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Y-M Lee, C Moon, Y J Kim, H J Lee, M S Lee, K-H Park
BACKGROUND: Gram-negative bacteria are increasingly the cause of catheter-related bloodstream infection (CRBSI), and the prevalence of multi-drug-resistant strains is rising rapidly. This study evaluated the impact of delayed central venous catheter (CVC) removal on clinical outcomes in patients with Gram-negative CRBSI. METHODS: Between January 2007 and December 2016, patients with Gram-negative bacteraemia and CVC placement, from two tertiary care hospitals, were included retrospectively...
May 2018: Journal of Hospital Infection
Consuelo Velázquez-Acosta, Sugehily Zarco-Márquez, Mari Carmen Jiménez-Andrade, Patricia Volkow-Fernández, Patricia Cornejo-Juárez
PURPOSE: The aim of this study was to describe the clinical characteristics and antimicrobial patterns of Stenotrophomonas maltophilia bloodstream infections (BSI) and pneumonia episodes in patients with cancer. METHODS: Patients with S. maltophilia BSI or pneumonia admitted from 1 Jan. 2000 to 31 Dec. 2016 were identified at the Instituto Nacional de Cancerología (INCan), a tertiary-care oncology hospital in Mexico City. RESULTS: During the study period, there were 171 isolates identified...
January 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Minming Wu, Yao Chen, Bin Du, Yan Kang
INTRODUCTION: Catheter use is associated with many complications and is an iatrogenic source of morbidity and mortality in intensive care units (ICU). The catheter being studied (Certofix Protect) was developed to reduce the risk of catheter related infections. This clinical trial will compare the safety and efficiency of Certofix Protect with that of an ordinary Certofix catheter. METHODS AND ANALYSIS: In this multicentre trial, we will randomly assigned dual lumen central venous catheterisation (≥5 ds) in patients in the adult ICU to the antimicrobial central venous catheter (CVC) group or the ordinary CVC group...
December 29, 2017: BMJ Open
Huey Yi Chong, Nai Ming Lai, Anucha Apisarnthanarak, Nathorn Chaiyakunapruk
Background: The efficacy of antimicrobial central venous catheters (CVCs) remains questionable. In this network meta-analysis, we aimed to assess the comparative efficacy of antimicrobial CVC impregnations in reducing catheter-related infections in adults. Methods: We searched 4 electronic databases (Medline, the Cochrane Central Register of Controlled Trials, Embase, CINAHL) and internet sources for randomized controlled trials, ongoing clinical trials, and unpublished studies up to August 2016...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Laura E B Nabarro, Chaitra Shankar, Agila K Pragasam, Georgekutty Mathew, Visali Jeyaseelan, Balaji Veeraraghavan, Valsan P Verghese
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) are an increasing cause of nosocomial infection in hospitalized children worldwide. Few studies have investigated risk factors for mortality in children with CRE bloodstream infection (BSI). Data are particularly scarce in areas where NDM and OXA carbapenemases predominate. Here, we investigate mortality rates, clinical and microbiologic risk factors for mortality in 50 pediatric patients with CRE BSI in India. METHODS: Children younger than 17 years old with meropenem-resistant Klebsiella pneumoniae or Escherichia coli isolated from blood culture in 2014 and 2015 were identified from laboratory records...
June 2017: Pediatric Infectious Disease Journal
Praveen Thokala, Martin Arrowsmith, Edith Poku, Marissa Martyn-St James, Jeff Anderson, Steve Foster, Tom Elliott, Tony Whitehouse
PURPOSE: To estimate the economic impact of a Tegaderm(TM) chlorhexidine gluconate (CHG) gel dressing compared with a standard intravenous (i.v.) dressing (defined as non-antimicrobial transparent film dressing), used for insertion site care of short-term central venous and arterial catheters (intravascular catheters) in adult critical care patients using a cost-consequence model populated with data from published sources. MATERIAL AND METHODS: A decision analytical cost-consequence model was developed which assigned each patient with an indwelling intravascular catheter and a standard dressing, a baseline risk of associated dermatitis, local infection at the catheter insertion site and catheter-related bloodstream infections (CRBSI), estimated from published secondary sources...
September 2016: Journal of Infection Prevention
Anne-Marie Chaftari, Mary Jordan, Ray Hachem, Zanaib Al Hamal, Ying Jiang, Ammar Yousif, Kumait Garoge, Poonam Deshmukh, Issam Raad
BACKGROUND: The Centers for Disease Control and Prevention recently introduced the concept of mucosal barrier injury (MBI) in an attempt to recognize the possibility of a gastrointestinal source for certain bloodstream infections. This could underestimate the central venous catheter (CVC) as the source of central line-associated bloodstream infection (CLABSI) in cancer. The definition of catheter-related bloodstream infection (CRBSI) by the Infectious Diseases Society of America is a more specific and stringent definition that identifies the CVC as the source of infection...
