Reduction in catheter-related infections after switching from povidone-iodine to chlorhexidine for the exit-site care of tunneled central venous catheters in children on hemodialysis

2014 ◽  
Vol 18 ◽  
pp. S13-S18 ◽  
Author(s):  
Fabio Paglialonga ◽  
Silvia Consolo ◽  
Antonietta Biasuzzi ◽  
Jolanda Assomou ◽  
Elisabetta Gattarello ◽  
...  
Keyword(s):  
Povidone Iodine ◽  
Central Venous Catheters ◽  
Exit Site ◽  
Central Venous

scholarly journals Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients

2019 ◽  
Vol 8 (3) ◽  
pp. 412 ◽  
Author(s):  
Chang-Hua Chen ◽  
Yu-Min Chen ◽  
Yu Yang ◽  
Yu-Jun Chang ◽  
Li-Jhen Lin ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Treated Group ◽  
Central Venous Catheters ◽  
Exit Site ◽  
Central Venous ◽  
Hemodialysis Catheter ◽  
Significant Difference ◽  
All Cause Mortality ◽  
The Impact ◽  
Catheter Function

Catheter-related bloodstream infections (CRBSIs) and exit-site infections (ESIs) are common complications associated with the use of central venous catheters for hemodialysis. The aim of this study was to analyze the impact of routine locking solutions on the incidence of CRBSI and ESI, in preserving catheter function, and on the rate of all-cause mortality in patients undergoing hemodialysis. We selected publications (from inception until July 2018) with studies comparing locking solutions for hemodialysis catheters used in patients undergoing hemodialysis. A total of 21 eligible studies were included, with a total of 4832 patients and 318,769 days of catheter use. The incidence of CRBSI and ESI was significantly lower in the treated group (citrate-based regimen) than in the controls (heparin-based regimen). No significant difference in preserving catheter function and all-cause mortality was found between the two groups. Our findings demonstrated that routine locking solutions for hemodialysis catheters effectively reduce the incidence of CRBSIs and ESIs, but our findings failed to show a benefit for preserving catheter function and mortality rates. Therefore, further studies are urgently needed to conclusively evaluate the impact of routine locking solutions on preserving catheter function and improving the rates of all-cause mortality.

Combined skin disinfection with chlorhexidine/propanol and aqueous povidone-iodine reduces bacterial colonisation of central venous catheters

2004 ◽  
Vol 30 (6) ◽  
pp. 1081-1088 ◽  
Author(s):  
Julia Langgartner ◽  
Hans-J�rg Linde ◽  
Norbert Lehn ◽  
Michael Reng ◽  
J�rgen Sch�lmerich ◽  
...  
Keyword(s):  
Povidone Iodine ◽  
Central Venous Catheters ◽  
Bacterial Colonisation ◽  
Central Venous ◽  
Skin Disinfection

scholarly journals The Impact of Early Dressing Removal on the Tunneled Central Venous Catheters

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 93s-93s
Author(s):  
G. Ammar
Keyword(s):  
Infection Rate ◽  
Central Venous Catheters ◽  
Control Group ◽  
Site Infection ◽  
Exit Site ◽  
Central Venous ◽  
Exit Site Infection ◽  
Significant Difference ◽  
The Impact ◽  
Interventional Group

Background: There were many studies compared between different types of dressing such as chlorhexidine gluconate gel (CHG), (CHG) disc, gauze dressing and transparent dressing regarding its intact to the skin, infection rate and patients satisfaction. However, there was few studies regarding the impact of removing the dressing on the occurrence of exit site infection of tunneled central venous catheters. Aim: The objective of the current study was to evaluate the impact of early central venous catheter (CVC) dressing removal of the well-healed exit site infections. Methods: It was a quasi-experiment pilot study conducted over 15 months duration in a specialized oncology center. All adult patients who had newly inserted tunneled central venous catheters (CVC) in place were recruited. Patients were distributed to control and experimental group based on first come first served. Patients in the control group (n=8) received the standard protocol of applying (CVC) dressing, while patients in the interventional group (n=8) received the protocol of no dressing. Results: There was no significant difference in the infection rate between the two groups ( P = 1), so that, a total of two cases had developed catheter-related bloodstream infection (CLABSI), one in the control group and the other in the interventional group. Moreover, one patient in the interventional group had developed exit site infection. However, patients with no dressing protocol (interventional group) perceived an improvement in their quality of life and they were satisfied with this protocol. Conclusion: Applying no dressing protocol to a well-healed exit site CVCs showed encouraging results in terms of exit site and bloodstream infections. That is to say; it did not predispose patients to increased risk of infections. Furthermore, patients with no dressing protocol feel more comfortable in their lifestyle.

