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Infection AND Central venous catheter

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https://www.readbyqxmd.com/read/29472511/development-and-implementation-of-an-antimicrobial-lock-therapy-guideline-in-a-pediatric-hospital
#1
Tracy N Zembles, Linda S Flannery, Anna R Huppler
PURPOSE: The development and implementation of an antimicrobial lock therapy guideline at a large pediatric hospital are described. SUMMARY: Central venous access devices (CVADs) are essential in the medical management of patients requiring long-term total parenteral nutrition, chemotherapy, or hemodialysis. However, the use of a CVAD carries a significant risk of the development of central line-associated bloodstream infection (CLABSI). Antimicrobial lock therapy is indicated for patients with CLABSIs who have no signs of exit site or tunnel infection and for whom catheter salvage is a goal...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29472415/cluster-randomized-trial-of-devices-to-prevent-catheter-related-bloodstream-infection
#2
Steven M Brunelli, David B Van Wyck, Levi Njord, Robert J Ziebol, Laurie E Lynch, Douglas P Killion
Central venous catheters (CVCs) contribute disproportionately to bloodstream infection (BSI) and, by extension, to infection-related hospitalization, mortality, and health care costs in patients undergoing dialysis. Recent product advancements may reduce BSIs, but a sufficiently powered comparative-effectiveness study is needed to facilitate evidence-based patient care decisions. In a 13-month, prospective, cluster-randomized, open-label trial, we compared BSI rates in facilities using ClearGuard HD antimicrobial barrier caps (ClearGuard group) with those in facilities using Tego hemodialysis connectors plus Curos disinfecting caps (Tego+Curos group)...
February 22, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29470531/epidemiology-and-risk-factors-of-extensively-drug-resistant-pseudomonas-aeruginosa-infections
#3
Nattawan Palavutitotai, Anupop Jitmuang, Sasima Tongsai, Pattarachai Kiratisin, Nasikarn Angkasekwinai
BACKGROUND: The incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality. METHODS: We retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014. RESULTS: Of the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12...
2018: PloS One
https://www.readbyqxmd.com/read/29468780/efficacy-analysis-of-routine-catheter-tip-cultures-in-a-neonatal-intensive-care-unit
#4
Taito Kitano, Kumiko Takagi, Ikuyo Arai, Hajime Yasuhara, Reiko Ebisu, Ayako Ohgitani, Daisuke Kitagawa, Miyako Oka, Kazue Masuo, Hideki Minowa
OBJECTIVES: Although routine catheter tip cultures are not recommended, previous reports have indicated that some cases of colonization, such as with S. aureus, can lead to subsequent bacteremia. To evaluate the safety of colonized cases without antimicrobial treatment, as well as the effectiveness of routine catheter tip cultures in the neonatal intensive care unit (NICU), we performed a retrospective data analysis in a Japanese community hospital. METHODS: We reviewed all peripherally inserted central venous catheter tip culture results from the NICU ward between April 2012 and June 2017 to determine whether they had antimicrobial treatments or subsequent infections...
February 22, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29456363/inadvertent-central-arterial-catheterization-an-unusual-cause-of-ischemic-stroke
#5
Nakul Katyal, Amanda Korzep, Christopher Newey
Central venous catheter (CVC) insertion is extensively utilized in Intensive Care Units for evaluation of hemodynamic status, administration of intravenous drugs, and for providing nutritional support in critically ill patients. Unfortunately, CVC use is associated with complications including lung injury, bleeding, infection, and thrombosis. We present a patient with an acute ischemic stroke from an inadvertently placed CVC into the right common carotid artery. A 57-year-old male presented to our institution for left hemiplegia and seizures 2 days after a CVC was placed...
January 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29444733/medically-attended-catheter-complications-are-common-in-patients-with-outpatient-central-venous-catheters
#6
Steven S Spires, Peter F Rebeiro, Mickie Miller, Katie Koss, Patty W Wright, Thomas R Talbot
OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line-associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services...
February 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29443407/implanted-vascular-access-device-options-a-focused-review-on-safety-and-outcomes
#7
REVIEW
Merilda O Blanco-Guzman
Implantable vascular access devices are frequently used in patients who have poor peripheral venous access. These devices can be partially implanted as tunneled and nontunneled central catheters, or they can be fully implanted as ports. Compared with long-term catheters, implanted ports have lower infection rates and improved perceptions of quality of life, but complications still occur in 2% to 18% of patients, frequently requiring removal of the device. Since the conception of implantable vascular access device ports, numerous advances in port design, materials, and techniques for implantation and care have been developed with the goal of overcoming frequent complications...
