Catheter-related Bloodstream Infections Research Articles

Midline vs Peripherally Inserted Central Catheter for Outpatient Parenteral Antimicrobial Therapy

ImportanceLittle is known about the safety of midline catheters vs peripherally inserted central catheters (PICCs) for outpatient parenteral antimicrobial therapy (OPAT).ObjectiveTo compare outcomes from midline catheters vs PICCs for OPAT.Design, Setting, and ParticipantsThis retrospective cohort study included patients who received antimicrobial therapy through a midline catheter or PICC between January 2017 and November 2023 across 69 Michigan hospitals. Because peripherally compatible OPAT was the indication of interest, vancomycin therapy was excluded. Data were analyzed from April to June 2024.ExposuresInsertion of a midline catheter or PICC for OPAT following hospitalization.Main Outcomes and MeasuresThe primary outcome was major device complications (ie, catheter-related bloodstream infection or catheter-related venous thromboembolism). Secondary outcomes included minor device complications (eg, catheter dislodgement, occlusion, tip migration, infiltration, superficial thrombophlebitis, or exit site concerns) and device failure, defined as catheter removal following device complication. Cox proportional hazards regression models were fit to device type and outcomes, adjusting for patient and device confounders and device dwell.ResultsOf 2824 included patients, 1487 (53.5%) were male, and the median (IQR) age was 66.8 (55.9-77.1) years. Of 2824 devices placed for OPAT, 1999 (70.8%) were midline catheters and 825 (29.2%) were PICCs. The median (IQR) dwell time was 12 (8-17) days for midline catheters and 19 (12-27) days for PICCs (P < .001). A major device complication occurred in 44 patients (1.6%) overall, including 16 (0.8%) with midline catheters and 28 (3.4%) with PICCs (P < .001). OPAT delivered via midline catheters was associated with a lower risk of major complications vs PICCs (adjusted hazard ratio [aHR], 0.46; 95% CI, 0.23-0.91). Risks of minor complications and device failure were similar across device types (minor complications: 206 of 1999 [10.3%] vs 114 of 825 [13.8%]; aHR, 1.07; 95% CI, 0.83-1.38; device failure: 191 of 1999 [9.6%] vs 100 of 825 [12.1%]; aHR, 1.26; 95% CI, 0.96-1.65). For device dwell of 14 or fewer days, midline catheters were associated with a lower risk of major complications (12 of 1324 [0.9%] vs 16 of 304 [5.3%]; aHR, 0.29; 95% CI, 0.12-0.68) and similar risk of failure (151 of 1324 [11.4%] vs 52 of 304 [17.1%]; aHR, 0.79; 95% CI, 0.56-1.12) vs PICCs. For dwell longer than 14 days, no significant difference in rates of major complications (4 of 675 [0.6%] vs 12 of 521 [2.3%]; aHR, 0.42; 95% CI, 0.13-1.40) or device failure (40 of 675 [5.9%] vs 48 of 521 [9.2%]; aHR, 1.02; 95% CI, 0.64-1.61) were observed.Conclusions and RelevanceIn this study, midline catheters appeared to be safe alternatives to PICCs for OPAT, particularly if infusions were planned for 14 or fewer days.

Sex-disaggregated analysis of central venous catheter-related bloodstream infections in patients with cancer

