Hospital-acquired infective endocarditis during Covid-19 pandemic

Background. The COVID pandemic has had a major impact on healthcare in hospitals, including the diagnosis and treatment of infections. Hospital-acquired infective endocarditis (HAIE) is a severe complication of medical procedures that has shown a progressive increase in recent years. Objectives. to determine whether the incidence of HAIE during the first two months of the epidemic (March-April 2020) was higher than previously observed and to describe the clinical characteristics of these cases. The probability of studied event (HAIE) during the studied period was calculate by Poisson distribution. Results. Four cases of HAIE were diagnosed in our institution during the study period. The incidence of HAIE during the study period was 2/patient-month and 0.25/patient-month during the previous 5 years (p=0.024). Two cases appeared during admission for COVID-19 with pulmonary involvement treated with metilprednisolone and tocilizumab. The other two cases were admitted to the hospital during the epidemic. All cases underwent central venous and urinary catheterization during admission. The etiology of HAIE was Enterococcus faecalis (2 cases), Staphylococcus aureus and Candida albicans (one case each). A source of infection was identified in three cases (central venous catheter, peripheral venous catheter, sternal wound infection, respectively). One patient was operated on. There were no fatalities during the first 30 days of follow-up. Conclusion. The incidence of HAIE during COVID-19 pandemic in our institution was higher than usual. In order to reduce the risk of this serious infection, optimal catheter care, appropriate use of corticosteroids and interleukin antagonists and early treatment of every local infection should be prioritized during coronavirus outbreaks.

Download Full-text

Care of Peripheral Venous Catheter Sites: Advantages of Transparent Film Dressings Over Tape and Gauze

Journal of the Association for Vascular Access ◽

10.1016/j.java.2014.09.001 ◽

2014 ◽

Vol 19 (4) ◽

pp. 256-261 ◽

Cited By ~ 19

Author(s):

Stéphanie F. Bernatchez

Keyword(s):

Bloodstream Infections ◽

Venous Catheter ◽

The United States ◽

Central Venous ◽

Term Care ◽

Peripheral Venous Catheter ◽

Care Facilities ◽

Review Current ◽

Peripheral Venous Line

AbstractPeripheral intravenous (PIV) catheters are the most commonly used catheters in hospitals, with up to 70% of patients requiring a peripheral venous line during their hospital stay. This represents 200 million PIV catheters used per year in acute-care hospitals in the United States alone. These medical devices are also used in other health care settings, such as long-term care facilities and nursing homes, and common indications include the administration of medications, nutrients, and fluids. These catheters require proper maintenance and care to avoid complications such as phlebitis, infiltration, occlusion, local infection, and bloodstream infection. Recently it has been suggested that PIV catheter use may lead to a higher rate of complications than previously thought. This is important because some studies have claimed that the rate of bloodstream infections due to PIV catheters is actually comparable to the rates observed with central venous catheters, rather than much lower as previously thought. Moreover, catheter-related infections are now seen as largely preventable. Our goal was to review the current literature and provide an overview of the various approaches used to manage PIV catheter sites as well as review current recommendations.

Download Full-text

Incidence of bloodstream infection among patients on hemodialysis by central venous catheter

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692010000100012 ◽

2010 ◽

Vol 18 (1) ◽

pp. 73-80 ◽

Cited By ~ 14

Author(s):

Cibele Grothe ◽

Angélica Gonçalves da Silva Belasco ◽

Ana Rita de Cássia Bittencourt ◽

Lucila Amaral Carneiro Vianna ◽

Ricardo de Castro Cintra Sesso ◽

...

Keyword(s):

Central Venous Catheter ◽

Bloodstream Infection ◽

Severe Infection ◽

Venous Catheter ◽

Central Venous Catheter Insertion ◽

Central Venous ◽

Double Lumen ◽

One Year ◽

Very High

This study evaluated the incidence and risk factors of bloodstream infection (BSI) among patients with a double-lumen central venous catheter (CVC) for hemodialysis (HD) and identified the microorganisms isolated from the bloodstream. A follow-up included all patients (n=156) who underwent hemodialysis by double-lumen CVC at the Federal University of São Paulo - UNIFESP, Brazil, over a one-year period. From the group of patients, 94 presented BSI, of whom 39 had positive cultures at the central venous catheter insertion location. Of the 128 microorganisms isolated from the bloodstream, 53 were S. aureus, 30 were methicillin-sensitive and 23 were methicillin-resistant. Complications related to BSI included 35 cases of septicemia and 27 cases of endocarditis, of which 15 cases progressed to death. The incidence of BSI among these patients was shown to be very high, and this BSI progressed rapidly to the condition of severe infection with a high mortality rate.

