Long-Term Silicone Central Venous Catheters Impregnated With Minocycline and Rifampin Decrease Rates of Catheter-Related Bloodstream Infection in Cancer Patients: A Prospective Randomized Clinical Trial

2004 ◽  
Vol 22 (15) ◽  
pp. 3163-3171 ◽  
Author(s):  
Hend Hanna ◽  
Robert Benjamin ◽  
Ioannis Chatzinikolaou ◽  
Badie Alakech ◽  
Deborah Richardson ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cancer Patients ◽  
Bloodstream Infection ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Care Hospital ◽  
Central Venous ◽  
Catheter Related Bloodstream Infection

PurposeTo evaluate the efficacy of long-term nontunneled silicone catheters impregnated with minocycline and rifampin (M-R) in reducing catheter-related bloodstream infections.Patients and MethodsThis prospective, randomized, double-blind clinical trial was conducted at M.D. Anderson Cancer Center, a tertiary care hospital in Houston, TX. All patients in the trial had a malignancy.ResultsBetween September 1999 and May 2002, 356 assessable catheters were used: 182 M-R and 174 nonimpregnated. The patients' characteristics were comparable between the two study groups. The mean (± standard deviation) duration of catheterization with M-R catheters was comparable to that of nonimpregnated catheters (66.21 ± 30.88 v 63.01 ± 30.80 days). A total of 17 catheter-related bloodstream infections occurred during the course of the study. Three were associated with the use of M-R catheters and 14 were associated with the nonimpregnated catheters, with a rate of catheter-related bloodstream infection of 0.25 and 1.28/1,000 catheter-days, respectively (P = .003). Gram-positive cocci accounted for the majority of the organisms causing the infections. There were no allergic reactions associated with M-R catheters.ConclusionLong-term nontunneled central venous catheters impregnated with minocycline and rifampin are efficacious and safe in reducing catheter-related bloodstream infections in cancer patients.

scholarly journals Tsukamurella catheter-related bloodstream infection in a pediatric patient with pulmonary hypertension

2010 ◽  
Vol 2 (1) ◽  
pp. 5
Author(s):  
Kristen A. Wendorf ◽  
Claudia M. Espinosa ◽  
William D. LeBar ◽  
Jason B. Weinberg
Keyword(s):  
Pulmonary Hypertension ◽  
Bloodstream Infection ◽  
Pediatric Patient ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Catheter Related Bloodstream Infection ◽  
Immunocompetent Patients

Catheter-related bloodstream infections (CR-BSI) are important complications in patients with long-term indwelling central venous catheters. In this report, we present the case of a 14-year-old male with pulmonary hypertension treated with continuous treprostinil infusion, who presented with a CR-BSI caused by a Tsukamurella species. This case highlights the potential for this unusual organism to cause infection in immunocompetent patients.

Clinical usefulness of catheter-drawn blood samples and catheter-tip cultures for the diagnosis of catheter-related bloodstream infections in neonates

2020 ◽  
Vol 41 (7) ◽  
pp. 854-856
Author(s):  
Janita Ferreira ◽  
Paulo Augusto Moreira Camargos ◽  
Viviane Rosado ◽  
Leni Márcia Anchieta ◽  
Roberta Maia de Castro Romanelli
Keyword(s):  
Adverse Events ◽  
Bloodstream Infection ◽  
Efficient Method ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Blood Sampling ◽  
Central Venous ◽  
Blood Samples ◽  
Catheter Tip ◽  
Catheter Related Bloodstream Infection

AbstractCatheter-drawn blood sampling is an efficient method of diagnosing catheter-related bloodstream infection (CRBSI) in neonates; it has greater sensitivity and accuracy than methods using catheter-tip cultures. No association was detected between catheter-drawn blood sampling and the occurrence of adverse events with central venous catheters.

Salvage of Long-Term Central Venous Catheters During an Outbreak ofPseudomonas putidaandStenotrophomonas maltophiliaInfections Associated With Contaminated Heparin Catheter-Lock Solution

2008 ◽  
Vol 29 (2) ◽  
pp. 125-130 ◽  
Author(s):  
M. Beatriz Souza Dias ◽  
Alina Bernardes Habert ◽  
Vera Borrasca ◽  
Valeska Stempliuk ◽  
Aina Ciolli ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Central Venous Catheters ◽  
High Response Rate ◽  
Care Hospital ◽  
Central Venous ◽  
Blood Samples ◽  
Asymptomatic Patients ◽  
Lock Solution ◽  
Catheter Lock