February 2018: Transfusion
https://www.readbyqxmd.com/read/29432818/differential-time-to-positivity-of-central-and-peripheral-blood-cultures-is-inaccurate-for-the-diagnosis-of-staphylococcus-aureus-long-term-catheter-related-sepsis
#8
Hanène Bouzidi, Aurélie Emirian, Antoine Marty, Elisabeth Chachaty, Agnès Laplanche, Bertrand Gachot, François Blot
OBJECTIVES: Differential time to positivity of cultures of blood drawn simultaneously from central venous catheter and peripheral sites is widely used to diagnose catheter-related bloodstream infections without removing the catheter. However, the accuracy of this technique for some pathogens such as Staphylococcus aureus is debated in routine practice. METHODS: In a 320-bed reference cancer centre, we retrospectively studied the charts of patients with at least one blood culture positive for S...
February 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29428697/transient-bacteremia-induced-by-dental-cleaning-is-not-associated-with-infection-of-central-venous-catheters-in-patients-with-cancer
#9
Saad Usmani, Linda Choquette, Robert Bona, Richard Feinn, Zainab Shahid, Rajesh V Lalla
OBJECTIVE: The aim of this study was to determine the incidence of bacteremia resulting from dental cleaning and of subsequent established bloodstream infection (BSI) caused by oral microorganisms in patients with cancer with central venous catheters (CVCs). STUDY DESIGN: Twenty-six patients with cancer with CVCs and absolute neutrophil count over 1000 cells/µL received dental cleaning without antibiotic prophylaxis. Periodontal status was assessed at baseline by using the Periodontal Screening and Recording (PSR) score...
January 11, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29423646/equivalent-success-and-complication-rates-of-tunneled-common-femoral-venous-catheter-placed-in-the-interventional-suite-vs-at-patient-bedside
#10
Alex Chau, Jose Alberto Hernandez, Sheena Pimpalwar, Daniel Ashton, Kamlesh Kukreja
BACKGROUND: Femoral tunneled central line placement in the pediatric population offers an alternative means for intravenous (IV) access, but there is concern for higher complication and infection rates when placed at bedside. OBJECTIVE: To describe the complications and infection outcomes of primary femoral tunneled central venous catheter placement in the interventional radiology suite compared to the portable bedside location at a single tertiary pediatric institution...
February 8, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29422174/efficacy-of-a-care-bundle-to-prevent-multiple-infections-in-the-intensive-care-unit-a-quasi-experimental-pretest-posttest-design-study
#11
Gulay Yazici, Hulya Bulut
BACKGROUND: Healthcare-associated infections extend hospitalization time, increase treatment costs and increase morbidity-mortality rates. OBJECTIVES: To evaluate the efficacy of a care bundle aimed at preventing three most frequent intensive care unit-acquired infections. MATERIALS AND METHOD: This quasi-experimental study occurred in an 18-bed tertiary care intensive care unit at a university hospital in Turkey. The sample consisted of 120 patients older than 18years and receiving invasive mechanical ventilation therapy, or had a central venous catheter or urinary catheter...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29419626/effect-of-a-patency-bundle-on-central-venous-catheter-complications-among-hospitalized-adult-patients-a-best-practice-implementation-project
#12
Vivian Huang
OBJECTIVES: The aim of this project was to improve continuity of care by decreasing central catheter occlusions in adults in two acute care units with high use of central venous catheters. Specific objectives were to introduce a patency bundle and train nurses on thrombolytic administration for timely resolution of catheter occlusions. INTRODUCTION: Central venous catheters are a vital component of medical care of acutely ill hospitalized patients. Occluded catheters delay treatment and can increase infection risk...
February 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29412895/executive-summary-diagnosis-and-treatment-of-catheter-related-bloodstream-infection-clinical-guidelines-of-the-spanish-society-of-clinical-microbiology-and-infectious-diseases-seimc-and-the-spanish-society-of-intensive-care-medicine-and-coronary-units-semicyuc
#13
Fernando Chaves, José Garnacho-Montero, José Luis Del Pozo, Emilio Bouza, José Antonio Capdevila, Marina de Cueto, M Ángeles Domínguez, Jaime Esteban, Nuria Fernández-Hidalgo, Marta Fernández Sampedro, Jesús Fortún, María Guembe, Leonardo Lorente, Jose Ramón Paño, Paula Ramírez, Miguel Salavert, Miguel Sánchez, Jordi Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias)...
