Skip to main content
SpringerLink
Log in

ICU Prevention Strategies

  • Chapter
Catheter-Related Infections in the Critically Ill

Part of the book series: Perspectives on Critical Care Infectious Diseases ((CCID,volume 8))

  • 117 Accesses

Conclusions

CR-BSI remains a leading cause of nosocomial infections, particularly in ICUs, and is the most frequent cause of hospital-acquired bacteremia. Although CR-BSI have milder consequences than other bacteremic infections, it is a typical device-associated iatrogenic infection and therefore mostly accessible to prevention, if rigorous policies are adopted. It should be one of the main targets of quality improvement programs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med 2000; 132: 391–402.

    CAS  PubMed  Google Scholar 

  2. O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, Masur H, McCormick RD, Mermel LA, Pearson ML, Raad, II, Randolph A and Weinstein RA. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 2002; 51: 1–29.

    Google Scholar 

  3. Timsit JF. Réactualisation de la XIIe Conférence de Consensus de la S.R.L.F.. Infections liées aux cathéters veineux centraux en réanimation. Réanimation 2003; 12: in press.

    Google Scholar 

  4. Sitges-Serra A, Linares J, Perez JL, Jaurrieta E and Lorente L. A randomized trial on the effect of tubing changes on hub contamination and catheter sepsis during parenteral nutrition. JPEN J Parenter Enteral Nutr 1985; 9: 322–5.

    CAS  PubMed  Google Scholar 

  5. Raad, II, Hohn DC, Gilbreath BJ, Suleiman N, Hill LA, Bruso PA, Marts K, Mansfield PF and Bodey GP. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 1994; 15: 231–8.

    CAS  PubMed  Google Scholar 

  6. Parienti JJ, Thibon P, Heller R, Le Roux Y, von Theobald P, Bensadoun H, Bouvet A, Lemarchand F and Le Coutour X. Hand-rubbing with an aqueous alcoholic solution vs traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study. JAMA 2002; 288: 722–7.

    Article  PubMed  Google Scholar 

  7. Chaiyakunapruk N, Veenstra DL, Lipsky BA and Saint S. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta-analysis. Ann Intern Med 2002; 136: 792–801.

    CAS  PubMed  Google Scholar 

  8. Calfee DP and Farr BM. Comparison of four antiseptic preparations for skin in the prevention of contamination of percutaneously drawn blood cultures: a randomized trial. J Clin Microbiol 2002; 40: 1660–5.

    Article  CAS  PubMed  Google Scholar 

  9. Parienti JJ, Ducheyron D., M. R, Malbruny B, Leclercq R, Lecontour X and Charbonneau P. Prospective Randomized Trial of 10% Povidone-Iodine (PVI) versus 5% Alcohol Plus 5% Povidone-Iodine (APVI) for Prevention of Central Venous Catheter (CVC) Colonization. 2002;318.

    Google Scholar 

  10. McDonnell G and Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999; 12: 147–79.

    CAS  PubMed  Google Scholar 

  11. Timsit JF. Central venous access in intensive care unit patients: is the subclavian vein the royal route? Intensive Care Med 2002; 28: 1006–8.

    Article  PubMed  Google Scholar 

  12. Ruesch S, Walder B and Tramer MR. Complications of central venous catheters: internal jugular versus subclavian access—-a systematic review. Crit Care Med 2002; 30: 454–60.

    PubMed  Google Scholar 

  13. Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, Rigaud JP, Casciani D, Misset B, Bosquet C, Outin H, Brun-Buisson C and Nitenberg G. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 2001; 286: 700–7.

    Article  CAS  PubMed  Google Scholar 

  14. Timsit JF, Sebille V, Farkas JC, Misset B, Martin JB, Chevret S and Carlet J. Effect of subcutaneous tunneling on internal jugular catheter-related sepsis in critically ill patients: a prospective randomized multicenter study. JAMA 1996; 276: 1416–20.

    Article  CAS  PubMed  Google Scholar 

  15. Timsit JF, Bruneel F, Cheval C, Mamzer MF, Garrouste-Orgeas M, Wolff M, Misset B, Chevret S, Regnier B and Carlet J. Use of tunneled femoral catheters to prevent catheter-related infection. A randomized, controlled trial. Ann Intern Med 1999; 130: 729–35.

