scholarly journals Comment on: Changing epidemiology of central venous catheter-related bloodstream infections: increasing prevalence of Gram-negative pathogens

2012 ◽  
Vol 67 (6) ◽  
pp. 1565-1566 ◽  
Author(s):  
R. Sorde ◽  
B. Almirante ◽  
M. Palomar ◽  
A. Pahissa
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous ◽  
Gram Negative

scholarly journals Impact of Catheter Management on Clinical Outcome in Adult Cancer Patients With Gram-Negative Bacteremia

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Johny Fares ◽  
Melissa Khalil ◽  
Anne-Marie Chaftari ◽  
Ray Hachem ◽  
Ying Jiang ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Mucosal Barrier ◽  
Central Venous ◽  
Gram Negative ◽  
Central Venous Catheter Removal ◽  
Mucosal Barrier Injury

Abstract Objective Gram-negative organisms have become a major etiology of bloodstream infections. We evaluated the effect of central venous catheter management on cancer patients with gram-negative bloodstream infections. Method We retrospectively identified patients older than 14 years with central venous catheters who were diagnosed with gram-negative bloodstream infections to determine the effect of catheter management on outcome. Patients were divided into 3 groups: Group 1 included patients with central line-associated bloodstream infections (CLABSI) without mucosal barrier injury and those whose infection met the criteria for catheter-related bloodstream infection; group 2 included patients with CLABSI with mucosal barrier injury who did not meet the criteria for catheter-related bloodstream infection; and group 3 included patients with non-CLABSI. Results The study included 300 patients, with 100 patients in each group. Only in group 1 was central venous catheter removal within 2 days of bloodstream infection significantly associated with a higher rate of microbiologic resolution at 4 days compared to delayed central venous catheter removal (3–5 days) or retention (98% vs 82%, P = .006) and a lower overall mortality rate at 3-month follow-up (3% vs 19%, P = .01). Both associations persisted in multivariate analyses (P = .018 and P = .016, respectively). Conclusions Central venous catheter removal within 2 days of the onset of gram-negative bloodstream infections significantly improved the infectious outcome and overall mortality of adult cancer patients with catheter-related bloodstream infections and CLABSI without mucosal barrier injury.

Prominent Prevalence of Coagulase-Negative Staphylococcus Bloodstream Infections in Neutropenic Hematology/Oncology Children with Central Venous Catheter

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4664-4664
Author(s):  
Young-Ho Lee ◽  
Yeon Jung Lim ◽  
Soon-young Song ◽  
Ji-hye Kim ◽  
Sung-hee Oh ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Retrospective Analysis ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Coagulase Negative Staphylococcus ◽  
Gram Negative Bacteria ◽  
Central Venous ◽  
Gram Negative ◽  
Susceptibility Tests ◽  
Febrile Episodes

Abstract A retrospective analysis was performed on febrile neutropenic episodes in children with hematologic and oncologic diseases from 2005 to 2008. We reviewed total 255 febrile episodes occurred during the 3-year period in a total of 114 patients. Twenty-eight episodes of bacteremia occurred during neutropenic period in a total of 16 patients. All these patients had central venous catheter. There were 18 febrile episodes of Grampositive bacteria (64.3%), 9 episodes of Gram-negative bacteria (32.1%), and 1 episode of Candida (3.6%). The isolated organisms were as follows: Coagulase-negative Staphylococcus (CNS, N=17, 60.7%), Staphylococcus aureus (N=1, 3.6%), Enterobacter spp. (N=2, 7.1%), Pseudomonas spp. (N=2, 7.1%), Klebsiella (N=2, 7.1%), E. coli (N=2, 7.1%), Acinetobacter (N=1, 3.6%), Candida. (N=1, 3.6%). The bloodstream infection with CNS were more prevalent in children with Chemo-port (12 episodes in 6 from 34 patients, 17.6%) than in children with Hickman catheter (5 episodes in 5 from 22 patents, 22.7%), even though statistically not significant. In antibiotic susceptibility tests, all gram positive bacteria were resistant to penicillin and oxacillin, and sensitive to vancomycin and teicoplanin. In the case of Gram-negative bacteria, resistant rates to amikacin, gentamicin, imipenem, and piperacillin/tazobactam were 4.8%, 38.1%, 14.3%, and 42.9%, respectively. Based on this retrospective analysis, which reflects predominance of CNS bacteremia in febrile neutropenic patients, more emphasis needs to be laid on the empirical antibiotic regimen including vancomycin or teicoplanin as well as the strict skin preparations during procedures in children with central venous catheter.

scholarly journals Changing epidemiology of central venous catheter-related bloodstream infections: increasing prevalence of Gram-negative pathogens

2011 ◽  
Vol 66 (9) ◽  
pp. 2119-2125 ◽  
Author(s):  
M. Marcos ◽  
A. Soriano ◽  
A. Inurrieta ◽  
J. A. Martinez ◽  
A. Romero ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous ◽  
Gram Negative

scholarly journals Bedside ultrasound as a screening test for the diagnosis of catheter-related bloodstream infection (CRBI)

2021 ◽  
Author(s):  
Chiara de Sio ◽  
Mario Venafro ◽  
Giampiero Foccillo ◽  
Riccardo Nevola ◽  
Lucio Monaco
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Signs And Symptoms ◽  
Venous Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Roc Curve Analysis ◽  
Suspected Infection ◽  
Intravascular Devices ◽  
A Prospective Study

Abstract Purpose Between 15 and 30% of all nosocomial bacteremias and sepsis are associated with the use of intravascular devices. Catheter-related bloodstream infections (CRBI) are infections in which the organism identified in the blood is also present on the tip of the catheter itself or in a blood sample taken through it. The aim of the study was to evaluate the role of ultrasound in the diagnosis of infections related to the use of central catheters. Methods Between January 2018 and June 2019, we carried out a prospective study on 36 patients with a central catheter, such as a central venous catheter (CVC), a central catheter with peripheral insertion (PICC), or a fully implanted central venous catheter (PORT-a-cath) and who had signs and symptoms of infection. These patients were submitted to an ultrasound of the catheter upon arrival in the ward in case of suspected infection, or at the time of the onset of signs and symptoms of infection (if these arose during hospitalization). Patients with a central catheter but without signs and symptoms of infection were not included in the study. The end point of the study was to evaluate sensitivity (SENS), specificity (SPEC), positive and negative predictive value (PPV-NPV) and overall diagnostic accuracy (ODA) of ultrasound in the diagnosis of CRBI through Receiver Operating Characteristic (ROC) curve analysis. Results US showed a SENS of 94%, a SPEC of 84%, a PPV of 84%, an NPV of 94% and an ODA of 88.8% for the diagnosis of CRBI. Conclusions Preliminary data from our study show that US of intravascular devices has a high SENS and SPEC in the diagnosis of CRBI, and can, therefore, be used as a valid tool to decide whether to remove the device early or leave it in place.

Microbiological screening for earlier detection of central venous catheter-related bloodstream infections

2013 ◽  
Vol 43 (9) ◽  
pp. 964-969 ◽  
Author(s):  
Jasmin Wagner ◽  
Gernot Schilcher ◽  
Ines Zollner-Schwetz ◽  
Martin Hoenigl ◽  
Thomas Valentin ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous
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