Infectious Complications of Central Venous Catheters Increase the Risk of Catheter-Related Thrombosis in Hematology Patients: A Prospective Study

Purpose We studied whether the risk of central venous catheter (CVC) -related thrombosis increased after an episode of CVC-related infection in patients undergoing intensive chemotherapy. Secondly, we determined whether thrombosis can be predicted or excluded by CVC lock fluid surveillance cultures. Patients and Methods In a prospective setting, 105 consecutive patients were carefully examined for CVC-related infection and thrombosis. In all patients, microbial surveillance cultures of CVC lock fluid were taken every other day. All patients with clinical suspicion of CVC-related thrombosis underwent Doppler ultrasound or additional venography. Results The cumulative incidence of CVC-related infection was 24% (25 of 105 patients). Clinically manifest thrombosis occurred in 13 (12%) of 105 patients. In patients with CVC-related infection, the risk of thrombosis increased markedly in comparison to those without infection (relative risk, 17.6; 95% CI, 4.1 to 74.1). In patients having two or more positive subsequent CVC lock fluid cultures with identical micro-organisms, 71.4% developed thrombosis, as compared with 3.3% in patients with negative or a single positive culture. Conclusion The risk of clinically manifest thrombosis is increased after an episode of CVC-related infection in patients undergoing intensive chemotherapy. Surveillance culturing of CVC lock fluid may be clinically useful in estimating the risk for thrombosis and the instigation of focused early intervention.

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Prevention of Central Venous Catheter–Related Bloodstream Infections Using Non-Technologic Strategies

Infection Control and Hospital Epidemiology ◽

10.1017/s0195941700079984 ◽

2004 ◽

Vol 25 (8) ◽

pp. 675-677 ◽

Cited By ~ 4

Author(s):

Silvia Acosta Gnass ◽

Luisa Barboza ◽

Dafne Bilicich ◽

Pablo Angeloro ◽

Walter Treiyer ◽

...

Keyword(s):

Tertiary Care ◽

Bloodstream Infections ◽

Venous Catheter ◽

Infectious Complications ◽

Central Venous ◽

Methicillin Resistant ◽

Sterile Drape ◽

Improvement Programs ◽

A Prospective Study ◽

Quality Improvement Programs

AbstractObjective:To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them.Design:This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from April 1997 to December 2001.Setting:The medical–surgical ICU of a tertiary-care, university-affiliated hospital in Argentina.Methods:We studied all patients admitted to the ICU using non-impregnated CVCs. Maximal sterile barrier precautions (ie, use of cap, mask, sterile gown, sterile gloves, and large sterile drape), strict handwashing, preparation of the patients' skin with antiseptic solutions, insertion and management of catheters by trained personnel, and continuing quality improvement programs aimed at appropriate insertion and maintenance of catheters were employed.Results:During the study period, 2,525 patients were admitted to the ICU. Eight hundred sixty-eight patients had 1,037 CVCs inserted. The number of CVC-related bloodstream infections (BSIs), acquired in the ICU, was 2.7 per 1,000 CVC-days (13 nosocomial CVC-related BSIs during 4,770 days of CVC use). Microorganisms isolated included methicillin-susceptible Staphylococcus aureus (n = 6), methicillin-resistant S. aureus (n = 2), coagulase-negative methicillin-resistant Staphylococcus (n = 2), Escherichia coli (n = 1), Klebsiella pneumoniae (n = 1), and Enterobacter cloacae (n = 1).Conclusions:A low rate of catheter-related BSI was achieved without antimicrobial-impregnated catheters. The incidence of CVC-associated bacteremias corresponded to the 10th to 20th percentile range of the National Nosocomial Infections Surveillance System hospitals for the same type of ICU.