August 1, 2016: American Journal of Infection Control
Nai Ming Lai, Jacqueline E Taylor, Kenneth Tan, Yao Mun Choo, Azanna Ahmad Kamar, Nor Asiah Muhamad
BACKGROUND: Central venous catheters (CVCs) provide secured venous access in neonates. Antimicrobial dressings applied over the CVC sites have been proposed to reduce catheter-related blood stream infection (CRBSI) by decreasing colonisation. However, there may be concerns on the local and systemic adverse effects of these dressings in neonates. OBJECTIVES: We assessed the effectiveness and safety of antimicrobial (antiseptic or antibiotic) dressings in reducing CVC-related infections in newborn infants...
March 23, 2016: Cochrane Database of Systematic Reviews
Anke Bramesfeld, Stephanie Wrede, Klaus Richter, Mareike Steen, Björn Broge, Jürgen Pauletzki, Joachim Szecsenyi
BACKGROUND: The number of catheter related bloodstream infections (CRBSI) could be reduced and the outcome improved if specific standards in the quality of care were maintained. Therefore, the development of quality assurance (QA) procedures was commissioned to be included in the national mandatory QA programme in Germany. METHODS: Indicators representing quality deficiencies and potential for improvement of quality in relation to prevention and management of central venous catheters (CVC) were developed by (1) evidence-based literature searches and the compiling of an indicator register; (2) a multi-professional expert panel including patient representatives who selected indicators from this register by using a modified RAND/UCLA Appropriateness Method; (3) defining methods for data assessment, risk adjustment and feedback of indicator results to service providers; and (4) consulting all relevant medical societies and other stakeholders with regard to the QA procedures that had been developed...
October 21, 2015: BMC Infectious Diseases
Steven Declercq, Paul De Munter, Inge Derdelinckx, Jan Verhaegen, Willy E Peetermans, Steven Vanderschueren, Eric Van Wijngaerden
BACKGROUND: Patients infected with human immunodeficiency virus (HIV) have an increased risk for bloodstream infections (BSIs). Published recent data on characteristics, etiology, and outcome of BSIs in HIV patients in high income countries are scarce. METHODS: Blood cultures from 2001 to 2011 from adult HIV patients were retrieved. Blood cultures considered to be contamination based on isolates and clinical context were excluded. Clinical and microbiological characteristics of BSIs and patients were described, those of community-acquired and nosocomial episodes were compared, and risk factors for 6-month mortality were analyzed...
September 2015: Infectious Diseases
Xihn-Xuh Chen, Yi-Chu Lo, Lin-Hui Su, Chin-Lu Chang
BACKGROUND/PURPOSE: Diagnosis of catheter-related bloodstream infection (CRBSI) requires specific laboratory evidence. A simpler definition, central line-associated bloodstream infection (CLABSI), is recommended for surveillance purposes. Because exclusion of all other infection sources is difficult, CRBSI cases may be overestimated by using the CLABSI definition. METHODS: A retrospective observational study was performed at a regional hospital in southern Taiwan from September 2012 to December 2013...
December 2015: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Marisela Tan, Jackie Lau, B Joseph Guglielmo
OBJECTIVE: To evaluate the evidence regarding the use of ethanol lock therapy (ELT) for catheter-related bloodstream infection (CRBSI) prophylaxis and treatment. DATA SOURCES: A literature search was conducted using PubMed (August 2003-January 2013) with search terms: ethanol lock, ethanol locks, ethanol lock therapy, prophylaxis, prevention, catheter-related bloodstream infection, and catheter-related infection. Additional sources were identified through a subsequent review of relevant articles...
May 2014: Annals of Pharmacotherapy
Vineet Gupta, Mohamed H Yassin
The incidence of end-stage renal disease (ESRD) has almost doubled over past 2 decades. Despite decreasing overall hospital admission rates for ESRD population, the rate of infection-related hospitalizations has steadily increased. Infection remains the second most common cause of mortality in this patient population. Specifically, in the hemodialysis (HD) patients, the vascular access related infections are the most common identifiable source of infection. This concise review provides an update on the bacteremia related to vascular access primarily the catheters (Catheter Related Blood Stream Infection- CRBSI) in HD patients emphasizing on the determinants ranging from the epidemiology to pathogenesis, risk factors, cost implications and prevention...