    CAS  PubMed  Google Scholar 

  16. Raad, II, Luna M, Khalil SA, Costerton JW, Lam C and Bodey GP. The relationship between the thrombotic and infectious complications of central venous catheters. Jama 1994; 271: 1014–6.

    Article  CAS  PubMed  Google Scholar 

  17. Timsit JF, Farkas JC, Boyer JM, Martin JB, Misset B, Renaud B and Carlet J. Central vein catheter-related thrombosis in intensive care patients: incidence, risks factors, and relationship with catheter-related sepsis. Chest 1998; 114: 207–13.

    CAS  PubMed  Google Scholar 

  18. Randolph AG, Cook DJ, Gonzales CA and Andrew M. Benefit of heparin in central venous and pulmonary artery catheters: a meta-analysis of randomized controlled trials. Chest 1998; 113: 165–71.

    CAS  PubMed  Google Scholar 

  19. Appelgren P, Ransjo U, Bindslev L, Espersen F and Larm O. Surface heparinization of central venous catheters reduces microbial colonization in vitro and in vivo: results from a prospective, randomized trial. Crit Care Med 1996; 24: 1482–9.

    CAS  PubMed  Google Scholar 

  20. Pierce CM, Wade A and Mok Q. Heparin-bonded central venous lines reduce thrombotic and infective complications in critically ill children. Intensive Care Med 2000; 26: 967–72.

    CAS  PubMed  Google Scholar 

  21. Timsit JF. Scheduled replacement of central venous catheters is not necessary. Infect Control Hosp Epidemiol 2000; 21: 371–4.

    CAS  PubMed  Google Scholar 

  22. Hoffmann KK, Weber DJ, Samsa GP and Rutala WA. Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection risks. JAMA 1992; 267: 2072–6.

    Article  CAS  PubMed  Google Scholar 

  23. Maki DG, Stolz SS, Wheeler S and Mermel LA. A prospective, randomized trial of gauze and two polyurethane dressings for site care of pulmonary artery catheters: implications for catheter management. Crit Care Med 1994; 22: 1729–37.

    CAS  PubMed  Google Scholar 

  24. Mermel LA, Farr BM, Sherertz RJ, Raad, II, O’Grady N, Harris JS and Craven DE. Guidelines for the management of intravascular catheter-related infections. Infect Control Hosp Epidemiol 2001; 22: 222–42.

    CAS  PubMed  Google Scholar 

  25. Maki D, LA. M, Kluger D, Narins L, Knasinski V, Parentau S and Covington P. The efficacy of a chlorexidine-impregnated sponge (Biopatch) for the prevention of intravascular catheter-related infection: a prospective, randomized, controlled, multicenter study [abstract].2000.

    Google Scholar 

  26. Garland JS, Alex CP, Mueller CD, Otten D, Shivpuri C, Harris MC, Naples M, Pellegrini J, Buck RK, McAuliffe TL, Goldmann DA and Maki DG. A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001; 107: 1431–6.

    Article  CAS  PubMed  Google Scholar 

  27. Segura M, Alvarez-Lerma F, Tellado JM, Jimenez-Ferreres J, Oms L, Rello J, Baro T, Sanchez R, Morera A, Mariscal D, Marrugat J and Sitges-Serra A. A clinical trial on the prevention of catheter-related sepsis using a new hub model. Ann Surg 1996; 223: 363–9.

    Article  CAS  PubMed  Google Scholar 

  28. Luna J, Masdeu G, Perez M, Claramonte R, Forcadell I, Barrachina F and Panisello M. Clinical trial evaluating a new hub device designed to prevent catheter-related sepsis. Eur J Clin Microbiol Infect Dis 2000; 19: 655–62.

    Article  CAS  PubMed  Google Scholar 

  29. Cohen Y, Fosse JP, Karoubi P, Reboul-Marty J, Dreyfuss D, Hoang P and Cupa M. The “hands-off” catheter and the prevention of systemic infections associated with pulmonary artery catheter: a prospective study. Am J Respir Crit Care Med 1998; 157: 284–7.

    CAS  PubMed  Google Scholar 

  30. Flowers RH, 3rd, Schwenzer KJ, Kopel RF, Fisch MJ, Tucker SI and Farr BM. Efficacy of an attachable subcutaneous cuff for the prevention of intravascular catheter-related infection. A randomized, controlled trial. JAMA 1989; 261: 878–83.

