scholarly journals A case of Mycobacterium goodii infection related to an indwelling catheter placed for the treatment of chronic symptoms attributed to Lyme disease

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Andrew Shelton ◽  
Luca Giurgea ◽  
Mahdi Moshgriz ◽  
Marc Siegel ◽  
Hana Akselrod
Keyword(s):  
Lyme Disease ◽  
Broad Spectrum ◽  
Venous Catheter ◽  
Antibiotic Use ◽  
Central Line ◽  
Invasive Disease ◽  
Central Venous ◽  
Indwelling Catheter ◽  
Prosthetic Joint Infections ◽  
Mycobacterium Goodii

Mycobacterium goodii has only rarely been reported to cause invasive disease in humans. Previously reported cases of M. goodii infection have included prosthetic joint infections, pacemaker pocket infections, and pneumonia. We present a case of bacteremia with concomitant pulmonary septic emboli that developed in a 32-year-old woman with an indwelling central line. The line had been placed one year previously for intermittent treatment with intravenous, broad-spectrum antibiotics, administered by an outside physician for the treatment of symptoms attributed to chronic Lyme disease. The long duration of antibiotic use and presence of a central venous catheter predisposed the patient to this infection. Patients should be counseled regarding the serious risks of long courses of broad-spectrum intravenous antibiotics via central venous catheters to treat non-specific symptoms attributed to Lyme disease.

scholarly journals Estratégia Multidimensional na Redução de Infeção Associada a Cateter Venoso Central em Pediatria

2016 ◽  
Vol 29 (6) ◽  
pp. 373
Author(s):  
Jorge Rodrigues ◽  
Andrea Dias ◽  
Guiomar Oliveira ◽  
José Farela Neves
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous ◽  
Group 2

<p><strong>Introduction:</strong> To determine the central-line associated bloodstream infection rate after implementation of central venous catheter-care practice bundles and guidelines and to compare it with the previous central-line associated bloodstream infection rate.<br /><strong>Material and Methods:</strong> A prospective, longitudinal, observational descriptive study with an exploratory component was performed in a Pediatric Intensive Care Unit during five months. The universe was composed of every child admitted to Pediatric Intensive Care Unit who inserted a central venous catheter. A comparative study with historical controls was performed to evaluate the result of the intervention (group 1 <em>versus</em> group 2).<br /><strong>Results:</strong> Seventy five children were included, with a median age of 23 months: 22 (29.3%) newborns; 28 (37.3%) with recent surgery and 32 (43.8%) with underlying illness. A total of 105 central venous catheter were inserted, the majority a single central venous catheter (69.3%), with a mean duration of 6.8 ± 6.7 days. The most common type of central venous catheter was the short-term, non-tunneled central venous catheter (45.7%), while the subclavian and brachial flexure veins were the most frequent insertion sites (both 25.7%). There were no cases of central-line associated bloodstream infection reported during this study. Comparing with historical controls (group 1), both groups were similar regarding age, gender, department of origin and place of central venous catheter insertion. In the current study (group 2), the median length of stay was higher, while the mean duration of central venous catheter (excluding peripherally inserted central line) was similar in both groups. There were no statistical differences regarding central venous catheter caliber and number of lumens. Fewer children admitted to Pediatric Intensive Care Unit had central venous catheter inserted in group 2, with no significant difference between single or multiple central venous catheter.<br /><strong>Discussion:</strong> After multidimensional strategy implementation there was no reported central-line associated bloodstream infection<br /><strong>Conclusions:</strong> Efforts must be made to preserve the same degree of multidimensional prevention, in order to confirm the effective reduction of the central-line associated bloodstream infection rate and to allow its maintenance.</p>

scholarly journals Earlier Positivity of Central-Venous- versus Peripheral-Blood Cultures Is Highly Predictive of Catheter-Related Sepsis

1998 ◽  
Vol 36 (1) ◽  
pp. 105-109 ◽  
Author(s):  
François Blot ◽  
Eric Schmidt ◽  
Gérard Nitenberg ◽  
Cyrille Tancrède ◽  
Bernard Leclercq ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Peripheral Blood ◽  
Venous Catheter ◽  
Blood Cultures ◽  
Central Venous ◽  
Indwelling Catheter ◽  
Blood Samples ◽  
Reference Center ◽  
Reliable Tool ◽  
Period Data

To diagnose catheter-related sepsis without removing the catheter, we evaluated the differential positivity times of cultures of blood drawn simultaneously from central venous catheter and peripheral sites. In a 450-bed cancer reference center, simultaneous central- and peripheral-blood cultures were prospectively performed for patients with suspicion of catheter-related sepsis over an 18-month period. Data for 64 patients for whom the same microorganisms were found when central- and peripheral-blood samples were cultured were retrospectively reviewed by two independent physicians blinded to the differential positivity time values in order to establish or refute the diagnosis of catheter-related sepsis. The diagnosis was established in 28 cases, refuted in 14, and indeterminate in the remaining 22. The differential positivity time was significantly greater for patients with catheter-related sepsis (P < 10−4). A cutoff limit of +120 min had 100% specificity and 96.4% sensitivity for the diagnosis of catheter-related sepsis. These results strongly suggest that measurement of the differential positivity time might be a reliable tool facilitating the diagnosis of catheter-related sepsis in patients with an indwelling catheter.

scholarly journals Central line-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myeloid leukaemia in Piraeus, Greece

2006 ◽  
Vol 55 (8) ◽  
pp. 1153-1156 ◽  
Author(s):  
G. B. Christakis ◽  
S. Perlorentzou ◽  
P. Alexaki ◽  
A. Megalakaki ◽  
I. K. Zarkadis
Keyword(s):  
Acute Myelogenous Leukaemia ◽  
Neutropenic Patient ◽  
Venous Catheter ◽  
16S Rrna Gene Sequencing ◽  
Central Line ◽  
Rrna Gene ◽  
Central Venous ◽  
Acute Myelogenous ◽  
Rrna Gene Sequencing ◽  
Roseomonas Mucosa

A case of central venous catheter-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myelogenous leukaemia is reported. The patient was successfully treated with amikacin and piperacillin-tazobactam. The clinical isolate was identified as R. mucosa by 16S rRNA gene sequencing.

Reducing central catheter-associated infections in pediatric surgery clinic: Implementation of a care bundle

2021 ◽  
Vol 11 (1) ◽  
pp. 57-65
Author(s):  
Eda Dolgun ◽  
Okgün Alcan Aliye ◽  
Ayşe Islamoğlu ◽  
Birsen Eroğlu ◽  
Meltem Polat ◽  
...  
Keyword(s):  
Pediatric Surgery ◽  
Healthcare Professionals ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Recovery Process ◽  
Central Line ◽  
Care Bundle ◽  
Central Venous ◽  
Implementation Period ◽  
Bundle Compliance

Purpose: Central line care bundle comprises a few evidence-based interventions for improving patients' outcomes and recovery process. This semi-experimental study aimed to determine the effect of pediatric central line care bundle implementation on central line-associated bloodstream infections (CLABSI) rates. Materials and methods: A central line care bundle was implemented for pediatric surgery patients (n=70). Baseline observations were made to determine the central line care bundle compliance of healthcare professionals for 435 catheter days. Subsequently, physicians and nurses were educated about the central line care bundle. After the implementation period, 722 catheter days were observed to determine post-implementation compliance. Baseline CLABSI rates were compared with post-implementation CLABSI rates. Results: It was found that the entire central line care bundle compliance was 32.4% pre-implementation and 86.3% post-implementation. After education, the physicians' and nurses' central line care bundle compliance showed statistically significant improvement (p= 0.0001). There were five CLABSI events in the pre-implementation period and three CLABSI events in the post-implementation period. It was determined that the number of CLABSI decreased in the post-implementation period compared to the pre-implementation period, but this difference was not statistically significant (p= 0.207). Conclusions: Central line care bundle implementation decreased the CLABSI rates. It is recommended the Implementation of a central line care bundle on the care of pediatric surgery patients with the central venous catheter.