June 2013: Infectious Disorders Drug Targets
Pedro M Olaechea, Mercedes Palomar, Francisco Álvarez-Lerma, Juan José Otal, Josu Insausti, M Jesús López-Pueyo
PURPOSE: To analyze the impact of primary and catheterrelated bloodstream infections (PBSI/CRBSI) on morbidity and mortality. METHODS: A matched case-control study (1:4) was carried out on a Spanish epidemiological database of critically ill patients (ENVIN-HELICS). To determine the risk of death in patients with PBSI/CRBSI a matched Cox proportional hazard regression analysis was performed. RESULTS: Out of the 74,585 registered patients, those with at least one episode of monomicrobial PBSI/CRBSI were selected and paired with patients without PBSI/CRBSI for demographic and diagnostic criteria and seriousness of their condition on admission to the Intensive Care Unit (ICU)...
March 2013: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Ethel Suman, Sushma Janet D'souza, Pyari Jacob, M R Sushruth, M Shashidhar Kotian
BACKGROUND: Intravascular catheters and urinary catheters are an important source of hospital-acquired infections. Many microorganisms colonize indwelling catheters, including central venous catheters (CVCs) forming biofilms and cause infections that are difficult to treat. Although various methods have been employed to reduce biofilms, enzymes involved in bacterial cell wall synthesis could provide novel targets for the development of anti-biofilm agents. N-Acetylglucosamine-1-phosphate uridyltransferase (GlmU) is an essential enzyme in aminosugars metabolism and catalyzes the formation of uridine-diphospho-N-acetylglucosamine (UDP-GlcNAc), an important precursor in the peptidoglycan and lipopolysaccharide biosynthesis of Gram-positive and Gram-negative bacteria...
September 2011: Indian Journal of Medical Sciences
Hugo Sax, Lauren Clack, Sylvie Touveneau, Fabricio da Liberdade Jantarada, Didier Pittet, Walter Zingg
BACKGROUND: The implementation of evidence-based infection control practices is essential, yet challenging for healthcare institutions worldwide. Although acknowledged that implementation success varies with contextual factors, little is known regarding the most critical specific conditions within the complex cultural milieu of varying economic, political, and healthcare systems. Given the increasing reliance on unified global schemes to improve patient safety and healthcare effectiveness, research on this topic is needed and timely...
February 19, 2013: Implementation Science: IS
R Krause, T Valentin, H Salzer, M Hönigl, A Valentin, H Auner, I Zollner-Schwetz
PURPOSE: Paired blood cultures, drawn from the catheter and a peripheral vein, used for calculation of the differential time to positivity (DTP), have been proposed for the detection of catheter-related bloodstream infections (CRBSIs). The most relevant catheter lumen to be sampled in multi-lumen central venous catheters (CVCs) has not been recommended. METHODS: Forty-four febrile neutropaenic patients, following haematopoietic stem cell transplantation (HSCT) and with multi-lumen CVCs in place, were investigated using the DTP method of blood samples drawn from every lumen of the CVC and a peripheral vein...
February 2013: Infection
E D Olthof, R J Rentenaar, A J M M Rijs, G J A Wanten
BACKGROUND & AIMS: Some home parenteral nutrition (HPN) patients develop catheter related bloodstream infections (CRBSI) despite using an anti-microbial catheter lock solution taurolidine. The aim of this study was to assess whether long-term use of taurolidine leads to selective growth of microorganisms with increased taurolidine minimum inhibitory concentrations (MICs). METHODS: Bloodstream infections among 158 HPN patients with long-term taurolidine catheter locking were analyzed retrospectively...
August 2013: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Mayar Al Mohajer, Rabih O Darouiche
The diagnosis of sepsis is challenging given the lack of appropriate diagnostic methods and the inaccuracy of diagnostic criteria. Early resuscitation, intravenous antibiotics, and source control are crucial in the management of septic patients. The treatment of catheter-related bloodstream infection (CRBSI) often comprises 1 to 2 weeks of intravenous antibiotics plus catheter removal. Infections related to surgical devices are more difficult to manage because they require longer duration of therapy and possibly multiple surgical procedures...
November 2012: Medical Clinics of North America
Mandy Corrigan, Donald F Kirby
Catheter-related bloodstream infection (CRBSI) is a common and life-threatening infectious complication of home parenteral nutrition (PN). CRBSI is associated with hospital admissions, morbidity, mortality, loss of venous access, and healthcare costs. Ethanol has bactericidal and fungicidal properties, making it an ideal locking solution for preventing CRBSI. The authors report 6 patients with a recurrence of CRBSI when ethanol lock (ETL) was withheld due to a national shortage. This is the first known report of the ramifications of a national ethanol shortage on redevelopment of CRBSI in home PN patients with a history of CRBSIs...
July 2012: JPEN. Journal of Parenteral and Enteral Nutrition
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