Download Full-text

O083: Prohibit (preventing hospital-acquired infections by intervention and training): preliminary results of a European multi-center study on the effectiveness of a hand hygiene campaign and a central venous catheter bundle

Antimicrobial Resistance and Infection Control ◽

10.1186/2047-2994-2-s1-o83 ◽

2013 ◽

Vol 2 (S1) ◽

Cited By ~ 1

Author(s):

T van der Kooi ◽

◽

M Wolkewitz ◽

B van Benthem ◽

S de Greeff ◽

...

Keyword(s):

Central Venous Catheter ◽

Hand Hygiene ◽

Venous Catheter ◽

Central Venous ◽

Hospital Acquired Infections ◽

Hand Hygiene Campaign ◽

Multi Center Study ◽

Hospital Acquired ◽

And Training ◽

Center Study

Download Full-text

In vivo development of heterogeneous glycopeptide-intermediate Staphylococcus aureus (hGISA), GISA and daptomycin resistance in a patient with meticillin-resistant S. aureus endocarditis

Journal of Medical Microbiology ◽

10.1099/jmm.0.006486-0 ◽

2009 ◽

Vol 58 (3) ◽

pp. 376-380 ◽

Cited By ~ 18

Author(s):

Andrew Kirby ◽

Kavya Mohandas ◽

Caroline Broughton ◽

Timothy J. Neal ◽

Godfrey W. Smith ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Infective Endocarditis ◽

Central Venous Catheter ◽

Venous Catheter ◽

Resistance Mechanisms ◽

Central Venous ◽

Glycopeptide Resistance ◽

Mrsa Infection ◽

Central Venous Catheter Infection

We report a patient who developed a meticillin-resistant Staphylococcus aureus (MRSA) central venous catheter infection complicated by infective endocarditis. The patient was initially treated with glycopeptides, which led to the development of heterogeneous glycopeptide resistance, the detection of which required the use of a macro Etest screening test. Subsequently, the causative strain, confirmed by PFGE as a UK epidemic MRSA-15, was treated with daptomycin, and again resistance developed in vivo. The development in vivo of resistance to both these agents suggests that the resistance mechanisms may be associated. We suggest that the clinician managing MRSA infection should anticipate daptomycin resistance when reduced glycopeptide susceptibility is detected.

Download Full-text

DisseminatedMycobacterium interjectumInfection with Bacteremia, Hepatic and Pulmonary Involvement Associated with a Long-Term Catheter Infection

Case Reports in Infectious Diseases ◽

10.1155/2017/6958204 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

David Sotello ◽

D. Jane Hata ◽

Mohammed Reza ◽

Raj Satyanarayana ◽

Vichaya Arunthari ◽

...

Keyword(s):

Venous Catheter ◽

Pulmonary Involvement ◽

Healthy Children ◽

Central Venous ◽

Catheter Infection ◽

First Case ◽

Night Sweats ◽

One Year ◽

Central Venous Catheter Infection

We present a 49-year-old female with one year of intermittent fevers, chills, night sweats, and significant weight loss. Liver and lung biopsy showed evidence of a granulomatous process. Blood and liver biopsy cultures yielded growth of presumedMycobacterium interjectum, thought to be related to a disseminated long-term central venous catheter infection. She successfully received one year of combined antimicrobial therapy after catheter removal without recurrence of disease.M. interjectumhas been previously described as a cause of lymphadenitis in healthy children and associated with pulmonary disease in adults, although other localized infections have been reported. This is the first case described of a disseminatedM. interjectuminfection with bacteremia, hepatic and pulmonary involvement associated with a long-term catheter infection.

Download Full-text

Central Venous Catheter with Subcutaneous Injection Port (Port-A-Cath): 8 Years Clinical Follow up with Children

Pediatric Hematology and Oncology ◽

10.3109/08880019309029489 ◽

1993 ◽

Vol 10 (3) ◽

pp. 233-239 ◽

Cited By ~ 31

Author(s):

F. Wesenberg ◽

H. Flaatten Md ◽

C. W. Janssen

Keyword(s):

Central Venous Catheter ◽

Subcutaneous Injection ◽

Venous Catheter ◽

Central Venous ◽

Injection Port

Download Full-text

Bedside Procedures for General Surgeons: Part 1

10.2310/7ccsp.2322 ◽

2017 ◽

Author(s):

Thomas H. Cogbill ◽

Basem S Marcos

Keyword(s):

Percutaneous Tracheostomy ◽

Venous Catheter ◽

Central Venous ◽

Successful Performance ◽

Protective Gear ◽

Sterile Technique ◽

General Surgeons ◽

Key Steps ◽

Chest Decompression

This review focuses on six procedures that are commonly performed by general surgeons in the emergency department, critical care unit, and operating room. Although considered basic procedures, all have their own set of key steps that must be learned, practiced, and mastered. Included in the description for each procedure are technical points that are intended to facilitate successful performance of the procedures and pitfalls to avoid. The most frequent complications for each procedure are briefly discussed in an effort to raise awareness so that they can be recognized and managed expeditiously. Common to all of these procedures is a need to understand the indications based on a careful history, physical examination, and review of pertinent objective data. Whenever possible, informed consent should be obtained from the patient or family prior to the procedure and a complete surgical timeout performed. Sterile technique and personal protective gear/universal precautions should be employed whenever feasible. Finally, these patients should be followed postoperatively and appropriate follow-up studies and/or treatments arranged. This review contains 19 figures, 7 tables, and 33 references. Key words: central venous catheter, intraosseous vascular access, needle chest decompression, percutaneous arterial catheter, percutaneous tracheostomy, tracheostomy, venous cutdown

