Venous Catheter-related Infections Research Articles

In Vivo Effectiveness of Several Antimicrobial Locks To Eradicate Intravascular Catheter Coagulase-Negative Staphylococci Biofilms.

Tunneled central venous catheter (TCVC) related infection remains a challenge in the care of hemodialysis patients. We aimed to determine the best antimicrobial lock therapy (ALT) to eradicate coagulase-negative staphylococci (CoNS) biofilms. We studied the colonization status of the catheter every 30 days by quantitative blood cultures (QBC) drawn through all catheter lumens. Those patients with a significant culture (i.e.,100 to 1,000 CFU/mL) of a CoNS were classified as patients with a high risk of developing catheter-related bloodstream infections (CRBSI). They were assigned to receive daptomycin, vancomycin, teicoplanin lock solution, or the standard of care (SoC) (i.e., heparin lock). The primary endpoint was to compare eradication ability (i.e., negative QBC for 30 days after ending ALT) rates between different locks and the SoC. A second objective was to analyze the correlation between ALT exposure and isolation of CoNS with antimicrobial resistance. Daptomycin lock was associated with a significant higher eradication success than with the SoC: 85% versus 30% (relative risk [RR] = 14, 95% confidence interval [CI] = 2.4 - 82.7); followed by teicoplanin locks with a 83.3% success (RR = 11.7; 95% CI = 2 - 70.2). We observed CoNs isolates with a higher teicoplanin MIC in patients with repeated teicoplanin locks exposure (coefficient = 0.3; 95% CI = 0.11 - 0.47). However, teicoplanin MICs decreased in patients treated with vancomycin locks (coefficient = -0.56; 95% CI = -0.85 - -0.02). Methicillin-resistance decreased with accumulative ALT (RR = 0.82; 95% CI = 0.69 - 0.98). In this study, daptomycin locks achieve the highest eradication rate of CoNS from hemodialysis catheters in vivo.

Educational Nursing Guideline: It’s Effect on Preventing Central Venous Catheter Related Infection among Patients Receiving Total Parenteral Nutrition

Infection of central venous catheter continues to be one of the most serious health problems among patients receiving total parenteral nutrition, and this infection remains a leading cause of morbidity and mortality among hospitalized patients. Therefore, reduction of central venous catheter infection may be achieved through providing appropriate education and training for all health team members specially nurses. Aim of the study: Evaluate effect of educational nursing guideline on preventing central venous catheter-related infection among patients receiving total parenteral nutrition. Data Collection Tools: First Tool; Self-administered Questionnaire that included two parts; Part one: Demographic characteristics of the nurses; Part two: Nurses’ knowledge about central venous catheter infection preventive measures. Second Tool: Nurses’ Practice Observational Checklist and Third Tool: Visual Infusion Phlebitis Score that was used to assess catheter-related infection. Results: The results of this study showed that, there was a highly statistically significant difference between both groups (study & control) regarding prevention of central venous catheter-related infection (P Conclusion: Implementing educational nursing guideline for preventing central venous catheter-related infection among the patients who receive total parental nutrition showed a highly statistically significant positive effect on reducing the developed grade of phlebitis. Recommendations: This study recommended conducting the developed educational nursing guideline program for nurses to train them on central venous catheter, use proper procedures for the insertion, maintenance, and appropriate infection control measures to prevent central venous catheter-related infection.

Application of High-Throughput Sequencing Technology in the Pathogen Identification of Diverse Infectious Diseases in Nephrology Departments.

Objective: The purpose of this study was to explore the clinical applications of high-throughput sequencing (HTS) in the identification of pathogens in patients with urinary tract infection (UTI), peritoneal dialysis-associated peritonitis (PDAP), central venous catheter related blood infections (CRBIs), and lung infections in the nephrology department. Methods: Midstream urine samples from 112 patients with UTI, peritoneal fluid samples from 67 patients with PDAP, blood samples from 15 patients with CRBI, and sputum specimens from 53 patients with lung infection were collected. The HTS and ordinary culture methods were carried out in parallel to identify the pathogens in each sample. Pathogen detection positive rate and efficacy were compared between the two methods. Results: The pathogen positive detection rates of HTS in UTI, PDAP, CRBI, and lung infection were strikingly higher than those of the culture method (84.8% vs. 35.7, 71.6% vs. 23.9%, 75% vs. 46.7%, 84.9% vs. 5.7%, p < 0.05, respectively). HTS was superior to the culture method in the sensitivity of detecting bacteria, fungi, atypical pathogens, and mixed microorganisms in those infections. In patients who had empirically used antibiotics before the test being conducted, HTS still exhibited a considerably higher positive rate than the culture method (81.6% vs. 39.0%, 68.1% vs. 14.9%, 72.7% vs. 36.4%, 83.3% vs. 4.2%, p < 0.05, respectively). Conclusions: HTS is remarkably more efficient than the culture method in detecting pathogens in diverse infectious diseases in nephrology, and is particularly potential in identifying the pathogens that are unable to be identified by the common culture method, such as in cases of complex infection with specific pathogens or subclinical infection due to preemptive use of antibiotics.

Study of risk factors and therapeutic outcomes in Central Venous Catheter related Blood Stream infection in neonatal intensive care unit

Study of risk factors and therapeutic outcomes in Central Venous Catheter related Blood Stream infection in neonatal intensive care unit

Epidemiology of Central Venous Catheters Infection in Hemodialysis Patients

Background: Vascular access infections in hemodialysis patients increase by 2-3 folds in central venous catheters compared to arteriovenous fistula or graft. Among these infections exit site infections, tunnel infections and catheter- related bloodstream infections (CRBSI), are the most common complications. CRBSIs are major risk of hospitalization as well as mortality in hemodialysis patients. Objective: To study the epidemiology of central venous catheter related infections (CVC-RI), patterns of microbial infections and antibiotic sensitivity among our hemodialysis patients. Patients and methods: 94 ESRD patients on hemodialysis with temporary central venous catheter (CVC) inserted for more than 48 hours, monitored for the development of CVC related infections (CVC-RI) and divided into two main groups according to presence of catheter infection; (A) non-infected catheter patients and group (B) infected catheter patients Results: The rate of CVC-RI is high in our hemodialysis patients (42.5 %). There was a significant difference between the two studied groups as regard duration of HD and catheterization duration. Patients with evident catheter infections had significantly higher total leucocytic count (TLC) and C-reactive protein (CRP) values. There was a significant positive correlation between CRP with catheter duration and TLC. Staphylococcus aureus was the most prevalent isolated bacteria. Vancomycin was the most common used antibiotic among infected patients. Conclusion: CVC-RI rate is high in our hemodialysis patients (42.5 %). Prolonged duration of CVC usage and diabetes are major risk factors related to infections. Both S. aureus and Gram-negative micro-organisms were the most common organisms found in our study. Vancomycin and imipenem were the most common effective antibiotics according to our blood cultures.

Epidemiology of Central Venous Catheters Infection in Hemodialysis Patients

Background: Vascular access infections in hemodialysis patients increase by 2-3 folds in central venous catheters compared to arteriovenous fistula or graft. Among these infections exit site infections, tunnel infections and catheter- related bloodstream infections (CRBSI), are the most common complications. CRBSIs are major risk of hospitalization as well as mortality in hemodialysis patients. Objective: To study the epidemiology of central venous catheter related infections (CVC-RI), patterns of microbial infections and antibiotic sensitivity among our hemodialysis patients. Patients and methods: 94 ESRD patients on hemodialysis with temporary central venous catheter (CVC) inserted for more than 48 hours, monitored for the development of CVC related infections (CVC-RI) and divided into two main groups according to presence of catheter infection; (A) non-infected catheter patients and group (B) infected catheter patients Results: The rate of CVC-RI is high in our hemodialysis patients (42.5 %). There was a significant difference between the two studied groups as regard duration of HD and catheterization duration. Patients with evident catheter infections had significantly higher total leucocytic count (TLC) and C-reactive protein (CRP) values. There was a significant positive correlation between CRP with catheter duration and TLC. Staphylococcus aureus was the most prevalent isolated bacteria. Vancomycin was the most common used antibiotic among infected patients. Conclusion: CVC-RI rate is high in our hemodialysis patients (42.5 %). Prolonged duration of CVC usage and diabetes are major risk factors related to infections. Both S. aureus and Gram-negative micro-organisms were the most common organisms found in our study. Vancomycin and imipenem were the most common effective antibiotics according to our blood cultures.