    Article  PubMed  Google Scholar 

  31. Maki DG, Cobb L, Garman JK, Shapiro JM, Ringer M and Helgerson RB. An attachable silver-impregnated cuff for prevention of infection with central venous catheters: a prospective randomized multicenter trial. Am J Med 1988; 85: 307–14.

    Article  CAS  PubMed  Google Scholar 

  32. Smith HO, DeVictoria CL, Garfinkel D, Anderson P, Goldberg GL, Soeiro R, Elia G and Runowicz CD. A prospective randomized comparison of an attached silver-impregnated cuff to prevent central venous catheter-associated infection. Gynecol Oncol 1995; 58: 92–100.

    Article  CAS  PubMed  Google Scholar 

  33. Bonawitz SC, Hammell EJ and Kirkpatrick JR. Prevention of central venous catheter sepsis: a prospective randomized trial. Am Surg 1991; 57: 618–23.

    CAS  PubMed  Google Scholar 

  34. Veenstra DL, Saint S, Saha S, Lumley T and Sullivan SD. Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis. JAMA 1999; 281: 261–7.

    Article  CAS  PubMed  Google Scholar 

  35. Walder B, Pittet D and Tramer MR. Prevention of bloodstream infections with central venous catheters treated with anti-infective agents depends on catheter type and insertion time: evidence from a meta-analysis. Infect Control Hosp Epidemiol 2002; 23: 748–56.

    PubMed  Google Scholar 

  36. Tattawasart U, Maillard JY, Furr JR and Russell AD. Development of resistance to chlorhexidine diacetate and cetylpyridinium chloride in Pseudomonas stutzeri and changes in antibiotic susceptibility. J Hosp Infect 1999; 42: 219–29.

    Article  CAS  PubMed  Google Scholar 

  37. Darouiche RO, Raad, II, Heard SO, Thornby JI, Wenker OC, Gabrielli A, Berg J, Khardori N, Hanna H, Hachem R, Harris RL and Mayhall G. A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group. N Engl J Med 1999; 340: 1–8.

    Article  CAS  PubMed  Google Scholar 

  38. Raad I, Darouiche R, Dupuis J, Abi-Said D, Gabrielli A, Hachem R, Wall M, Harris R, Jones J, Buzaid A, Robertson C, Shenaq S, Curling P, Burke T and Ericsson C. Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. The Texas Medical Center Catheter Study Group. Ann Intern Med 1997; 127: 267–74.

    CAS  PubMed  Google Scholar 

  39. Eggimann P, Harbarth S, Constantin MN, Touveneau S, Chevrolet JC and Pittet D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000; 355: 1864–8.

    Article  CAS  PubMed  Google Scholar 

  40. Robert J, Fridkin SK, Blumberg HM, Anderson B, White N, Ray SM, Chan J and Jarvis WR. The influence of the composition of the nursing staff on primary bloodstream infection rates in a surgical intensive care unit. Infect Control Hosp Epidemiol 2000; 21: 12–7.

    CAS  PubMed  Google Scholar 

  41. Fridkin SK, Pear SM, Williamson TH, Galgiani JN and Jarvis WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996; 17: 150–8.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Réanimation Médicale et Infectieuse, Hôpital Bichat-Claude Bernard, Paris, France

    Jean-François Timsit Ph.D.

Authors
  1. Jean-François Timsit Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Critical Care Medicine Department Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Drive Building 10, Room 7D43, Bethesda, MD, 20892

    Naomi P. O’Grady M.D.

  2. University Hospital Infection Control Program Department of Internal Medicine, University of Geneva Hospitals, 1211, Geneva 14, Switzerland

    Didier Pittet M.D.

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer Science + Business Media, Inc.

About this chapter

Cite this chapter

Timsit, JF. (2004). ICU Prevention Strategies. In: O’Grady, N.P., Pittet, D. (eds) Catheter-Related Infections in the Critically Ill. Perspectives on Critical Care Infectious Diseases, vol 8. Springer, Boston, MA. https://doi.org/10.1007/1-4020-8010-7_11

Download citation

  • DOI: https://doi.org/10.1007/1-4020-8010-7_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4020-8009-8

  • Online ISBN: 978-1-4020-8010-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation