CATHETER SALVAGE STRATEGY FOR LONG-TERM CENTRAL VENOUS CATHETER-ASSOCIATED STAPHYLOCOCCUS AUREUS INFECTIONS IN CHILDREN

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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Precision in Central Venous Catheter Tip Placement: A Review of the Literature

Journal of the Association for Vascular Access ◽

10.2309/java.15-3-3 ◽

2010 ◽

Vol 15 (3) ◽

pp. 112-125 ◽

Cited By ~ 21

Author(s):

Russell Hostetter ◽

Nadine Nakasawa ◽

Kim Tompkins ◽

Bradley Hill

Keyword(s):

Central Venous Catheter ◽

Selection Criteria ◽

Weighted Average ◽

Venous Catheter ◽

Central Venous ◽

Catheter Tip ◽

Tip Position ◽

Landmark Technique ◽

The Ideal

Abstract Background: Long term venous catheters have been used to deliver specialized therapies since 1968. The ideal tip position of a central venous catheter provides reliable venous access with optimal therapeutic delivery, while minimizing short-and long-term complications. Ideal position limits have evolved and narrowed over time, making successful placement difficult and unreliable when depending exclusively on the landmark technique. Objective: To review and analyze contemporary literature and calculate an overall accuracy rate for first attempt placement of a PICC catheter in the ideal tip position. Methods: Key PICC placement terms were used to search the database PubMED-indexed for MEDLINE in June and October, 2009. The selection of studies required: a patient cohort without tip placement guidance technology; a documented landmark technique to place catheter tips; data documenting initial catheter placement and, that the lower third of the SVC and the cavo-atrial junction (CAJ) were included in the placement criteria. With few exceptions, articles written between 1993 and 2009 met the stated selection criteria. A composite of outcomes associated with tip placement was analyzed, and an overall percent proficiency of accurate catheter tip placement calculated. Results: Nine studies in eight articles met the selection criteria and were included for analysis. Rates of first placement success per study ranged from 39% to 75%, with the majority (7/9) being single center studies. The combined overall proficiency of these studies calculated as a weighted average was 45.87%.

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Vascular access devices used during harvest of peripheral blood stem cells: high complication rate in patients with a long-term dialysis central venous catheter

Bone Marrow Transplantation ◽

10.1038/sj.bmt.1701988 ◽

1999 ◽

Vol 24 (7) ◽

pp. 793-797 ◽

Cited By ~ 13

Author(s):

E Johansson ◽

M Hansson ◽

A Sollén Nilsson ◽

P Engervall

Keyword(s):

Stem Cells ◽

Central Venous Catheter ◽

Complication Rate ◽

Venous Catheter ◽

High Complication Rate ◽

Central Venous ◽

Peripheral Blood Stem Cells ◽

Vascular Access Devices ◽

Blood Stem Cells

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Relapsing pyrogenic reactions due to Xanthomonas maltophilia in a dialysis patient with a long-term central venous catheter

Nephrology Dialysis Transplantation ◽

10.1093/oxfordjournals.ndt.a027043 ◽

1996 ◽

Vol 11 (1) ◽

pp. 197-198 ◽

Cited By ~ 6

Author(s):

M. Ganadu ◽

G. L. Mura ◽

A. M. Campus ◽

G. L. Cherchi ◽

V. Fanelli ◽

...

Keyword(s):

Central Venous Catheter ◽

Dialysis Patient ◽

Venous Catheter ◽

Central Venous ◽

Xanthomonas Maltophilia

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Interventions to obstructive long-term central venous catheter in cancer patients: a meta-analysis

Supportive Care in Cancer ◽

10.1007/s00520-018-4500-y ◽

2018 ◽

Vol 27 (2) ◽

pp. 407-421 ◽

Cited By ~ 2

Author(s):

Ana Cristina Carvalho da Costa ◽

Jéssica Marques Ribeiro ◽

Christiane Inocêncio Vasques ◽

Graziela De Luca Canto ◽

André Luís Porporatti ◽

...

Keyword(s):

Central Venous Catheter ◽

Cancer Patients ◽

Meta Analysis ◽

Venous Catheter ◽

Central Venous

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Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

Infection Control and Hospital Epidemiology ◽

10.1086/501658 ◽

1999 ◽

Vol 20 (7) ◽

pp. 494-498 ◽

Cited By ~ 25

Author(s):

Pascal Astagneau ◽

Sylvie Maugat ◽

Tuan Tran-Minh ◽

Marie-Cécile Douard ◽

Pascale Longuet ◽

...

Keyword(s):

Cohort Study ◽

Central Venous Catheter ◽

Cancer Patients ◽

Venous Catheter ◽

Central Venous ◽

Hiv Patients ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Hiv And Cancer

Objectives:To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.Design:Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.Setting:Services of infectious diseases and oncology of 12 university hospitals in Paris, France.Participants:In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.Results:Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.Conclusions:Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

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