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Mechanisms crbsi

Leonardo Lorente
Central venous catheters are commonly used in critically ill patients. Such catheterization may entail mechanical and infectious complications. The interest in catheter-related infection lies in the morbidity, mortality and costs that it involved. Numerous contributions have been made in the prevention of catheter-related infection and the current review focuses on the possible current role of antimicrobial impregnated catheters to reduce catheter-related bloodstream infections (CRBSI). There is evidence that the use of chlorhexidine-silver sulfadiazine (CHSS), rifampicin-minocycline, or rifampicin-miconazol impregnated catheters reduce the incidence of CRBSI and costs...
May 4, 2016: World Journal of Critical Care Medicine
Line Dahlstrøm Christensen, Mette Holst, Laura Fuglsang Bech, Lotte Drustrup, Louis Nygaard, Anders Skallerup, Henrik Højgaard Rasmussen, Lars Vinter-Jensen
BACKGROUND & AIM: Patients with intestinal failure (IF) are dependent on parenteral nutrition delivered through central access such as Hickman™ catheters. The peripherally inserted central catheter (PICC) is becoming increasingly popular for the purpose. The aim of the present study was to compare complication rates between the two types of catheters. PATIENTS AND METHODS: Over a six-year period (2008-2014), we included 136 patients with IF receiving home parenteral nutrition (HPN)...
July 28, 2015: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Laura Valbousquet Schneider, Sandrine Duron, François-Xavier Arnaud, Aurore Bousquet, Yann Kervella, Caroline Bouzad, Jacques Baccialone, Christophe A'Teriitehau, Julien Potet
PURPOSE: The purpose of this study is to evaluate the complications of peripherally inserted central catheters (PICCs) in orthopedic patients with chronic bone orthopedic infection. MATERIALS AND METHODS: The institutional review board approved this retrospective study and informed consent was waived. Records of 180 consecutives PICCs placed in patients hospitalized in the orthopedic surgery department were reviewed. All patients had bones infections necessitating a long-term intravenous antibiotics therapy...
July 2015: Journal of Vascular Access
Leonardo Lorente, María M Martín, Pablo Vidal, Sergio Rebollo, María I Ostabal, Jordi Solé-Violán
INTRODUCTION: Best clinical practice for patients with suspected catheter-related infection (CRI) remains unclear according to the latest Infectious Diseases Society of America (IDSA) guidelines. Thus, the objective of this study was to analyze clinical practice concerning the central venous catheter (CVC) and its impact on prognosis in patients with suspected CRI. METHODS: We performed a prospective, multicenter, observational study in 18 Spanish Intensive Care Units (ICUs)...
October 17, 2014: Critical Care: the Official Journal of the Critical Care Forum
Panida Srisan, Sangravee Juhong, Wiboon Kanjanapatanakul
BACKGROUND: Central venous catheterization (CVC) is an indispensable route of venous access in management of critically ill patients. Potential CVC related complications include mechanical and infectious complications. OBJECTIVE: To determine type, incidence and risk factor of CVC related complications in pediatric patients. MATERIAL AND METHOD: Prospective observational study of all patients who underwent CVC in pediatric intensive care unit (PICU) at Queen Sirikit National Institute of Child Health, over a 1-year period...
June 2014: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Pavani Rangachari, Michael Madaio, R Karl Rethemeyer, Peggy Wagner, Lauren Hall, Siddharth Roy, Peter Rissing
BACKGROUND: The problem of interest in this study is the challenge of consistent implementation of evidence-based infection prevention practices at the unit level, a challenge broadly characterized as "change implementation failure." The theoretical literature suggests that periodic top-down communications promoting tacit knowledge exchanges across professional subgroups may be effective for enabling change in health care organizations. However, gaps remain in understanding the mechanisms by which top-down communications enable practice change at the unit level...
October 2015: Health Care Management Review
Paolo Cotogni, Cristina Barbero, Cristina Garrino, Claudia Degiorgis, Baudolino Mussa, Antonella De Francesco, Mauro Pittiruti
PURPOSE: Few prospective follow-up studies evaluating the use of peripherally inserted central catheters (PICCs) to deliver chemotherapy and/or home parenteral nutrition (HPN) have focused exclusively on oncology outpatients. The aim of this prospective study was to assess the reliability and the safety of PICCs over a 5-year use in non-hospitalized cancer patients requiring long-term intravenous therapies. METHODS: Since June 2008, all adult oncology outpatient candidates for PICC insertion were consecutively enrolled and the incidence of catheter-related complications was investigated...