Pantoea species-A Rare Cause of Central Venous Catheter Related Sepsis in Hemodialysis Patient

There has been a significant increase in nosocomial infections in Intensive Care Units and Oncology Department. Sepsis is a major cause of morbidity and mortality in chronic kidney disease patients. In hemodialysis patient, central venous catheter related blood stream infections are major cause for concern. Most common organisms isolated are gram positive which usually respond to antibiotics and sometimes needing catheter removal. However Pantoea species have been rarely reported as causative agent of CVC sepsis. Herein we report a case of Pantoea species causing CVC sepsis in hemodialysis patient. J Microbiol Infect Dis 2020; 10(2):103-105.

The Seasonality of Peripheral Venous Catheter-Related Bloodstream Infection

The Seasonality of Peripheral Venous Catheter-Related Bloodstream Infection

Investigation of Nosocomial Cluster Infections of Peripheral Venous Catheter-Related Bloodstream Infection

Object: Determine the cause of nosocomial cluster infections of peripheral venous catheter-related bloodstream infection (PIVC-BSI), and provide advice on prevention, control and nursing measures. Method: A retrospective analysis of nosocomial cluster infections that occurred in a tertiary hospital on July 28-30, 2019. Blood samples from patients suspected of PIVC-BSI were retained for bacterial culture. The clinical data of the patients, environmental hygiene indicators were collected. Results: All 8 patients had chills within 0.5 - 3.5 hours after intravenous infusion, and the highest body temperature reached 41°C. The peripheral blood samples of 4 patients were cultured as Burkholderia cepacia infection, and the eluate from the catheter tip of 2 patients cultured the same bacteria as the blood culture. The humidity in the treatment preparation room was 60% - 80%. There was mold in the sterile storage cabinet. Conclusion: The nosocomial cluster infection of PIVC-BSI was caused by Burkholderia cepacia colonizing the tip of the peripheral intravenous catheter, and the high air humidity was the most likely factor. The ability of nurses to identify and respond to PIVC-BSI as well as the infection control management level of each department still needs to be improved.

Central Venous Catheter bundle: professional knowledge and behavior in adult Intensive Care Units.

To evaluate knowledge and behavior of professionals in Intensive Care Units regarding the actions recommended in the bundle on preventing central venous catheter-related bloodstream infection. Cross-sectional descriptive quantitative study, conducted in three Intensive Care Units. The data were collected through a face-to-face questionnaire applied to health professionals. The software R 3.3.1 was used for data analysis. Two-hundred and ninety-two professionals participated. Regarding knowledge, the hand hygiene item presented a higher level both for the insertion (92.46%) and maintenance (97.27%) moments. Usage of chlorhexidine as an antiseptic, followed by alcohol (47.94%) and providing a date for hub or connectors (19.87%) were the least known items. As for behavior, the professionals reported: using always the correct attire for catheter insertion (84.25%), never waiting for the antiseptic to dry before catheter insertion (25.34%) and never cleaning hub or connectors with 70% alcohol (23.86%). Results show that the professionals' knowledge and behavior regarding the central venous catheter bundle present deficiencies, revealing the importance of promoting training programs for this knowledge domain.