Central Venous Catheter Salvage in Ambulatory Central Line–Associated Bloodstream Infections

PEDIATRICS ◽  
2021 ◽  
Author(s):  
William J.H. Ford ◽  
David G. Bundy ◽  
Suzette Oyeku ◽  
Moonseong Heo ◽  
Lisa Saiman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pediatric Patients ◽  
Secondary Analysis ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Type Number ◽  
Central Venous ◽  
Medical Centers ◽  
Associated Risk Factors

BACKGROUND Guidelines for treatment of central line–associated bloodstream infection (CLABSI) recommend removing central venous catheters (CVCs) in many cases. Clinicians must balance these recommendations with the difficulty of obtaining alternate access and subjecting patients to additional procedures. In this study, we evaluated CVC salvage in pediatric patients with ambulatory CLABSI and associated risk factors for treatment failure. METHODS This study was a secondary analysis of 466 ambulatory CLABSIs in patients &lt;22 years old who presented to 5 pediatric medical centers from 2010 to 2015. We defined attempted CVC salvage as a CVC left in place ≥3 days after a positive blood culture result. Salvage failure was removal of the CVC ≥3 days after CLABSI. Successful salvage was treatment of CLABSI without removal of the CVC. Bivariate and multivariable logistic regression analyses were used to test associations between risk factors and attempted and successful salvage. RESULTS A total of 460 ambulatory CLABSIs were included in our analysis. CVC salvage was attempted in 379 (82.3%) cases. Underlying diagnosis, CVC type, number of lumens, and absence of candidemia were associated with attempted salvage. Salvage was successful in 287 (75.7%) attempted cases. Underlying diagnosis, CVC type, number of lumens, and absence of candidemia were associated with successful salvage. In patients with malignancy, neutropenia within 30 days before CLABSI was significantly associated with both attempted salvage and successful salvage. CONCLUSIONS CVC salvage was often attempted and was frequently successful in ambulatory pediatric patients presenting with CLABSI.

THE EFFICACY OF MEDICAL SIMULATION COURSE ON IMPROVING ULTRASOUND—GUIDED CENTRAL VENOUS CATHETER INSERTION

2015 ◽  
Vol 1 (1) ◽  
pp. 41.2-41 ◽  
Author(s):  
Sawsan M Alyousef ◽  
Mohammed Almaani ◽  
Jihad Zahraa ◽  
Ali Hassan ◽  
Hani Lababidi
Keyword(s):  
Central Venous Catheter ◽  
Training Programs ◽  
Venous Catheter ◽  
Central Line ◽  
Skill Assessment ◽  
Medical Simulation ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Knowledge And Skills ◽  
Hands On

BackgroundWhile insertion of CVC (central venous catheter) is common, it is an intricate procedure and not risk-free. Traditionally, inexperienced residents learn to insert CVC on real patients and thus can put patients' life at risk. One way to reduce medical errors is to use high-fidelity simulation for training tomorrow's practitioners on ultrasound-guided CVC insertion.ObjectiveTo evaluate the efficacy of medical simulation based learning course on knowledge and skills improvement on ultrasound-guided CVC insertion.MethodsA pre-assessment was performed through a pre-test and hands-on skill assessment for central line insertion under U/S guidance (Internal Jugular, Subclavian or Femoral lines) utilizing a standardized checklist. All candidates then attended one day course that included theoretical and hands-on simulation training using phantoms. A post-test and hands-on assessment was performed at the end of the day.ResultsTwenty residents from Internal Medicine and Paediatrics were enrolled in the study at King Fahad Medical City Simulation Center. There was significant improvement in the knowledge based training: 90% showed significant increase in their MCQ scores (p<0.001), 10% had equal scores and none showed decline in their scores. For the hands-on skills: All 20 candidates showed significant improvement in their skills (p<0.001).ConclusionA one day simulation course on CVC insertion under ultrasound guidance significantly improves the knowledge and skills for residents in training programs.RecommendationsSuch courses and other similar should be compulsory for all Residents training programs as it is called safe training.

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