Prevention of infections associated with vascular catheters

Abstract

Catheter-related bloodstream infection is the most common life threatening complication of intravascular catheters. Most cases of catheter-related infection are caused by skin organisms that originate either from the skin of the patient and migrate along the external surface of the catheter or from the skin of the medical personnel causing hub contamination and subsequent bacterial migration along the internal surface of the catheter. A number of measures have been reported in clinical trials to protect against vascular catheter-related infection. Preventive measures that utilize antimicrobial agents include application of topical disinfectants, flushing catheters with the combination of antimicrobial and antithrombotic agents, use of silver-impregnated subcutaneous cuffs for short-term central venous catheters, antimicrobial coating of catheters either with antiseptics or with antibiotics, and use of an antiseptic catheter hub. Protective measures that do not utilize antimicrobial agents include placement and maintenance of vascular catheters by a skilled infusion therapy team and institution of maximal sterile barriers.