February 2015: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Na Jiang, Ying Wang, Qi Wang, Haijing Li, Jingyun Mai, Zhenlang Lin
OBJECTIVE: To investigate the incidence of nosocomial infections of extremely premature infants and to explore the risk factors and strategies for infection control. METHOD: There were 118 extremely premature infants who were confirmed to have nosocomial infection in neonatal intensive care unit of the authors' hospital from January 2008 to December 2012. Their data of the infection rate, risk factors and clinical characteristics were retrospectively analyzed. RESULT: During the study, nosocomial infection occurred in 78 extremely premature infants 129 times...
February 2014: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Hans Van Der Meersch, Dirk De Bacquer, Stefaan J Vandecasteele, Barbara Van den Bergh, Pieter Vermeiren, Jan De Letter, An S De Vriese
BACKGROUND: A complication of long-term use of tunneled cuffed catheters for hemodialysis is the high rate of infection and thrombus-related dysfunction. Specific mechanical features of tunneled cuffed catheters may improve hemodynamic performance and decrease thrombosis and infection rates. However, there currently is no proven advantage of one design over another. STUDY DESIGN: Single-center randomized clinical trial. SETTING & PARTICIPANTS: 302 hemodialysis patients who required a tunneled cuffed catheter as temporary or definite vascular access...
December 2014: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Yoshio Haga, Nobutomo Miyanari, Tadateru Takahashi, Shoichiro Koike, Ryozo Kobayashi, Hiroya Mizusawa, Chikaaki Nakamichi, Mataro Goto
BACKGROUND: Risk factors for catheter-related bloodstream infections (CRBSIs) may change over time with progress in infection control. This study was undertaken to explore the current risk factors for CRBSIs in hospitalized patients. METHODS: Adult patients with non-tunneled central venous catheters (CVCs) in 12 Japanese referral hospitals were prospectively enrolled between December 2009 and January 2012. Patients were monitored for CRBSIs for up to 8 weeks from CVC insertion; data were collected regarding patient characteristics, the purpose of CVC insertion, insertion methods, mechanical complications during insertion, and post-insertion catheter care...
October 2013: Scandinavian Journal of Infectious Diseases
Hayri Ramadan, Nalan Metin Aksu, Meltem Akkas, Mehmet Husamettin Akkucuk, Figen Coskun, Yesim Cetinkaya Sardan
AIM: To investigate the rate of catheter-related bloodstream infections (CRBSI) and mechanical complications due to central venous catheter (CVC) insertion in the emergency department (ED) and the contributing factors. METHODS: A total of 236 patients who were admitted to our ED and underwent CVC insertion between July 2008 and July 2009 were included in this prospective study. The CVC indications, the urgency of the insertion (emergency or elective), catheter complications (mechanical or CRBSI) and the compliance of the emergency physician placing the catheter with infection control and prevention measures were investigated...
February 2013: Medicinski Glasnik
Paolo Cotogni, Mauro Pittiruti, Cristina Barbero, Taira Monge, Augusta Palmo, Daniela Boggio Bertinet
BACKGROUND: Although home parenteral nutrition (HPN) is often indicated in cancer patients, many physicians are concerned about the risks potentially associated with the use of central venous access devices (VADs) in these patients. The aim of this prospective study was to investigate the actual incidence of VAD-related complications in cancer patients on HPN. METHODS: All adult cancer patient candidates for VAD insertion and HPN were enrolled. The incidence of complications associated with 4 types of VADs (peripherally inserted central catheter [PICC], Hohn catheter, tunneled Groshong catheter, and port) was investigated, as well as the most significant risk factors...
May 2013: JPEN. Journal of Parenteral and Enteral Nutrition
Xiaoli Ge, Rodrigo Cavallazzi, Chunbo Li, Shu Ming Pan, Ying Wei Wang, Fei-Long Wang
BACKGROUND: Central venous access (CVA) is widely used. However, its thrombotic, stenotic and infectious complications can be life-threatening and involve high-cost therapy. Research revealed that the risk of catheter-related complications varied according to the site of CVA. It would be helpful to find the preferred site of insertion to minimize the risk of catheter-related complications. This review was originally published in 2007 and was updated in 2011. OBJECTIVES: 1...