Introduction: Men are generally more susceptible to bacterial infections than women. Central venous catheters (CVCs), often used to administer systemic treatment in patients with cancer, are an important source of infection. However, little is known about sex-specific differences of CVC-related bloodstream infections (CRBSIs) in patients with cancer. This study aimed to compare CRBSIs in men vs. women in a large cohort of patients with cancer. Methods: Data were derived from the SECRECY registry including non-selected patients with centrally inserted non-tunneled internal jugular or subclavian vein CVCs in 10 hematology and oncology sites in Germany. Only CRBSIs classified as definite CRBSI (dCRBSI) or probable CRBSI were included, and the combination of both was summarized as dpCRBSI. CVCs were matched 1:1 for underlying disease, anatomic site of CVC insertion, type of CVC dressing, antimicrobial coated CVC, complicated CVC insertion and CVC in situ time by propensity score matching (PSM). Endpoints were CRBSI rates and incidences in CVCs inserted in men vs. women. Results: A total of 5075 CVCs registered from March 2013 to March 2024 were included in the analysis, of which 3024 comprises the PSM cohort. 1512 (50.0%) CVCs were inserted in men. Underlying diseases mainly were hematological malignancies (96.4%). While there was no statistically significant difference between men and women in the dCRBSI rate (5.4% vs. 4.1%; p=0.12) and the dCRBSI incidence (3.8 vs. 2.9/1000 CVC days; p=0.11), the rate of dpCRBSI (9.9% vs. 6.7%; p=0.002) and the dpCRBSI incidence (7.0 vs. 4.7/1000 CVC days; p=0.002) were significantly higher in men vs. women. The proportion of coagulase-negative staphylococci as causative agent of both dCRBSI and dpCRBSI was higher in men than in women (58.8% vs. 41.2%; p=0.07, and 61.5% vs. 38.5%; p=0.002, respectively). A multivariable regression revealed neutropenia as an independent risk factor for dCRBSI and male sex as risk factor for dCRBSI and dpCRBSI. Conclusion: In patients with hematological malignancies, men have a higher risk of CRBSI than women. This finding may be attributed to the high number of jugular vein inserted CVCs which in men may be associated with higher rates of skin colonization than in women. Special preventive measures such as earlier removal of CVCs in men may be studied in future.

Nursing practice of guidelines for prevention and control of vascular Catheter-Related bloodstream infections.

To apply the Ottawa Model of Research Use to translate the Guidelines for the Prevention and Control of Vascular Catheter-Associated Bloodstream Infections. The Ottawa model of research use is used to provide a framework and guidance. This study was organized by the Nursing Department of the Affiliated Hospital of Hebei Engineering University, and the Intravenous Therapy Group was responsible for the implementation of the study. The hospital's intravenous therapy administrators, members of the sedation team, and specialist nurses will be organized to evaluate the importance, exactness, and clinical practicability of 34 entries. Twelve clinical departments and IV therapy clinics with a high number of central venous catheters were used as sites for translating evidence from this project. The evidence-based team assessed the practice environment, potential practitioners, and clinical status of clinical translation of evidence through symposia, review of relevant systems, operational procedures, on-site inspections, and questionnaires. They compare evidence with existing processes and decide on change strategies. Before and after the application of the evidence, there was a significant increase in the knowledge, belief, and behavior of healthcare workers on CLABSI prevention and control, especially in the acquisition of related knowledge (χ2 = 26.648 p < 0.001). The associated implementation rate was also significantly improved, with a significant decrease in CLABSI incidence from 0.29 per 1000 to 0.11 per 1000 (χ2 = 8.625 p = 0.004). The assessment of the integration of issues showed that 8 aspects, including workflow, knowledge mastery, monitoring reports, and aseptic operations, do not meet the qualified standards. Through this clinical change, a perfect prevention and control system has been established, and the level of knowledge, belief, and behavior of medical staff in preventing CLABSI has been improved, while the incidence of CLABSI has been reduced.

