard and antiseptic central venous catheters. A prospective randomized trial. Arch Surg. 1996; 131:986-9. Google Scholar17. Groeger JS, Lucas AB, Coit D, LaQuaglia M, Brown AE, Turnbull A, et al. A prospective, randomized evaluation of the effect of the silver impregnated subcutaneous cuffs for preventing tunneled chronic venous access catheter infections in cancer patients. Ann Surg. 1993; 218:206-10. Google Scholar18. Centers for Disease Control and Prevention. National Nosocomial Infection Surveillance System Semiannual Report. December 1996. Atlanta, GA: Centers for Disease Control and Prevention; 1996. Google Scholar19. Edwards JR, Culver DH, Gaynes RP. Temporal trends in device-associated infection rates in intensive care units in the United States [Abstract]. The National Nosocomial Infection Surveillance System. Infect Control Hosp Epidemiol. 1997; 18(Part 2):50. Google Scholar20. Timsit JF, Sebille V, Farkas JC, Misset B, Martin JB, Chevret S, et al. Effect of subcutaneous tunneling on internal jugular catheter-related sepsis in critically ill patients: a prospective randomized multicenter study. JAMA. 1996; 276:1416-20. Google Scholar21. Mimoz O, Pieroni L, Lawrence C, Edouard A, Costa Y, Samii K, et al. Prospective, randomized trial of two antiseptic solutions for prevention of central venous or arterial catheter colonization and infection in intensive care unit patients. Crit Care Med. 1996; 24:1818-23. Google Scholar Author, Article, and Disclosure InformationAuthors: Michele L. Pearson, MD; Elias Abrutyn, MDAffiliations: Centers for Disease Control and Prevention; Atlanta, GA 30333Allegheny University of the Health Sciences; Philadelphia, PA 19102Corresponding Author: Michele L. Pearson, MD, Hospital Infections Program, Mailstop E-69, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333.Current Author Addresses: Dr. Pearson: Hospital Infections Program, Mailstop E-69, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrevention of Central Venous Catheter-Related Bloodstream Infection by Use of an Antiseptic-Impregnated Catheter Dennis G. Maki , Susan M. Stolz , Susan Wheeler , and Leonard A. Mermel Central Venous Catheters Coated with Minocycline and Rifampin for the Prevention of Catheter-Related Colonization and Bloodstream Infections Issam Raad , Rabih Darouiche , Jacques Dupuis , Dima Abi-Said , Andrea Gabrielli , Ray Hachem , Matthew Wall , Richard Harris , James Jones , Antonio Buzaid , Claudia Robertson , Salwa Shenaq , Patrick Curling , Thomas Burke , and Charles Ericsson Catheter-Related Bacteremia and Outcome of Attempted Catheter Salvage in Patients Undergoing Hemodialysis Kieren A. Marr , Daniel J. Sexton , Peter J. Conlon , G. Ralph Corey , Steven J. Schwab , and Kathryn B. Kirkland Metrics Cited byAntibiotics in interventional radiologyPatient's cells colonize the biofilm of Tenckhoff catheters used in peritoneal dialysisAntibacterial bioactive materialsFactors contributing to the contamination of peripheral intravenous catheters in dogs and catsCatheter-Related Bloodstream Infection in the Intensive Care UnitA Statistical Approach to Reduce Hospital-Associated InfectionsChlorhexidine - Pharmacology and Clinical ApplicationsTissue plasminogen activator to prevent central venous access device infections: a systematic review of central venous access catheter thrombosis, infection and thromboprophylaxisReduction of catheter-related colonisation by the use of a silver zeolite-impregnated central vascular catheter in adult critical careFundamentals of Infection Control and Strategies for the Intensive Care UnitSurveillance of Infections Associated With Intravenous Catheters in Dogs and Cats in an Intensive Care UnitDrug/device combinations for local drug therapies and infection prophylaxisColonization and Bloodstream Infection with Single- Versus Multi-Lumen Central Venous Catheters: A Quantitative Systematic ReviewBacteremia after hematopoietic stem cell transplantation: incidence and predictive value of surveillance culturesIntravenous therapyInfections nosocomialesInfectious syndromes in solid tumor therapyImpact of oligon central venous catheters on catheter colonization and catheter-related bloodstream infectionPrevention of Bloodstream Infections With Central Venous Catheters Treated With Anti-Infective Agents Depends on Catheter Type and Insertion Time: Evidence From a Meta-AnalysisPrevention and management of pediatric catheter-related infectionsFundamentals of Infection Control and Surveillance Strategies for the ICUInternal Jugular Vein Access for Hemodialysis using Dual-Lumen Silicon Catheters with Dacron CuffCan We Achieve Consensus on Central Venous Catheter-Related Infections?Novel methods for the prevention of infection of intravascular devicesCan antimicrobial central venous catheters prevent associated infection?Venous air embolism from central venous catheterization: A need for increased physician awarenessThe Future of Vascular Access: Will the Benefits Be Worth the Risk?Catheter Infections: Diagnosis, Etiology, Treatment, and PreventionThe ex vivo antimicrobial activity and colonization rate of two antimicrobial-bonded central venous cathetersNosocomial infections in the nurseryDiagnosis of central venous catheter related sepsis--a critical look insideIn Vitro Antimicrobial Activity of a New Antiseptic Central Venous CatheterCatheter-associated infections: A necessary evilNosocomial Colonization, Septicemia, and Ilickman/Broviac Catheter-Related Infections in Bone Marrow Transplant Recipients: A 5-Year Prospective Study 15 August 1997Volume 127, Issue 4Page: 304-306KeywordsAntimicrobialsBacteremiaBloodCatheter-related infectionsCathetersHealth care providersHospitalsInfectious disease controlPathogensRelative risk ePublished: 15 August 2000 Issue Published: 15 August 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...