Role of the Central Venous Catheter in Bloodstream Infections Caused by Coagulase-negative Staphylococci in Very Preterm Neonates

Central line–associated bloodstream infections (CLABSIs) are still a major cause of morbidity and mortality in pediatric hematology-oncology patients in many countries. This cross-sectional study was a retrospective review of CLABSI in inpatient pediatric hematology-oncology cases with long-term central venous catheter at the Pediatric Hematology Department from January 2013 to June 2014. Characteristics of CLABSI events in pediatric patients with hematologic malignancies and related nonmalignant hematologic conditions are documented. CLABSI developed in 61.8% ( n = 21) of the 34 hospitalized patients included in the study. The CLABSI rate was 7.8 per 1,000 inpatient central venous catheter days. Coagulase-negative staphylococci was the predominant pathogen in 47.6% of the patients with CLABSI. The high rate of CLABSI requires prevention strategies to reduce CLABSI immediately. This study provides guidance in prioritizing strategies for reducing rates of infection.

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The impact of staffing on central venous catheter-associated bloodstream infections in preterm neonates – results of nation-wide cohort study in Germany

Antimicrobial Resistance and Infection Control ◽

10.1186/2047-2994-2-11 ◽

2013 ◽

Vol 2 (1) ◽

pp. 11 ◽

Cited By ~ 19

Author(s):

Rasmus Leistner ◽

Sarah Thürnagel ◽

Frank Schwab ◽

Brar Piening ◽

Petra Gastmeier ◽

...

Keyword(s):

Cohort Study ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

Preterm Neonates ◽

Central Venous ◽

The Impact

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The Role of Understaffing in Central Venous Catheter-Associated Bloodstream Infections

Infection Control and Hospital Epidemiology ◽

10.1086/647262 ◽

1996 ◽

Vol 17 (3) ◽

pp. 150-158 ◽

Cited By ~ 132

Author(s):

Scott K. Fridkin ◽

Suzanne M. Pear ◽

Theresa H. Williamson ◽

John N. Galgiani ◽

William R. Jarvis

Keyword(s):

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Venous

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Catheter Design Influences Recurrence of Catheter-Related Bloodstream Infection in Children With Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2003.03.012 ◽

2003 ◽

Vol 21 (18) ◽

pp. 3520-3525 ◽

Cited By ~ 34

Author(s):

Patricia M. Flynn ◽

Brian Willis ◽

Aditya H. Gaur ◽

Jerry L. Shenep

Keyword(s):

Central Venous Catheter ◽

Management Strategies ◽

Multivariable Analysis ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Venous ◽

Short Term ◽

Coagulase Negative Staphylococci ◽

Catheter Design

Purpose: Multiple studies have demonstrated that catheter-related bloodstream infections (CRBI) can be successfully treated without catheter removal (in situ therapy), but there is insufficient information available to determine if catheter design can influence the eradication of bacteremia or recurrence. Patients and Methods: Bacteremic episodes in patients at St Jude Children’s Research Hospital between January 1996 and May 2001 were identified and patient records were reviewed. Results: A total of 172 unique episodes of CRBI were identified. In situ therapy resulted in successful eradication of bacteremia in 87% of the episodes. Bacteremia recurred in 10% of the episodes. Although catheter design (Hickman and Broviac versus totally implantable central venous catheter) did not influence short-term eradication of bacteremia, totally implantable central venous catheters were significantly associated with recurrence of bacteremia (odds ratio, 10; 95% confidence interval, 3.1 to 33.3). In a multivariable analysis, this association between catheter design and recurrence remained statistically significant after adjustment for other factors that influenced recurrence in this study (isolation of coagulase-negative staphylococci and inadequate duration of initial antibiotic therapy). Conclusion: This study demonstrates that patients with CRBI with a totally implantable central venous catheter in place are more likely to develop recurrent bacteremia. Management strategies to prevent recurrence in this setting should be explored.

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Surveillance of Hemodialysis-Associated Primary Bloodstream Infections: The Experience of Ten Hospital-Based Centers

Infection Control and Hospital Epidemiology ◽

10.1086/502000 ◽

2002 ◽

Vol 23 (12) ◽

pp. 721-724 ◽

Cited By ~ 48

Author(s):

Margaret Dopirak ◽

Connie Hill ◽

Marylee Oleksiw ◽

Diane Dumigan ◽

Jean Arvai ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Central Venous Catheter ◽

Descriptive Analysis ◽

Bloodstream Infections ◽

Venous Catheter ◽

Hemodialysis Access ◽

Central Venous ◽

Coagulase Negative Staphylococci ◽

Large Pool

Objective:To determine baseline rates of primary bloodstream infection (BSI) among a large pool of patients receiving hemodialysis using standardized surveillance tools and methodology.Design:Prospective, descriptive analysis of primary BSI rates.Setting:Ten hospital-based hemodialysis centers in Connecticut.Patients:All patients receiving long-term hemodialysis in the participating facilities.Results:A total of 158 BSIs occurred during 142,525 dialysis sessions within a 12-month study period. Of the BSIs, 15.2% occurred in patients with fistula or graft access and 84.8% in patients with central venous catheter access (P < .001). Rates per 100 patient-years in centers ranged from 0 to 30.8, with a mean of 16.6. Rates per 1,000 dialysis sessions ranged from 0 to 2.1, with a mean of 1.1. Coagulase-negative staphylococci and Staphylococcus aureus (including methicillin-resistant S. aureus) accounted for 61% and Klebsiella or Enterobacter species for 14.6% of infections. Of the patients, 63.3% received vancomycin, 24.7% received cefazolin, and 41.7% received aminoglycosides. Rates declined in the second 6 months of the study from 1.4 to 0.8 infections per 1,000 dialysis sessions (P < .001).Conclusions:Primary BSI rates varied widely among participating centers and declined during the study period. BSIs were strongly associated with central venous catheter access. Further studies are needed to determine the reasons for variance in rates between centers and among various types of hemodialysis access.

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Central venous catheter bundle implementation in an intensive care unit in Kuwait: Effect on central line-associated bloodstream infections

10.26226/morressier.56d5ba30d462b80296c95453 ◽

2016 ◽

Author(s):

Mona Salama

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Central Venous

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Costs and prolonged length of stay of central venous catheter-associated bloodstream infections (CVC BSI): a matched prospective cohort study

Infection ◽

10.1007/s15010-013-0494-z ◽

2013 ◽

Vol 42 (1) ◽

pp. 31-36 ◽

Cited By ~ 25

Author(s):

R. Leistner ◽

E. Hirsemann ◽

A. Bloch ◽

P. Gastmeier ◽

C. Geffers

Keyword(s):

Cohort Study ◽

Length Of Stay ◽

Central Venous Catheter ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Venous ◽

Prolonged Length

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

Journal of Ultrasound ◽

10.1007/s40477-020-00538-8 ◽

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.

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