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Innovations in Quality Improvement of Intravascular Catheter-Related Bloodstream Infections

  • Rajendra Karnatak
  • Mark E. Rupp
  • Kelly CawcuttEmail author
New Technologies and Advances in Infections Prevention (A Marra, Section Editor)
Part of the following topical collections:
  1. Topical Collection on New Technologies and Advances in Infection Prevention

Abstract

Purpose of review

Significant reductions in catheter-related bloodstream infections (CRBSI) have occurred in the United States. Reductions in CRBSIs are attributed to the widespread implementation of the practice-based measures and innovations in the diagnosis, treatment, and prevention of CRBSI.

Recent findings

Diagnosis of CRBSI historically required removal of the central venous catheter (CVC) for catheter tip culture. Removing the CVC for CRBSI diagnosis predisposes many patients to potential life-threatening complications. Advances in diagnostic techniques such as culturing catheter hubs, catheter entry site cultures, applying differential time to positivity, molecular diagnostics, biomarkers, and innovative approaches like biosensors on the CVC lumen may provide an alternative to CVC removal. Removal of the CVC is common for the treatment of CRBSI; however, antimicrobial lock therapy is increasingly used as a CVC salvage method. Implementation of newer technology such as antimicrobial coated catheters, chlorhexidine-impregnated dressings, and antiseptic port protectors are crucial for the prevention of CRBSIs. Increasing evidence also support newer sutureless CVC securement devices prevent CRBSIs.

Summary

CRBSI remains a significant clinical problem despite advances made in the diagnosis, management, and prevention. Molecular techniques are increasingly being used for pathogen identification in CRBSI, but the optimal diagnostic test remains debatable. Increasing experience is being gained with antimicrobial lock therapy for CRBSI treatment with catheter salvage. Use and adherence to practice-based measures and technological innovations has significantly reduced CRBSIs. Continued efforts are required to develop a cost-effective and targeted approach for CRBSI prevention.

Keywords

Catheter-related bloodstream infection Central line–associated bloodstream infection Central venous catheter Bacteremia Healthcare-associated infection Antimicrobial lock therapy 

Notes

Compliance with ethical standards

Conflicts of interest

1. Rajendra Karnatak: Dr. Karnatak declares no conflicts of interests.

2. Mark E Rupp: Dr. Rupp reports personal fees from 3M, personal fees from Citius, personal fees from Teleflex.

3. Kelly Cawcutt: Dr. Cawcutt declares paid for lecture on vascular access and attendance at an advisory board meeting for BD.

Human and animal rights informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Rajendra Karnatak
    • 1
  • Mark E. Rupp
    • 1
  • Kelly Cawcutt
    • 1
    Email author
  1. 1.Division of Infectious DiseasesUniversity of Nebraska Medical CenterOmahaUSA

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