Prevention of bacteremia attributed to luminal colonization of tunneled central venous catheters with vancomycin-susceptible organisms.

1990 ◽  
Vol 8 (9) ◽  
pp. 1591-1597 ◽  
Author(s):  
C Schwartz ◽  
K J Henrickson ◽  
K Roghmann ◽  
K Powell
Keyword(s):  
Fungal Infections ◽  
Central Venous Catheters ◽  
First Episode ◽  
Exit Site ◽  
Central Venous ◽  
Suspected Sepsis ◽  
Hematologic Disorders ◽  
Kaplan Meier ◽  
Vancomycin Resistant ◽  
To Receive

Forty-five children with oncologic or hematologic disorders requiring tunneled central venous catheters (TCVC) for the administration of immunosuppressive therapy were randomized to receive either 10 U/mL heparin (H) (24 patients) or a solution of 10 U/mL H and 25 micrograms/mL vancomycin (H-V) (21 patients) for all catheter flushes. Episodes of fever or suspected sepsis were evaluated to determine whether the addition of vancomycin to the flush solution would alter the incidence of symptomatic bacteremia attributed to luminal colonization of TCVC with vancomycin-susceptible bacteria. Patients were enrolled for 247 +/- 150 days, accounting for a total of 11,095 days of catheter use. Bacteremia attributed to luminal colonization with vancomycin-susceptible organisms occurred in five patients (six infections) receiving H alone compared with zero patients receiving H-V (P = .035). The time to the first episode of bacteremia with vancomycin-susceptible organisms, analyzed by Kaplan-Meier survival curves, was significantly longer in patients receiving H-V (P = .04). There were no differences in the incidence of other infections including bacteremia attributed to luminal colonization with vancomycin-resistant organisms, other bacteremias (including those arising from the catheter exit site), exit-site cellulitis, or fungal infections. No organisms resistant to vancomycin were identified. Vancomycin could not be detected in the peripheral blood of patients receiving vancomycin in the flush solution. No vancomycin-related toxicities were noted. We conclude that the use of an H-V flush solution in immunocompromised patients with TCVC can decrease the frequency of bacteremia attributed to luminal colonization with vancomycin-susceptible bacteria.

scholarly journals Double-Blind Prospective Randomized Study Comparing Topical Mupirocin and Placebo for the Prevention of Infection Associated with Central Venous Catheters

1997 ◽  
Vol 8 (4) ◽  
pp. 213-220 ◽  
Author(s):  
John M Conly ◽  
Robert Rennie ◽  
Leonard Tan ◽  
Colin Bagg ◽  
Karen Stein ◽  
...  
Keyword(s):  
Placebo Group ◽  
Insertion Site ◽  
Central Venous Catheters ◽  
Stepwise Logistic Regression ◽  
Exit Site ◽  
Central Venous ◽  
Double Blind ◽  
Distal Catheter ◽  
Catheter Related Infection ◽  
To Receive

OBJECTIVE: To compare the incidence of exit site colonization, local catheter-related infection and catheter-related bacteremia in patients randomized to receive either topical 2% mupirocin or placebo at the catheter exit site.PATIENTS AND METHODS: Patients requiring central venous catheters for more than three days were randomized to receive in a double-blind fashion either topical mupirocin or an identical placebo at the exit site three times weekly at the time of dressing change. Insertion, site care and removal of catheters were standardized. Serial semiquantitataive cultures of the skin at the catheter insertion site were performed using a sterile 25 cm2template. The distal and proximal catheter segments were cultured using a standardized semiquantitative technique, and any suspect catheter-related bacteremia was investigated with two sets of peripheral blood cultures, a 10 mL sample of infusate and clinical assessment. Both univariate and multivariate analyses were conducted on individual risk factors to determine factors that might influence the outcomes of local or systemic catheter-related infection.RESULTS: Local catheter-related infection (defined as more than 15 colony forming units [cfu] on culture of the proximal or distal catheter segment) occurred in six of 57 (10.5%) in the mupirocin group versus 18 of 69 (26%) in the placebo group (P<0.05) for the distal catheter segments and in one of 40 (2.5%) versus 13 of 47 (27.6%) for the proximal segments in the mupirocin and placebo groups (P<0.006), respectively. Catheter-related bacteremia occurred in one of 57 (1.8%) of the mupirocin group but in five of 69 (7.2%) of the placebo group (P=0.15). Stepwise logistic regression revealed that cutaneous colonization at the insertion site of at least 103cfu/mL/25 cm2(OR 2.6; CI 1.0 to 6.9) and the use of placebo (OR 3.3; CI 1.2 to 9.0) were significant factors predicting local catheter-related infection; whereas mupirocin was associated with reciprocal protective effect (OR 0.3; 95% CI 0.1 to 0.8).CONCLUSIONS: These findings suggest that patients receiving topical mupirocin at the exit site for long term central venous catheters have significantly less local catheter-related infection, and there is a trend towards less catheter-related bacteremia.

