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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...
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...
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...
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
J Cairo, R Hachem, G Rangaraj, B Granwehr, I Raad
Gram-negative bacillary bacteraemia (GNB) is associated with high morbidity and mortality among cancer patients. We conducted this study to determine the risk factors that may predict the catheter as the source of GNB in cancer patients. From July 2005 to December 2006 all 266 cancer patients with GNB and central venous catheters (CVCs) at The University of Texas M. D. Anderson Cancer Centre in Houston, were classified as catheter-related bloodstream infection (CRBSI) according to Infectious Diseases Society of America criteria...
November 2011: Clinical Microbiology and Infection
Lennert Slobbe, Jeanette K Doorduijn, Pieternella J Lugtenburg, Abdelilah El Barzouhi, Eric Boersma, Willem B van Leeuwen, Bart J A Rijnders
BACKGROUND: Catheter-related bloodstream infection (CRBSI) results in significant attributable morbidity and mortality. In this randomized, double-blind, placebo-controlled trial, we studied the efficacy and safety of a daily ethanol lock for the prevention of CRBSI in patients with a tunnelled central venous catheter (CVC). METHODOLOGY: From 2005 through 2008, each lumen of the CVC of adult hematology patients was locked for 15 minutes per day with either 70%-ethanol or placebo, where after the lock solution was flushed through...
2010: PloS One
Piotr Smuszkiewicz, Iwona Trojanowska, Hanna Tomczak
BACKGROUND: Usefulness and economic aspects of microbiological analysis of central venous catheter (CVC) tips in diagnosis of the catheter-related bloodstream infection (CRBSI). MATERIAL/METHODS: Retrospective study of an adult intensive care unit in a university hospital. Catheter removal was performed when the clinical state of the patient indicated that the catheter could be the source of infection or inflammation was observed at the puncture site. RESULTS: We microbiologically studied 238 CVC tips according to the Maki method and 723 blood samples from 120 septic patients treated during a 21-month period (32...
February 2009: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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
Prabha Ramritu, Kate Halton, Peter Collignon, David Cook, David Fraenkel, Diana Battistutta, Michael Whitby, Nicholas Graves
BACKGROUND: Bloodstream infection related to a central venous catheter is a substantial clinical and economic problem. To develop policy for managing the risks of these infections, all available evidence for prevention strategies should be synthesized and understood. METHODS: We evaluate evidence (1985-2006) for short-term antimicrobial-coated central venous catheters in lowering rates of catheter-related bloodstream infection (CRBSI) in the adult intensive care unit...
March 2008: American Journal of Infection Control
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