Haemophilia: Reasons for visits to the paediatric emergency department

IntroductionHaemophilia is a rare disease and its management can pose a challenge to Emergency Department paediatricians. AimTo describe the frequency and reasons for consultation by haemophilic children in the ED. Materials and methodsLongitudinal retrospective study was conducted in a paediatric Emergency Department of a tertiary care hospital. The study included haemophiliacs A and B, ages 0 to 16 years old, and who had consulted the Emergency Department for whatever reason over a span of 6 years (2011–2016). The data analysed include: age, type and severity of haemophilia, reason for query, prophylactic status, complementary examinations, established diagnosis, treatment, and number of visits to the Emergency Department. ResultsThe analysis included 116 males with a total of 604 Emergency Department visits. The mean age was 5.5 years, and the median age was 5.3 years. A total of 101 patients were categorised as haemophiliac A (38 mild, 4 moderate, 59 severe), and 15 as haemophiliac B (9 mild, 3 moderate, 3 severe). The main reasons for initial Emergency Department visits (ranked by triage) were: musculoskeletal problems/injury or bleeding (66.7%), causes unrelated to haemophilia (29%), suspected central venous catheter related infection (2.8%), and routine clotting factor infusion (1.5%). Additional tests were conducted during 335 visits (55.5%). Factor replacement was undertaken in 317 visits (52.5%). A total of 103 episodes (17.1%) required hospital admission, due to: head trauma (35.9%), central venous catheter -related infection (13.6%), haemarthrosis (8.7%), muscle haematoma (6.8%), and haematuria (5.8%). ConclusionHaemophilic patients went to the Emergency Department for common paediatric causes, but also requested consultation on specific problems related to haemophilia, with musculoskeletal problems/injury or bleeding being the main issues. The paediatric Emergency Department is an indispensable component of haemophilia care.

The axillary vein puncture can reduce the incidence of central venous catheter-related bloodstream infection

Objective To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI) . Methods The clinical data of 218 patients with central venous catheterization were retrospectively analyzed. Infected patients were treated as CLABSI group and non-infected patients as control group. Results Of the 218 patients, 24 patients were developed CLABSI. There was no significant difference in sex, age, primary infection status and puncture site between CLABSI group and control group. Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028), and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰. The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days). The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P < 0.05). Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P = 0.031) and non-axillary venous catheterization (P = 0.068). Conclusions Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time. Key words: Axillary vein; Ultrasound-guided; Central line-associated bloodstream infection; Case control study

CONHECIMENTO AUTORREFERIDO DAS EQUIPES MÉDICA E DE ENFERMAGEM QUANTO ÀS MEDIDAS DE PREVENÇÃO DE INFECÇÃO DA CORRENTE SANGUÍNEA

RESUMO Objetivo: avaliar o conhecimento autorreferido das equipes médica e de enfermagem quanto às medidas de prevenção de infecção da corrente sanguínea relacionada ao cateter venoso central. Métodos: estudo transversal realizado na unidade de terapia intensiva de um hospital público de urgência e emergência de Belo Horizonte, Minas Gerais. A população foi composta por médicos, enfermeiros e técnicos de enfermagem responsáveis pela inserção e manutenção dos cateteres venosos centrais. Conduziu-se entrevista face a face, sendo utilizado como instrumento um questionário estruturado. A fim de se conhecer a distribuição dos dados utilizou-se estatística descritiva e para análise dos fatores associados ao conhecimento a regressão de Poisson com variância robusta. O nível de significância considerado foi de 5% (p&lt;0,05) e o intervalo de confiança de 95%. O teste de Shapiro-Wilk foi utilizado para verificar a normalidade dos dados. Resultados: a mediana do conhecimento autorreferido nas diferentes questões pesquisadas foi de 42,8%. Na avaliação do conhecimento sobre a inserção do cateter o percentual autorreferido pelos médicos foi de 100%. Em contrapartida, as medidas de manutenção referidas pela equipe de enfermagem foram inferiores a 50%, destacando-se a desinfecção do hub (35%) e tempo de duração para essa desinfecção (7,2%). Conclusão: na análise global das questões elegíveis para avaliação do conhecimento das equipes, constatou-se um conhecimento limitado às medidas consideradas padrão ouro na prevenção de infecção da corrente sanguínea relacionada ao cateter venoso central, reforçando a importância de mais investimentos na discussão da prevenção dessa infecção, bem como na educação permanente.

Risk factors and microbial profile of central venous catheter related blood stream infection in medical cardiac care units, National Heart Institute, Egypt.

