The Role of Biofilm in Central Venous Catheter Related Bloodstream Infections: Evidence-based Nursing and Review of the Literature

2020 ◽  
Vol 15 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Nicola Ielapi ◽  
Emanuela Nicoletti ◽  
Carmela Lorè ◽  
Giorgio Guasticchi ◽  
Tiziana Avenoso ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Infectious Complications ◽  
Evidence Based ◽  
Central Venous ◽  
Device Management ◽  
Bibliographic Search ◽  
Materials Used ◽  
Evidence Based Nursing

Background: Biofilm is a fundamental component in the pathogenesis of infections related to the use of the central venous catheter (CVC,) which can represent an important health issue in everyday practice of nursing and medical staff. Objective: The objective of the following review is to analyze the components of biofilm and their role in catheter-related infection determinism in an evidencebased nursing perspective in such a way as to give health professionals useful suggestions in the prevention and management of these complications. Methods: The following databases were consulted for the bibliographic search: Medline, Scopus, Science Direct. Biofilm can be the cause of CVC extraction and can lead to serious haematogenic infectious complications that can increase the morbidity and mortality of affected patients. Results: Updated pathophysiologic knowledge of biofilm formation and appropriate diagnostic methodology are pivotal in understanding and detecting CVC-related infections. Lock therapy appears to be a useful, preventive, and therapeutic aid in the management of CVCrelated infections. New therapies attempting to stop bacterial adhesion on the materials used could represent new frontiers for the prevention of CVC-related infections. Conclusion: The correct evidence-based nursing methods, based on the use of guidelines, provides the opportunity to minimize the risks of infection through the implementation of a series of preventive measures both during the CVC positioning phase and in the subsequent phase, for example, during device management which is performed by medical and nursing staff.

Prevention of Central Venous Catheter-Associated Bloodstream Infections in Pediatric Intensive Care Units A Performance Improvement Collaborative

2009 ◽  
Vol 30 (7) ◽  
pp. 645-651 ◽  
Author(s):  
Howard E. Jeffries ◽  
Wilbert Mason ◽  
Melanie Brewer ◽  
Katie L. Oakes ◽  
Esther I. Mufioz ◽  
...  
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Pediatric Intensive Care ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Evidence Based ◽  
Central Venous ◽  
Improvement Project ◽  
Team Members ◽  
Prevention Interventions

Objective.The goal of this effort was to reduce central venous catheter (CVC)-associated bloodstream infections (BSIs) in pediatric intensive care unit (ICU) patients by means of a multicenter evidence-based intervention.Methods.An observational study was conducted in 26 freestanding children's hospitals with pediatric or cardiac ICUs that joined a Child Health Corporation of America collaborative. CVC-associated BSI protocols were implemented using a collaborative process that included catheter insertion and maintenance bundles, daily review of CVC necessity, and daily goals. The primary goal was either a 50% reduction in the CVC-associated BSI rate or a rate of 1.5 CVC-associated BSIs per 1,000 CVC-days in each ICU at the end of a 9-month improvement period. A 12-month sustain period followed the initial improvement period, with the primary goal of maintaining the improvements achieved.Results.The collaborative median CVC-associated BSI rate decreased from 6.3 CVC-associated BSIs per 1,000 CVC-days at the start of the collaborative to 4.3 CVC-associated BSIs per 1,000 CVC-days at the end of the collaborative. Sixty-five percent of all participants documented a decrease in their CVC-associated BSI rate. Sixty-nine CVC-associated BSIs were prevented across all teams, with an estimated cost avoidance of $2.9 million. Hospitals were able to sustain their improvements during a 12-month sustain period and prevent another 198 infections.Conclusions.We conclude that our collaborative quality improvement project demonstrated that significant reduction in CVC-associated BSI rates and related costs can be realized by means of evidence-based prevention interventions, enhanced communication among caregivers, standardization of CVC insertion and maintenance processes, enhanced measurement, and empowerment of team members to enforce adherence to best practices.

Central Venous Catheter-Related Infectious Complications in Pediatric Surgical Patients: A Single-Center Experience

2021 ◽  
Author(s):  
Rudrashish Haldar ◽  
Ankur Mandelia ◽  
Prabhaker Mishra ◽  
Ashwani Mishra ◽  
Yousuf Siddiqui
Keyword(s):  
Risk Factors ◽  
Central Venous Catheter ◽  
Dwell Time ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Infectious Complications ◽  
Surgical Patients ◽  
Coagulase Negative Staphylococcus ◽  
Central Venous ◽  
Single Center Experience

AbstractThe purpose of this study was to estimate the rate of central venous catheter (CVC) colonization and catheter-related bloodstream infections (CRBSIs) in pediatric surgical patients at our institute and to determine the various risk factors for their occurrence. The electronic medical records of 260 children undergoing surgery with simultaneous CVC insertion were retrospectively reviewed. Data on demographics, primary organ system involved, site of CVC, CVC dwell time, CVC colonization, CRBSI, and organisms isolated on culture were collated, categorized, and analyzed. The rate of CVC colonization and CRBSI was 32.8 per 1,000 catheter days (19.6%) and 17.4 per 1,000 catheter days (10.4%), respectively. Patients with CVC colonization and CRBSI had a significantly higher proportion of patients younger than 1 year of age (p = 0.014). The CVC dwell time was significantly higher in both CVC colonization (7 [5–8] days) and CRBSI (6 [5–9] days) patients (p = 0.005). The frequency of femoral catheterization was significantly higher in patients with CRBSI and CVC colonization (p < 0.001). Coagulase negative staphylococcus was the commonest isolate in CVC infections. Age (adjusted odds ratio [OR] = 0.87; p = 0.009), CVC dwell time (adjusted OR = 1.28; p = 0.003), and femoral CVC (adjusted OR = 9.61; p < 0.001) were independent risk factors for CRBSI. Conclusion: This study reveals important observations regarding the infectious complications of CVC in pediatric surgical patients. The rates of CVC colonization and CRBSI in this study were found to be higher as compared with previously reported rates in Western literature. However, these findings are significant in view of paucity of existing literature in pediatric surgical patients. In our study, higher risk of CRBSI was associated with younger age, increasing CVC dwell time, and femoral venous catheterization. We recommend strict compliance with CVC insertion and maintenance practices and adherence to CVC care bundles to minimize these serious complications.

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

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.

Microbiological screening for earlier detection of central venous catheter-related bloodstream infections

2013 ◽  
Vol 43 (9) ◽  
pp. 964-969 ◽  
Author(s):  
Jasmin Wagner ◽  
Gernot Schilcher ◽  
Ines Zollner-Schwetz ◽  
Martin Hoenigl ◽  
Thomas Valentin ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous
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