Diagnosis and Management of Central Venous Catheter-Related Infections

Abstract

Use of central venous catheters (CVCs) can lead to catheter-related bloodstream infections (CRBSIs) and such infections are associated with serious morbidity and mortality and with increased health care costs. The diagnosis of CRBSI needs to be accurate for adequate management. Semiquantitative catheter tip culture has been established as standard in most laboratories, but this method requires catheter removal. Catheter-sparing diagnostic methods, such as differential quantitative blood cultures and differential time to positivity have emerged as reliable diagnostic techniques. Management of CRBSIs involves deciding on catheter removal and the type and duration of systemic antimicrobial therapy. Such decisions depend on the identity of the organism causing the bloodstream infection and the clinical and radiographic manifestations suggesting a complicated course.