scholarly journals The SIC protocol: A seven-step strategy to minimize complications potentially related to the insertion of centrally inserted central catheters

2021 ◽  
pp. 112972982110360
Author(s):  
Fabrizio Brescia ◽  
Mauro Pittiruti ◽  
Matthew Ostroff ◽  
Timothy R Spencer ◽  
Robert B Dawson
Keyword(s):  
Central Venous Catheters ◽  
Immediate Early ◽  
Thoracic Region ◽  
Exit Site ◽  
Central Venous ◽  
Standardized Protocol ◽  
Adequate Coverage ◽  
Tip Position ◽  
Central Catheters ◽  
Late Insertion

Insertion of central venous catheters in the cervico-thoracic area is potentially associated with the risk of immediate/early untoward events, some of them negligible (repeated punctures), some relevant (accidental arterial puncture), and some severe (pneumothorax). Furthermore, different strategies adopted during insertion may reduce or increase the incidence of late catheter-related complications (infection, venous thrombosis, dislodgment). This paper describes a standardized protocol (S.I.C.: Safe Insertion of Centrally Inserted Central Catheters) for the systematic application of seven basic beneficial strategies to be adopted during insertion of central venous catheters in the cervico-thoracic region, aiming to minimize immediate, early, or late insertion-related complications. These strategies include: preprocedural evaluation, appropriate aseptic technique, ultrasound guided insertion, intra-procedural assessment of the tip position, adequate protection of the exit site, proper securement of the catheter, and adequate coverage of the exit site.

Central venous catheters in patients with AIDS

1997 ◽  
Vol 8 (7) ◽  
pp. 417-422 ◽  
Author(s):  
H E Goodman ◽  
R P Brettle ◽  
B Stevenson ◽  
B Hamilton ◽  
P Kalima ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Central Venous Catheters ◽  
Transmission Risk ◽  
Intravenous Therapy ◽  
Exit Site ◽  
Central Venous ◽  
Thrombotic Occlusion ◽  
Exit Site Infection ◽  
Kaplan Meier ◽  
Catheter Sepsis

Central venous catheters (CVCs) for patients with AIDS are at risk of a number of complications including bacterial infections. A 6-year retrospective review was undertaken of the records of the 33 patients (42% infected by injection drug use (IDU)) who received intravenous therapy both in hospital and at home via CVCs. Twenty-eight per cent of 53 insertions suffered a complication, the commonest of which was a pneumothorax (8%). The post insertion complication rate was 0.98/100 catheter days (cd). Thrombotic occlusion (0.15/100 cd) was the commonest non septic event while sepsis was overall the commonest event (0.69/ 100 cd) of which half were considered serious (0.33/100 cd). The most frequently isolated organisms were Staphylococci spp. (71%). The median time to an exit site infection was 59 days and to serious catheter sepsis 86 days. Infection did not differ significantly with age, gender, transmission risk activity or catheter type although Portacaths had the lowest rate of infection (0.33/100 cd). The median survival of the 53 CVCs was 88 days although if the temporary catheters were excluded it was 118 days. Kaplan-Meier estimates of survival analysis revealed 55%, 32% and 19% of all the CVCs surviving 3, 6 and 12 months respectively. Our experience suggests that home intravenous therapy and previous IDU does not preclude the use of CVCs although further research is needed on reducing the infection-related complications of such therapy.

Sign in / Sign up

Export Citation Format

Share Document