Objective.To describe the management of patients with long-term central venous catheters (CVCs) during an outbreak of infection due toPseudomonas putidaandStenotrophomonas maltophiliaassociated with contaminated heparin catheter-lock solution.Design.Descriptive study.Setting.Private, 250-bed tertiary-care hospital.Methods.In March 2003, we identified 2 febrile cancer patients withP. putidabacteremia. Over 2 days, 7 cases of bacteremia were identified; lots of syringes prefilled with heparin catheter-lock solution, supplied by a compounding pharmacy, were recalled and samples were cultured. More cases of bacteremia appeared during the following days, and any patient who had had a catheter lock infused with the suspect solution was asked to provide blood samples for culture, even if the patient was asymptomatic. Isolates that were recovered from culture were typed by pulsed-field gel electrophoresis. Antimicrobial salvage treatment of long-term CVCs was attempted.Results.A total of 154 patients had had their catheter lock infused with solution from the lots that were suspected of being contaminated. Only 48 of these patients had CVCs. By day 7 of the outbreak, 18 of these patients had become symptomatic. Twenty-six of the remaining 30 asymptomatic patients then also provided blood samples for culture, 10 of whom developed fever shortly after samples were collected. Thirty-two patients were identified who hadP. putidabacteremia; 9 also had infection due toS. maltophilia. Samples from 1 of the 3 lots of prefilled syringes in use at the time of the outbreak also grewP. putidaon culture. Molecular typing identified 3 different clones ofP. putidafrom patients and heparin catheter-lock solution, and 1 clone ofS. maltophilia. A total of 27 patients received antimicrobial therapy regimens, some of which included decontamination of the catheter lock with anti-infective lock solution. Of 27 patients, 19 (70%) retained their long-term CVC during the 6-month follow-up period.Conclusions.To our knowledge, this is one of the largest prospective experiences in the management of bloodstream infection associated with long-term CVCs. The infections were caused by gram-negative bacilli and were managed without catheter removal, with a high response rate. We emphasize the risks of using intravenous formulations of medications supplied by compounding pharmacies that produce large quantities of drugs.

scholarly journals Antimicrobial Impregnated Catheters in the Prevention of Catheter-Related Bloodstream Infection in Hospitalized Patients

2007 ◽  
Vol 12 (2) ◽  
pp. 77-90
Author(s):  
Sarah K. Wassil ◽  
Catherine M. Crill ◽  
Stephanie J. Phelps
Keyword(s):  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Hospitalized Patients ◽  
Central Venous ◽  
Related Factors ◽  
Future Directions ◽  
The Cost ◽  
Care Costs ◽  
Catheter Related Bloodstream Infection

Catheter-related bloodstream infections have a significant impact on increasing health care costs and morbidity and mortality in hospitalized patients. Many technologies have been created in an attempt to decrease the incidence of catheter-related bloodstream infection. One of these is the impregnation of central venous catheters with antiseptics (e.g., chlorhexidine and silver sulfadiazine) or antibiotics (e.g., minocycline and rifampin). While studies evaluating the efficacy of impregnated catheters have been conducted, the data are limited and their use remains variable across institutions. This paper will discuss catheter-related factors that predispose patients to catheter-related bloodstream infection, the types of antimicrobial-impregnated catheters in use today, studies evaluating their efficacy, and common concerns associated with the use of these catheters. Issues related to the cost-effectiveness of impregnated catheters and future directions for the prevention of catheter-related bloodstream infection will also be presented.

Prospective Incidence Study of Bloodstream Infection in Infants and Children With Central Venous Catheters After Cardiac Surgery in Italy

2009 ◽  
Vol 30 (7) ◽  
pp. 698-701 ◽  
Author(s):  
Stefania Bezzio ◽  
C. Scolfaro ◽  
R. Broglia ◽  
R. Calabrese ◽  
F. Mignone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Observational Study ◽  
Bloodstream Infection ◽  
Medical Staff ◽  
Prospective Observational Study ◽  
Central Venous Catheters ◽  
Central Venous ◽  
In Infants And Children ◽  
Catheter Related Bloodstream Infection

This prospective observational study was designed to assess the incidence of, risk factors for, and outcome of catheter-related bloodstream infection in children undergoing cardiac surgery. A staff specifically trained to handle the central venous catheters with proper aseptic techniques and an appropriate patient to medical staff ratio remain the most effective measures to prevent this infection.

scholarly journals Incidence rates of bloodstream infections in children with long-term central venous catheters at Instituto Nacional do Câncer, Brazil (1995 to 2001)

2002 ◽  
Vol 6 ◽  
pp. S29
Author(s):  
Marcelo Schirmer ◽  
Eduardo Velasco ◽  
Carlos A.S. Martins ◽  
Leda M. Dias ◽  
Vânia M.S.C. Gonçalves ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Incidence Rates ◽  
Central Venous Catheters ◽  
Central Venous

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.

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