IntroductionCatheter related blood stream infection (CRBSI) is the main complication of central venous catheter (CVC) use. The aim of the study is to improve the safety of patients with central venous catheter in National Heart Institute (NHI) medical cardiac care units.MethodsA Prospective cohort study was conducted on one hundred and eleven cardiac patients in (NHI) cardiac care units from August 2017 to February 2018. All patients subjected to central venous catheter (CVC) in cardiac care units, NHI, were included except: 1. Patients with obvious source of infection, 2. Immunocompromised patients, 3. patients having infective endocarditis, 4. patients whose catheter was put outside NHI.ResultsNoncompliance of health care providers to care bundle elements of CVC of Centers for Disease Control and Prevention (CDC) represents a risk factor for CRBSI occurrence. Coagulase negative staphylococci was the most common isolated organism.ConclusionHealth care providers should adhere care bundle elements recommended by CDC during insertion and handling of CVC. This will in turn decrease CRBSI.

Peripheral venous catheter related blood stream infection in intensive care unit

Background: Peripheral venous catheter related blood stream infections (PVC-BSI) are a common cause of morbidity and mortality in hospitals. Most of the catheter related blood stream infections occurs due to lack of proper aseptic measures. This study points out the risk factors microbial profile and antimicrobial susceptibility of isolates associated with PVC-BSI. The common organisms causing Catheter related BSI are Staphylococcus aureus (41.1%), and Klebsiella species (17.6%) followed by CONS and Enterococcus species. Objective of present study was to isolate and identify the organisms causing PCV-BSI, perform antimicrobial sensitivity testing of isolated organisms and to identify the associated risk factors and preventive measures that should be used.Methods: The study was conducted over a period of one year from August 2015 to July 2016 in the Department of Microbiology. Study group comprised of all the patients with peripheral venous catheterization who developed signs and symptoms of septicemia after 48 hrs of insertion of PVC. These patients were followed up from the time of catheterization till discharge. Peripheral venous catheter tip was collected under aseptic condition along with peripheral blood samples from a site other than the catheterized one. Samples were collected from patients at any point of time who developed signs and symptoms of septicemia after 48 hrs of catheter insertion. The length of time for which the PVC was in place was recorded.Results: In total, 87 cases were included in the study with mean catheter duration of 4.8 days accounting for 418 catheter days. Out of these 87 cases, 17 cases developed PVC-BSI (19.5%) and 34 cases developed colonization (24.1%). Staphylococcus species (41.1%) was the most common isolate.Conclusions: PVC-BSI has a significant role in hospital acquired infections and more studies are needed to establish this.

Changing microbiology of indwelling venous catheter related infection

Changing microbiology of indwelling venous catheter related infection

A study of occurance of central venous catheter related infection and factors affecting it

A study of occurance of central venous catheter related infection and factors affecting it

Changing microbiology of indwelling venous catheter related infection

Changing microbiology of indwelling venous catheter related infection

Application of cluster care in the catheter-related bloodstream infections

Objective To explore the application value of cluster nursing care in preventing central venous catheter-related bloodstream infections. Methods 200 patients with indwelling central venous catheter in ICU were selected as the research subjects.They were randomly divided into study group and control group by digital table, 100 cases in each group.The patients in the control group received routine nursing.The patients in the study group was given cluster based nursing.The catheter site, catheterization time, infection rate were compared between two groups. Results In the study group, the rates of internal jugular vein set pipe and lock venous catheter and femoral vein set tube were 82.00%(82/100), 14.00%(14/100), 4.00%(4/100), which in the control group were 79.00% (79/100), 15.00%(15/100), 6.00%(6/100), there were no statistically significant differences(P>0.05). The set tube time of the study group was (10.36±4.67)d, which of the control group was (11.28±4.58)d, the difference was not statistically significant(χ2=1.406, P>0.05). The catheter-related bloodstream infection rate of the study group was 1.00%(1/100), which was significantly lower than 9.00%(9/100) of the control group (χ2=6.736, P=0.009). Conclusion Compared with conventional nursing mode, cluster of nursing in patients with indwelling central venous catheter can significantly reduce the incidence of central venous catheter related blood stream infections, it is an effective nursing intervention mode. Key words: Catheter insertion, central vein; Bloodstream infection, catheter; Nursing

SUN-P103: Evaluation of Three Different Antibiotic Lock-Therapies in Combination with Urokinase for the Treatment of Central Venous Catheter-Related Bloodstream Infections

SUN-P103: Evaluation of Three Different Antibiotic Lock-Therapies in Combination with Urokinase for the Treatment of Central Venous Catheter-Related Bloodstream Infections