Improving central venous catheter care with chlorhexidine gluconate dressings: evidence from a systematic review and Meta-analysis

BackgroundThe prevention of catheter-related bloodstream infections (CRBSI) is a critical priority in the clinical management of central venous catheters (CVCs). This meta-analysis aims to evaluate the efficacy of chlorhexidine gluconate antibacterial dressings in the context of CVC care.MethodsA systematic literature search was performed in PubMed, Web of Science, Embase et al. databases up to May 28, 2024. The search targeted randomized controlled trials (RCTs) that investigated the impact of chlorhexidine gluconate antibacterial dressings on CVC-related outcomes. The meta-analysis was conducted using RevMan 5.3 software.ResultsThe final analysis included 14 RCTs involving a total of 8920 patients with CVCs, with participants divided into a chlorhexidine antibacterial dressing group (n = 4731) and a control group (n = 4189). The chlorhexidine dressing group demonstrated a statistically significant reduction in the incidence of CRBSI compared to the control group, with a relative risk (RR) of 0.48, 95% confidence interval (CI) 0.36–0.64, P < 0.001. The chlorhexidine dressing group also showed a significant decrease in bacterial colonization, with an RR of 0.46, 95% CI 0.38–0.55, P < 0.001. Assessment of publication bias through funnel plot asymmetry and Egger’s test revealed no significant bias in the included studies (all P > 0.05).ConclusionsThere is a notable reduction in the incidence of CRBSI and bacterial colonization in patients with CVCs through the application of chlorhexidine gluconate dressings. Given the compelling evidence, the integration of these dressings into standard nursing care protocols for the management of CVCs is advocated.

Bioinspired skin-like in vitro model for investigating catheter-related bloodstream infections

Intravenous (IV) catheter-related bloodstream infections (CRBSIs) cause significant risks in healthcare, necessitating advancements in catheter design and materials. This study investigates the effectiveness of Ecoflex, a silicone-based material, in studying CRBSIs through the development of skin-like replicas that mimic human skin properties for use in wearable sensing devices. We characterized the replica’s bioinspired surface roughness, wettability, bacterial adhesion, and mechanical properties and validated its performance using in vitro IV simulation. The results demonstrated that the bioinspired model replicates human skin textures with less than 7.5% error for surface roughness ranging from 0.05 μm to 6.3 μm. Wettability tests revealed that the artificial sebum application significantly reduced the static contact angles for deionized water and artificial sweat. Comprehensive mechanical testing revealed material high elasticity and resilience, suitable for dynamic biomedical applications. Bacterial adhesion studies using Staphylococcus epidermidis showed varying adhesion patterns influenced by surface roughness, highlighting the potential for material texture to impact infection risk. In IV therapy simulations, we observed bacterial growth dynamics over the incubation period. Our findings suggest that Ecoflex-based skin-like replicas can serve as a valuable tool for developing and testing new catheters, while the potential for use in other medical innovation devices, including wearable sensing devices, ultimately contributes to improved patient outcomes and infection control strategies.

Factors Associated With Mortality in Patients With Catheter-related Bloodstream Infection: A Multicenter Retrospective Study.

Catheter-related bloodstream infections (CRBSI) are frequently life-threatening. Several factors have been reported to be related to CRBSI development; however, the factors associated with CRBSI mortality are unclear as they have rarely been studied. This study investigated the factors associated with mortality in patients with CRBSI, specifically focusing on nutritional factors. This retrospective, multicenter study included in-patients with acute conditions and convalescent patients diagnosed with a CRBSI between January 2019 and December 2021 at 33 hospitals (23 general hospitals, two mixed-care hospitals, and eight convalescent hospitals). The primary outcome was death. Unadjusted and multivariable logistic regression analysis was performed to identify factors associated with mortality. A total of 453 patients with CRBSI were enrolled. The causes of death were analyzed for 382 (84.3%) who survived CRBSI and 71 (15.7%) who died. Multivariable analysis revealed that Candida detected in blood culture [adjusted odds ratio (aOR)=2.72, 95% confidence interval (CI)=1.15-6.41; p=0.025)], CRBSI onset within 30 days of catheter insertion (aOR=2.28, 95% CI=1.27-4.09; p=0.005), concurrent infection (aOR=2.07, 95% CI=1.19-3.60; p=0.009), low serum albumin level (aOR=1.64, 95% CI=1.02-2.63; p=0.044), and elevated C-reactive protein level (aOR=1.05, 95% CI=1.01-1.10; p=0.028) were risk factors for mortality, whereas the use of a peripherally inserted central catheter was associated with a reduced risk of CRBSI mortality (aOR=0.30, 95% CI=0.13-0.69; p=0.004). Enhanced monitoring of factors, such as candida detected in blood culture, CRBSI onset within 30 days of catheter insertion, concurrent infection, low serum albumin level, elevated C-reactive protein (CRP) level and the use of a peripherally inserted central catheter (PICC), is crucial for mitigating CRBSI severity and risk of death.

Interventions to prevent Neonatal Healthcare-associated Infection: a systematic review of RCT

Abstract Background Healthcare-acquired infections (HAI) in neonatal intensive care unit (NICU) specifically refer to infections that occur in newborn infants within the healthcare environment. Preterm infants, often more vulnerable to infections, in the NICU may be exposed to various medical interventions, devices, and environments that can increase the risk of infections. This systematic review aims to evaluate the effectiveness of interventions proposed to prevent neonatal healthcare-associated infections. Methods PubMed, Scopus and Web of Science databases were searched to identify any RCT study coming from high income countries, published from 2004, that investigated the efficacy of any intervention to prevent HAI in NICU. All type of HAI were considered. Results A total of seven studies were included (2 from USA, 5 from UE). Three studies focused on: administration of donor milk; probiotic Bifidobacterium breve; intravenous Staphylococcus aureus immune globulin; all failed to demonstrate any protective action. Of the four remaining studies that investigate different aspect of the vascular catheterization process only two lead a a statistical significant reduction of HAI. Garland et al. demonstrate in 85 neonates how vancomycin-heparin lock solution is capable to reduce catheter related blood stream infection (CRBSI) 8/43 neonates (18.6%) in the control group vs 0/42 in the vancomycin-heparin-lock group (P = 0.006). Bertini et al. demonstrate in 86 preterm infants how utilization of AgION catheter in Umbelical vein catheterization (UVC) lead to CRBSI rate reduction (2 vs. 22%; p = 0.005), shorter hospital stay (p = 0.04), lower case fatality rate due to Blood stream infection (p = 0.01). Conclusions Among the proposed methodology only the one acting on the catheterization process provide a statistical significant reduction of HAI onset. Widespread observation of proposed protocol may results in reduction of HAI in NICU. Key messages • Modfiication on the catheterization process provide a statistical significant reduction of HAI onset. • Knowing these measures assure reduction of HAI.

Improvement cycle to act against catheter-related bloodstream infections

Abstract Background Catheter-related bloodstream infections (CRBSI) pose significant risks, causing a prolongation of hospital stay, increasing costs and increasing the risk of complications and mortality. It is the first healthcare-associated infection in many hospitals including our institution. Preventing CRBSI is essential for safety in patient’s care. To achieve this, we’ve adopted improvement cycles as a tool, aiming to decrease CRBSI rates by 50%. Methods Over the period of 2012 to 2023, 9036 pediatric patients were monitored throughout their hospitalizations. We utilized improvement cycles through various interventions: first an intervention bundle, secondly avoiding multipuncture, thirdly improving sampling techniques, fourthly optimizing supply management, and lastly restructuring the vascular access clinic. Each cycle involved resource management and process enhancement. Progress was measured through percentage metrics and the primary outcome indicator was CRBSI rates. Results The first cycle achieved a 90% compliance, the achievements were compliance above 85% of the bundle. In the second cycle we attained an 85% compliance, implement a guideline for catheter insertion with only two punctures in practice. The third cycle saw a 70% compliance rate, involving a multidisciplinary team for taking samples, training and monitoring by a skilled supervisor. The fourth cycle reached a 60% compliance through a techno-vigilance process, it was a pity quickly practical solutions didn´t work in practice. The final cycle achieved a 70% compliance, establishing a functional vascular access clinic. Rates CRBSI decreased by 50% overall and in the pediatric intensive care unit, meeting our objective. However this reduction was not observed in other intensive care units. Conclusion Improvement cycles simplify changes. Their implementation is effective but requires close monitoring, support from resources and authorities, a committed and proactive team, and continuous changes according to results. There is a need to consolidate the strategies to sustain and enhance our achievements.