February 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29408389/hospital-ownership-a-risk-factor-for-nosocomial-infection-rates
#14
Christin Schröder, Michael Behnke, Christine Geffers, Petra Gastmeier
BACKGROUND: In some countries, a relationship between hospital ownership and the occurrence of healthcare associated infection rates (HCAI) has been described. AIM: To investigate the association between hospital ownership and occurrence of HCAI in Germany. METHODS: Five different components of the German national nosocomial infection surveillance system were analyzed with regard to the influence of hospital ownership in the period 2014-16 (Components for intensive care units (ICUs) with the endpoints ventilator associated pneumonia, central venous catheter associated bloodstream infections, and urinary catheter associated urinary tract infections, surgical site infections (SSI) following hip prosthesis, and colon surgery, meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile infections (CDI) and hand rub consumption per 1000 patient days)...
February 2, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29406956/diagnosis-and-treatment-of-catheter-related-bloodstream-infection-clinical-guidelines-of-the-spanish-society-of-infectious-diseases-and-clinical-microbiology-and-seimc-and-the-spanish-society-of-spanish-society-of-intensive-and-critical-care-medicine-and-coronary
#15
F Chaves, J Garnacho-Montero, J L Del Pozo, E Bouza, J A Capdevila, M de Cueto, M Á Domínguez, J Esteban, N Fernández-Hidalgo, M Fernández Sampedro, J Fortún, M Guembe, L Lorente, J R Paño, P Ramírez, M Salavert, M Sánchez, J Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (the Spanish Society of Infectious Diseases and Clinical Microbiology and [SEIMC] and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units [SEMICYUC])...
January 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29399528/anti-fouling-strategies-for-central-venous-catheters
#16
REVIEW
Alex Wallace, Hassan Albadawi, Nikasha Patel, Ali Khademhosseini, Yu Shrike Zhang, Sailendra Naidu, Grace Knuttinen, Rahmi Oklu
Central venous catheters (CVCs) are ubiquitous in the healthcare industry and carry two common complications, catheter related infections and occlusion, particularly by thrombus. Catheter-related bloodstream infections (CRBSI) are an important cause of nosocomial infections that increase patient morbidity, mortality, and hospital cost. Innovative design strategies for intravenous catheters can help reduce these preventable infections. Antimicrobial coatings can play a major role in preventing disease. These coatings can be divided into two major categories: drug eluting and non-drug eluting...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399329/intestinal-failure-a-review
#17
REVIEW
Philip Allan, Simon Lal
Intestinal failure (IF) is the inability of the gut to absorb necessary water, macronutrients (carbohydrate, protein, and fat), micronutrients, and electrolytes sufficient to sustain life and requiring intravenous supplementation or replacement. Acute IF (types 1 and 2) is the initial phase of the illness and may last for weeks to a few months, and chronic IF (type 3) from months to years. The challenge of caring for patients with IF is not merely the management of the underlying condition leading to IF or the correct provision of appropriate nutrition or both but also the prevention of complications, whether thromboembolic phenomenon (for example, venous occlusion), central venous catheter-related bloodstream infection, IF-associated liver disease, or metabolic bone disease...
2018: F1000Research
https://www.readbyqxmd.com/read/29397962/clearance-of-tunneled-central-venous-catheter-associated-blood-stream-infections-in-children
#18
Maziar M Nourian, Angelina L Schwartz, Austin Stevens, Eric R Scaife, Brian T Bucher
BACKGROUND: The optimal time to reinsert central venous catheters (tCVC) after a documented central line associated blood stream infection (CLABSI) is unclear. The goal of this study is to identify risk factors for children who develop persistent bacteremia after tCVC removal due to CLABSI. METHODS: We performed a retrospective cohort study from a tertiary children's hospital. Children who underwent removal of a tCVC due to CLABSI were included in our analysis. Our primary outcome was persistent bacteremia after tCVC removal defined by a persistently positive blood culture...
December 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29391334/invasive-fungal-infections-in-patients-with-hematological-malignancies-emergence-of-resistant-pathogens-and-new-antifungal-therapies
#19
Maria N Gamaletsou, Thomas J Walsh, Nikolaos V Sipsas
Invasive fungal infections caused by drug-resistant organisms, are an emerging threat to heavily immunosuppressed patients with haematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis, empirical and pre-emptive therapy result in long term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the non-linear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors...
February 2, 2018: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/29390515/application-of-failure-mode-and-effect-analysis-in-managing-catheter-related-blood-stream-infection-in-intensive-care-unit
#20
Xixi Li, Mei He, Haiyan Wang
In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit.The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures...
December 2017: Medicine (Baltimore)
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