Diagnosis and prevention of catheter-related infections

Curr Opin Crit Care. 2007 Oct;13(5):563-71. doi: 10.1097/MCC.0b013e3282efa03f.

Abstract

Purpose of review: To highlight the major advances in diagnosing and preventing catheter-related infections published in research articles published between March 2004 and May 2007.

Recent findings: The challenge remains to make the diagnosis of catheter-related infection with good accuracy without catheter removal. The differential time to obtain positive qualitative blood culture appeared to be the most accurate available technique. Many catheter-related bloodstream infections are preventable. Simple interventions are often useful and multimodal programs are very efficacious, particularly in the intensive care setting. For long-term catheter-related bloodstream infection prevention, patient education appeared promising. Interesting evidence suggested that anticoagulant, by decreasing the biofilm formation, could decrease the risk of infection. For short-term central venous catheter-related infections research is ongoing on antiseptic dressings. Antiseptic lock appeared promising for preventing long-term central venous catheter bloodstream infections.

Summary: Nowadays, multimodal programs of catheter infection prevention are efficacious. Levels of catheter-related bloodstream infection of more than one or two per 1000 catheter-days are usually only found in the intensive care unit. It is a prerequisite to evaluate the cost-effectiveness of new techniques of prevention. As catheter-related bloodstream infections become rarer, strategies limiting unnecessary removal of catheters need to be developed and tested.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Local / therapeutic use
  • Bacteriological Techniques
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / methods
  • Catheters, Indwelling / microbiology
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Infection Control / methods*
  • Intensive Care Units / organization & administration*
  • Quality Assurance, Health Care / organization & administration
  • Sepsis / diagnosis*
  • Sepsis / microbiology
  • Sepsis / prevention & control*

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Fibrinolytic Agents