Bloodstream infections in a Brazilian Pediatric Tertiary Oncology Hospital: 30-month analysis regarding the classification of the infection, distribution of microorganisms and their resistance profile

Abstract Background Infections are a major cause of morbidity and mortality in pediatric oncology patients during their treatment. Bloodstream infections are the main site of infection in these patients. Bacteremia in these patients can be secondary to a primary infectious focus, result from central line associated bloodstream infections (CLABSIs) or mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI). Methods Descriptive study of bloodstream infections in pediatric patients undergoing oncological treatment and hematopoietic stem cell transplantation in a tertiary pediatric oncology hospital in Brazil from January 1st, 2021 to June 30th, 2023. Infections were classified according to the Centers for Disease Control and Prevention/ National Healthcare Safety Network (CDC/NHSN) criteria into CLABSIs, MBI-LCBIs and secondary bloodstream infections. Among the bloodstream infections that met CDC/NHSN criteria for CLABSI, were analyzed separately those who also met the criteria of catheter-related bloodstream infection (CRBSI) according to Infectious Diseases Society of America (IDSA). Results During this period were diagnosed 335 episodes of bloodstream infection (123 episodes in 2021, 150 in 2022 and 62 episodes in the first 6 months of 2023). There were 378 microorganisms isolated. These infections were classified into: 35% CLABSIs, 27% MBI-LCBIs, 23% CRBSIs, and 15% secondary bloodstream infections. Among the CLABSIs, the most common microorganisms were non-fermenting gram negative bacilli (NFGNB) 38%, enterobacteriaceae 35% and coagulase-negative staphylococcus (CoNS) 11%. Between CRBSIs, there were 31% enterobacteriaceae, 22% CoNS and 19% NFGNB. Among the MBI-LCBIs there were 66% enterobacteriaceae and 23% group viridans streptococci (VGS). Streptococcus pneumoniae (33%) was the most common microorganism in secondary infections followed by Staphylococcus aureus (17%). Assessing all infections together, the main enterobacteriaceae were Klebsiella spp. (40%) and only 50% of them were sensitive to cefepime while 10% were carbapenems resistant. Among NFGNB, 13% of Pseudomonas spp. and 5% of Acinetobacter spp. were carbapenems resistant. Between the gram-positive bacteria, 77% of the S. aureus were methicillin sensitive, the same percentage of the VGS were sensitive to cefepime. Conclusion Among bloodstream infections, there were a predominance of CLABSI followed by MBI-LCBIs. Antimicrobial resistance between gram-positive bacteria, is of little concern in our institution. In the case of gram-negative bacteria, resistance to cefepime is becoming worrying among enterobacteriaceae.

Efficacy and safety of intracavitary electrocardiography-guided peripherally inserted central catheters in pediatric patients: a systematic review and meta-analysis.