Download Full-text

Impact of duration of antibiotic therapy in central venous catheter-related bloodstream infection due to Gram-negative bacilli

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa244 ◽

2020 ◽

Vol 75 (10) ◽

pp. 3049-3055

Author(s):

María Ruiz-Ruigómez ◽

Mario Fernández-Ruiz ◽

Rafael San-Juan ◽

Francisco López-Medrano ◽

María Ángeles Orellana ◽

...

Keyword(s):

Central Venous Catheter ◽

Antibiotic Therapy ◽

Bloodstream Infection ◽

Venous Catheter ◽

Progressive Increase ◽

Therapeutic Failure ◽

Supporting Evidence ◽

Central Venous ◽

Gram Negative ◽

Catheter Related Bloodstream Infection

Abstract Background A progressive increase in the incidence of catheter-related bloodstream infection (CRBSI) due to Gram-negative bacilli (GNB) has been reported. Current guidelines recommend antibiotic treatment for at least 7–14 days, although the supporting evidence is limited. Methods We performed a retrospective single-centre study including all patients with a definite diagnosis of GNB CRBSI from January 2012 to October 2018 in which the central venous catheter (CVC) was removed. The occurrence of therapeutic failure [clinical failure (persistence of symptoms and laboratory signs of infection), microbiological failure (persistent bacteraemia or relapse) and/or all-cause 30 day mortality] was compared between episodes receiving short [≤7 days (SC)] or long courses [>7 days (LC)] of appropriate antibiotic therapy following CVC removal. Results We included 54 GNB CRBSI episodes with an overall rate of therapeutic failure of 27.8% (15/54). Episodes receiving SC therapy were more frequently due to MDR GNB [60.9% (14/23) versus 34.5% (10/29); P = 0.058] and had higher Pitt scores [median (IQR) 1 (0–4) versus 0 (0–2); P = 0.086]. There were no significant differences in the rate of therapeutic failure between episodes treated with SC or LC therapy [30.4% (7/23) versus 27.6% (8/29); OR 1.15; 95% CI 0.34–3.83; P = 0.822]. The use of SCs was not associated with increased odds of therapeutic failure in any of the exploratory models performed. Conclusions The administration of appropriate antibiotic therapy for ≤7 days may be as safe and effective as longer courses in episodes of GNB CRBSI once the CVC has been removed.

Download Full-text

Use of Central Venous Catheter and Peripheral Venous Catheter as Risk Factors for Nosocomial Bloodstream Infection in Very-Low-Birth-Weight Infants

Infection Control and Hospital Epidemiology ◽

10.1086/651303 ◽

2010 ◽

Vol 31 (4) ◽

pp. 395-401 ◽

Cited By ~ 28

Author(s):

Christine Geffers ◽

Anne Gastmeier ◽

Frank Schwab ◽

Katrin Groneberg ◽

Henning Rüden ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Central Venous Catheter ◽

Bloodstream Infection ◽

Very Low Birth Weight ◽

Venous Catheter ◽

Central Venous ◽

Vlbw Infants ◽

Peripheral Venous Catheter

Objective.To describe the relationship between the use of central and peripheral venous catheters and the risk of nosocomial, primary, laboratory-confirmed bloodstream infection (BSI) for neonates with a birth weight less than 1,500 g (very-low-birth-weight [VLBW] infants).Methods.Cox proportional hazard regression analysis with time-dependent variable was used to determine the risk factors for the occurrence of BSI in a cohort of VLBW infants. We analyzed previously collected surveillance data from the German national nosocomial surveillance system for VLBW infants. All VLBW infants in 22 participating neonatal departments who had a complete daily record of patient information were included.Results.Of 2,126 VLBW infants, 261 (12.3%) developed a BSI. The incidence density for BSI was 3.3 per 1,000 patient-days. The multivariate analysis identified the following significant independent risk factors for BSI: lower birth weight (hazard ratio [HR], 1.1–2.2), vaginal delivery (HR, 1.5), central venous catheter use (HR, 6.2) or peripheral venous catheter use (HR, 6.0) within 2 days before developing BSI, and the individual departments (HR, 0.0–4.6).Conclusions.After adjusting for other risk factors, use of peripheral venous catheter and use of central venous catheter were significantly related to occurrence of BSI in VLBW infants.

Download Full-text