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Prevention of Central Venous Catheter–Related Bloodstream Infections Using Non-Technologic Strategies

Infection Control and Hospital Epidemiology ◽

10.1086/502461 ◽

2004 ◽

Vol 25 (08) ◽

pp. 675-677 ◽

Cited By ~ 26

Author(s):

Silvia Acosta Gnass ◽

Luisa Barboza ◽

Dafne Bilicich ◽

Pablo Angeloro ◽

Walter Treiyer ◽

...

Keyword(s):

Tertiary Care ◽

Bloodstream Infections ◽

Venous Catheter ◽

Infectious Complications ◽

Central Venous ◽

Methicillin Resistant ◽

Sterile Drape ◽

Improvement Programs ◽

A Prospective Study ◽

Quality Improvement Programs

Abstract Objective: To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them. Design: This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from April 1997 to December 2001. Setting: The medical–surgical ICU of a tertiary-care, university-affiliated hospital in Argentina. Methods: We studied all patients admitted to the ICU using non-impregnated CVCs. Maximal sterile barrier precautions (ie, use of cap, mask, sterile gown, sterile gloves, and large sterile drape), strict handwashing, preparation of the patients' skin with antiseptic solutions, insertion and management of catheters by trained personnel, and continuing quality improvement programs aimed at appropriate insertion and maintenance of catheters were employed. Results: During the study period, 2,525 patients were admitted to the ICU. Eight hundred sixty-eight patients had 1,037 CVCs inserted. The number of CVC-related bloodstream infections (BSIs), acquired in the ICU, was 2.7 per 1,000 CVC-days (13 nosocomial CVC-related BSIs during 4,770 days of CVC use). Microorganisms isolated included methicillin-susceptible Staphylococcus aureus (n = 6), methicillin-resistant S. aureus (n = 2), coagulase-negative methicillin-resistant Staphylococcus (n = 2), Escherichia coli (n = 1), Klebsiella pneumoniae (n = 1), and Enterobacter cloacae (n = 1). Conclusions: A low rate of catheter-related BSI was achieved without antimicrobial-impregnated catheters. The incidence of CVC-associated bacteremias corresponded to the 10th to 20th percentile range of the National Nosocomial Infections Surveillance System hospitals for the same type of ICU.

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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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Optimum depth of central venous catheter - Comparision by pere′s, landmark and endocavitory (atrial) ECG technique: A prospective study

Anesthesia Essays and Researches ◽

10.4103/0259-1162.118966 ◽

2013 ◽

Vol 7 (2) ◽

pp. 216 ◽

Cited By ~ 3

Author(s):

Deepak Sharma ◽

VP Singh ◽

MK Malhotra ◽

Kumkum Gupta

Keyword(s):

Central Venous Catheter ◽

Prospective Study ◽

Venous Catheter ◽

Central Venous ◽

Optimum Depth ◽

A Prospective Study

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A New Formula-Based Measurement Guide for Optimal Positioning of Central Venous Catheters

Journal of the Association for Vascular Access ◽

10.2309/1552-8855-9.2.80 ◽

2004 ◽

Vol 9 (2) ◽

pp. 80-85 ◽

Cited By ~ 4

Author(s):

Phllip Lum

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous Catheters ◽

Central Venous ◽

Access Site ◽

Insertion Sites ◽

Tip Position ◽

A Prospective Study ◽

New Formula ◽

Percutaneous Insertion

Abstract Purpose: To validate the formula-based central venous catheter (CVC) length measurement “tailored” to individual's height and access site for predicting optimum SVC tip position. Method: A prospective study of 3 percutaneous insertion sites (PICC, SCC and JC). Formula-based “LUM'S CVC MEASUREMENT GUIDE” was used to determine the catheter length. Results: Overall, 97% (373) of the total 382 insertions were successfully placed with CVC tip in the distal SVC (SVC between carina and atrio-cava junction) location. Conclusion: The “tailored fit” formula to individual patient height is a reliable tool to predict CVC length. Appropriate catheter length can greatly reduce the guesswork and possibility of complications related to tip malposition.

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