To assess the efficacy and safety of intracavitary electrocardiography (IC-ECG)-guided peripherally inserted central catheter (PICC) placements in pediatric patients, emphasizing improvements over traditional placement methods. A literature search was conducted in April 2024 across PubMed, Cochrane Library, and EMBASE. Studies focusing on pediatric patients and reporting the efficacy and safety of IC-ECG-guided PICC placement via the upper extremity were included. This study was registered with the PROSPERO database (CRD42024549037) in accordance with PRISMA guidelines. Eleven studies were included, comprising five randomized controlled trials (RCTs) and six quasi-experimental studies. The pooled analysis showed that IC-ECG had an applicability and feasibility of 97% and 98%, respectively. The first puncture success rate was 91%, and the overall success rate was 98%. Sensitivity and specificity were 97% and 80%, respectively. IC-ECG significantly reduced overall complications compared to traditional methods (RR: 0.31, 95% CI [0.20-0.46], p < 0.00001), particularly in phlebitis (RR: 0.25, 95% CI [0.11-0.57], p = 0.001) and arrhythmias (RR: 0.09, 95% CI [0.01-0.70], p = 0.021). Similar results were observed in neonates. Only one case of catheter-related bloodstream infection (CRBSI) was reported, and no arrhythmia events were noted. IC-ECG-guided PICC placement is a highly effective and safe method for pediatric patients, including neonates, offering significant advantages over traditional techniques. Further high-quality studies are needed to standardize procedural techniques and explore cost-effectiveness.

The impact of femoral/internal jugular vein selection on postoperative infection in central vein cannulation of newborns undergoing cardiac surgery.

In the low-weight newborn patient group, the development of catheter related bloodstream infections after cardiac surgery significantly impacts morbidity and mortality. In our study, the effects of choosing femoral or internal jugular vein localization in newborns on postoperative infection will be examined. Our hypothesis is that there may be a higher risk of catheter related bloodstream infections in the femoral region. This study was conducted retrospectively on newborn cases who underwent congenital heart surgery between September 1, 2020, and March 1, 2022. The cases were divided into 2 groups: those with central catheters inserted in the femoral and in internal jugular veins. Postoperative infection parameters were examined and the results were statistically evaluated. The study was conducted with a total of 201 newborn cases, of which 61.2% (n = 123) were male and 38.8% (n = 78) were female. The age of the cases ranged from 0 to 1 month, with a mean of 12 ± 9 days. Weight measurements ranged from 1.8 to 5.5 kg, with a mean of 3.20 ± 0.66 kg. Central catheters were placed in the femoral vein (FV) region in 71.6% of the babies (n = 144) and in the internal jugular vein region in 28.4% (n = 57). When culture results were examined between postoperative days 3 to 14, blood culture tests were positive in 12.4% (n = 25). The most common bacteria in positive cases were Klebsiella spp. (n = 13) and methicillin-resistant Staphylococcus aureus (n = 5). There was no statistically significant difference in blood culture results between the groups (P > .05). Changes in white blood cells, C-reactive protein, and procalcitonin measurements between preoperative and postoperative day 3 did not show statistically significant difference between the groups (P > .05). According to the results of our study, the placement of FV and internal jugular vein in neonates undergoing cardiac surgery did not differ in terms of postoperative infection risk. With appropriate sterilization, preventive measures and care considerations, FV or internal jugular vein region may be preferred based on the practitioner's expertise and choice in this patient group.

The epidemiology and microbiology of central venous catheter related bloodstream infections among hemodialysis patients in the Philippines: a retrospective cohort study

BackgroundDespite efforts to improve the management of catheter-related bloodstream infections (CRBSI) in literature, temporary CVCs continue to be used for maintenance hemodialysis outside of acute care settings, particularly in the Philippines.MethodsWe conducted a retrospective cohort study to investigate the incidence, outcomes, risk factors, and microbiological patterns of CRBSI among adult kidney disease patients undergoing hemodialysis at the Philippine General Hospital, the country's largest tertiary referral center. We included all adult patients who received a CVC for hemodialysis from January 1, 2018, to August 31, 2019, and followed them for six months to observe the occurrence of CRBSI and its outcomes.ResultsOur study documented a CRBSI incidence rate of 6.72 episodes per 1000 catheter days, with a relapse rate of 5.08%, a reinfection rate of 15.74%, and a mortality rate of 6.09%. On multivariable regression analysis, we identified autoimmune disease, dialysis frequency of > 3 × per week, use of CVC for either blood transfusion or IV medications, renal hypoperfusion, drug-induced nephropathy, and hypertensive kidney disease as significant risk factors for CRBSI. Gram-negative bacteria, including B. cepacia complex, Enterobacter, and Acinetobacter spp, were the most common organisms causing CRBSI. Multidrug-resistant organisms (MDROs) comprised almost half of the isolates (n = 89, 44.5%), with Coagulase-negative Staphylococcus species having the highest proportion among gram-positive organisms and Acinetobacter spp. among gram-negative isolates.ConclusionOur findings emphasize the need for more stringent measures and interventions to prevent the propagation of identified pathogens, such as a review of sterile technique and adequate hygiene practices, continued surveillance, and expedited placement and utilization of long-term access for patients on maintenance hemodialysis. Furthermore, CVC use outside of hemodialysis should be discouraged, and common antibiotic regimens such as piperacillin-tazobactam and fluoroquinolones should be reviewed for their low sensitivity patterns among gram-negative isolates. Addressing these issues can improve hemodialysis patients' outcomes and reduce the CRBSI burden in our institution.

