Format

Send to:

Choose Destination
See comment in PubMed Commons below
Ann Intern Med. 2000 Mar 7;132(5):391-402.

Prevention of intravascular catheter-related infections.

Author information

  • 1Division of Infectious Diseases, Rhode Island Hospital and Brown University School of Medicine, Providence 02903, USA. lmermel@lifespan.org

Erratum in

  • Ann Intern Med 2000 Sep 5;133(5):395.

Abstract

PURPOSE:

To review the literature on prevention of intravascular catheter-related infections.

DATA SOURCES:

The MEDLINE database, conference proceedings, and bibliographies of review articles and book chapters were searched for relevant articles. Primary authors were contacted directly if data were incomplete.

STUDY SELECTION:

Studies met the following criteria unless otherwise stated: Trials were prospective and randomized; catheters were inserted into new sites, not into old sites over guidewires; catheter cultures were done by using semi-quantitative or quantitative methods; and, for prospective studies, catheter-related bloodstream infection was confirmed by microbial growth from percutaneously drawn blood cultures that matched catheter cultures.

DATA EXTRACTION:

Data on population, methods, preventive strategy, and outcome (measured as catheter-related bloodstream infections) were gathered. The quality of the data was graded by using preestablished criteria.

DATA SYNTHESIS:

The recommended preventive strategies with the strongest supportive evidence are full barrier precautions during central venous catheter insertion; subcutaneous tunneling short-term catheters inserted in the internal jugular or femoral veins when catheters are not used for drawing blood; contamination shields for pulmonary artery catheters; povidone-iodine ointment applied to insertion sites of hemodialysis catheters; specialized nursing teams caring for patients with short-term peripheral venous catheters, especially at institutions with a high incidence of catheter-related infection; no routine replacement of central venous catheters; antiseptic chamberfilled hub or hub-protective antiseptic sponge for central venous catheters; and use of chlorhexidine-silver sulfadiazine-impregnated or minocycline-rifampin-impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies that do not incorporate antimicrobial agents (for example, maximal barrier precautions).

CONCLUSIONS:

Simple interventions can reduce the risk for serious catheter-related infection. Adequately powered randomized trials are needed.

Comment in

  • ACP J Club. 2000 Nov-Dec;133(3):96.
PMID:
10691590
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Write to the Help Desk