2012: Cochrane Database of Systematic Reviews
Jing-yun Mai, Lin Dong, Zhen-lang Lin, Shang-qin Chen
OBJECTIVE: To investigate the incidence of nosocomial infections of newborn infants in neonates and to explore the risk factors and strategies of infection control. METHODS: There were 433 confirmed cases of nosocomial infection in the neonatal ward of the authors' hospital from January 2007 to December 2009. Their data of epidemiological and clinical characteristics, results of etiological examinations and antibiotic resistance were retrospectively analyzed. RESULTS: During the study, the number of hospitalizations were 6437...
December 2011: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Leonardo Lorente, Alejandro Jiménez, María M Martín, María T Brouard, José L Iribarren, Juan J Jiménez, María L Mora
Data on catheter-related bloodstream infection (CRBSI) in cubital artery access are scarce. Thus, the objective of this study was to compare the incidence of CRBSI in a large series of patients with femoral or cubital artery catheters. We found 11 events of CRBSI in 1085 femoral artery catheters during 6497 days and none in 449 cubital artery catheters during 2709 days. Poisson regression analysis showed a higher incidence of CRBSI in femoral than in cubital artery site access (1.69 vs 0 CRBSI events per 1000 catheter-days; odds ratio 6...
October 2011: Scandinavian Journal of Infectious Diseases
Javed I Memon, Rifat S Rehmani, Joan L Venter, Abdulsalam Alaithan, Irfan Ahsan, Shabana Khan
OBJECTIVE: To study the standard central venous catheter (CVC) practice in an adult intensive care unit (ICU) for potential improvement. METHODS: This is a prospective descriptive study conducted in an adult ICU of the 300-bedded King Abdul- Aziz Hospital, Al-Ahsa, Saudi Arabia. All consecutive patients admitted over 18 months (April 2007 to September 2008) were included. Details of CVCs, indications, complications, and patients' demographic information were recorded daily until CVCs were removed...
July 2010: Saudi Medical Journal
Sindhaghatta Venkatram, Sonal Rachmale, Balavenkatesh Kanna
"Bundles" strategies improve health care-associated infection (HCAI) rates in medical intensive care units (MICUs). However, few studies have analyzed HCAI rates adjusted for the device removal component of the bundles. An observational study of adult MICU patients while using bundles to prevent HCAIs associated with endovascular catheters, mechanical ventilation, and urinary tract catheters was conducted. The HCAI rates, unadjusted and adjusted for device use, were calculated using incidence rate ratios (unadjusted IRRs [uIRR] and adjusted IRRs [aIRR], respectively)...
March 2010: Journal of Critical Care
Juan C Yébenes, Mateu Serra-Prat
BACKGROUND: In 1992, the United States Food and Drug Administration required health care services to adopt needle-free devices to prevent health care workers' exposure to bloodborne pathogens resulting from needlestick injuries, and several systems of disinfectable needle-free connectors (DNC) were introduced. STUDIES: MICROBIAL COLONIZATION: Experimental studies showed that DNCs designed with a split septum (SS-DNCs) and mechanical valve systems (MLV-DNC) prevented endoluminal colonization as effectively as needles or conventional caps...
December 2008: American Journal of Infection Control
Walter Zingg, Vanessa Cartier-Fässler, Bernhard Walder
Most patients in the hospital need vascular access: a peripheral venous line, a short-term non-cuffed central venous catheter (CVC), a long-term cuffed CVC, an implantable port or an arterial line. Such devices, although often indispensable and of benefit, may have the disadvantage of mechanical complications, local exit-site infections or catheter-associated bloodstream infections (CRBSI). Apart from peripheral venous lines, non-cuffed CVCs are the most frequent catheter type in hospitals. The risk for CRBSI of such catheters is high with an incidence density of 2 to 7 episodes per 1000 catheter-days depending on ward-type, institution and geographical region...
September 2008: Best Practice & Research. Clinical Anaesthesiology
Mervyn Mer, Adriano Gianmaria Duse, Jacqueline Suzanne Galpin, Guy Antony Richards
Central venous catheters (CVCs) are extensively used worldwide. Mechanical, infectious and thrombotic complications are well described with their use and may be associated with prolonged hospitalization, increased medical costs and mortality. CVCs account for an estimated 90% of all catheter-related bloodstream infections (CRBSI) and a host of risk factors for CVC-related infections have been documented. The duration of use of CVCs remains controversial and the length of time such devices can safely be left in place has not been fully and objectively addressed in the critically ill patient...
February 2009: Clinical and Applied Thrombosis/hemostasis
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