Efficacy of urokinase in maintaining patency of hemodialysis catheters: Ameta-analysis.

Catheter malfunctions are associated with reduced blood flow and interrupted dialysis during hemodialysis. This meta-analysis aimed to determine whether the use of urokinase to lock hemodialysis catheters can maintain their patency and prevent catheter-related bloodstream infections (CRBSIs). The PubMed, Cochrane Library, Web of Science, Embase, and Chinese medical databases were searched for controlled trials of hemodialysis catheter locking using urokinase from database inception until July 15, 2021. The primary outcome was catheter malfunction, and the secondary outcomes were the peak catheter blood flow rate (Qb) and CRBSIs. Across 16 trials, 1,041 patients were randomized to receive either urokinase/urokinase mixture (treated) or heparin (control) locks once or thrice a week. Locking with urokinase alone or in combination with another substance significantly prevented catheter malfunction. The effect on Qb was significant, with that in the treated group being better than in the control group. Similarly, the incidence of CRBSIs in the treated group was lower. Urokinase locking maintains catheter patency more effectively than heparin. Prophylactic locking with urokinase or urokinase mixtures reduces incidences of catheter malfunction, which ensures the smooth progression of hemodialysis and reduces patient medical costs. The results of this study have important clinical implications and will provide guidance to medical practitioners globally.

Sepsis severity of chronic intestinal failure patients presenting with catheter related blood stream infection

Sepsis severity of chronic intestinal failure patients presenting with catheter related blood stream infection

Risk of mortality and catheter-related bloodstream infection with home parenteral nutrition; can a home care nurse reduce these possibilities?

Risk of mortality and catheter-related bloodstream infection with home parenteral nutrition; can a home care nurse reduce these possibilities?

Factors associated with mortality in patients with catheter-related bloodstream infection in Japan: A multicenter retrospective study

Factors associated with mortality in patients with catheter-related bloodstream infection in Japan: A multicenter retrospective study

National Estimates of Direct Health Care Costs Associated with Catheter-Related Bloodstream Infection among Hospitalized Hemodialysis Patients in Australia

National Estimates of Direct Health Care Costs Associated with Catheter-Related Bloodstream Infection among Hospitalized Hemodialysis Patients in Australia

Unveiling catheter related bloodstream infection rates in inpatient parenteral nutrition: A call for action

Unveiling catheter related bloodstream infection rates in inpatient parenteral nutrition: A call for action

Taurolocktmhep100 versus saline 0.9% as secondary prevention of catheter-related bloodstream infections in patients with chronic intestinal failure; a double-blinded, randomized study

Taurolocktmhep100 versus saline 0.9% as secondary prevention of catheter-related bloodstream infections in patients with chronic intestinal failure; a double-blinded, randomized study

Predictive Factors of Catheter-Related Bloodstream Infection among Patients on Hemodialysis

Predictive Factors of Catheter-Related Bloodstream Infection among Patients on Hemodialysis