Intravascular device-related infections in cancer patients

  • Issam I. Raad
  • Giuseppe Fraschini
Part of the Cancer Treatment and Research book series (CTAR, volume 79)


The successful management of oncology patients entails the safe use of intravascular catheters. Central venous catheters (CVC), particularly long-term silastic catheters, are commonly used in cancer patients to administer chemotherapy, antibiotics, blood products, and parenteral nutrition. Infection is one of the leading complications of these devices, and catheter-related septicemias represent the most frequent life-threatening complication of intravascular catheters [1–7]. The rate of septicemias associated with noncuffed CVC has ranged from 4 percent to 14 percent [8]. For long-term cuffed silastic catheters, a range of 8–43 percent has been reported [5]. More than 5 million CVCs are inserted in the United States annually [9]. Of those, about 0.5 million are cuffed silastic catheters [10]. Assuming a conservative average septicemia rate of only 8 percent, one would expect at least 400,000 CVC-related septicemias per year.


Central Venous Catheter Catheter Removal Catheter Infection Catheter Colonization Tunnel Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Press OW, Ramsey PG, Larson EB, Fefer A, Hickman RO. 1984. Hickman catheter infections in patients with malignancies. Medicine 63:189–200.PubMedCrossRefGoogle Scholar
  2. 2.
    Wurzel CL, Halom K, Feldman JG, Rubin LG. 1988. Infection rates of Broviac-Hickman catheters and implantable venous devices. Am J Dis Child 142:536–540.PubMedGoogle Scholar
  3. 3.
    Ingram J, Weitzman S, Greenberg ML, Parkin P, Filler R. 1991. Complications of indwelling venous access lines in the pediatric hematology patient: A prospective comparison of external venous catheters and subcutaneous ports. Am J Pediatr Hematol Oncol 13:130–136.PubMedCrossRefGoogle Scholar
  4. 4.
    Severien C, Nelson JD. 1991. Frequency of infections associated with implanted systems vs. cuffed, tunneled silastic venous catheters in patients with acute leukemia. Am J Dis Child 145:1433–1438.PubMedGoogle Scholar
  5. 5.
    Groeger JS, Lucas AB, Thaler HT, Friedlander-Klar H, Brown AE, Kiehn TE, Armstrong D. 1993. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 119:1168–1174.PubMedGoogle Scholar
  6. 6.
    Kiehn TE, Armstrong D. 1990. Changes in the spectrum of organisms causing bacteremia and ungemia in immunocompromised patients due to venous access devices. Eur J Clin Microbiol Infect Dis 9:869–872.PubMedCrossRefGoogle Scholar
  7. 7.
    Kappers Klunne MC, Degener JE, Stijnen T, Abels J. 1989. Complications from long-term indwelling central venous catheters in hematologic patients with special reference to infection. Cancer 64:1747–1752.PubMedCrossRefGoogle Scholar
  8. 8.
    Raad II, Bodey GP. 1992. Infectious complications of indwelling vascular catheters. Clin Infect Dis 15:197–210.PubMedCrossRefGoogle Scholar
  9. 9.
    Maki DG. 1991. Infection Caused by Intravascular Devices: Pathogenesis, Strategies for Prevention. London: Royal Society of Medicine Sevices, 1991.Google Scholar
  10. 10.
    Groeger JS, Lucas AB, Coit D. 1991. Venous access in the cancer patient. In: DeVita VT Jr, Hellman S, Rosenbert SA, eds Cancer: Principles and Practice of Oncology, 3rd ed Philadelphia: JB Lippincott, pp 1–14.Google Scholar
  11. 11.
    Maki DG, Cobb L, Garman JK, Shapiro JM, Ringer M, Helgerson RB. 1988. An attachable silver-impregnated cuff for prevention of infection with central venous catheters: A prospective randomized multicenter trial. Am J Med 85:307–314.PubMedCrossRefGoogle Scholar
  12. 12.
    Maki DG, Weise CE, Sarafin HW. 1977. A semiquantitatiave culture method for identifying intravenous catheter-related infections. N Engl J Med 296:1305–1309.PubMedCrossRefGoogle Scholar
  13. 13.
    Maki DG, Ringer M. 1987. Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. JAMA 258:2396–2403.PubMedCrossRefGoogle Scholar
  14. 14.
    Flowers RH III, Schwenzer KJ, Kopel RF, Fisch MJ, Tucker SI, Farr BM. 1989. Efficacy of an attachable subcutaneous cuff for the prevention of intravascular catheter-related infection. JAMA 261:878–883.PubMedCrossRefGoogle Scholar
  15. 15.
    Wang EEL, Prober CG, Ford-Jones L, Gold R. 1984. The management of central intravenous catheter infections. Pediatr Infect Dis J 3:110–113.CrossRefGoogle Scholar
  16. 16.
    Hiemenz J, Skelton J, Pizzo PA. 1986. Perspective on the management of catheter-related infections in cancer patients. Pediatr Infect Dis J 5:6–11.CrossRefGoogle Scholar
  17. 17.
    Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. 1988. CDC definitions for nosocomial infections. Am J Infect Control 16:128–140.PubMedCrossRefGoogle Scholar
  18. 18.
    Collignon PG, Soni N, Pearson IY, Woods WP, Munro R, Sorrell TC. 1986. Is semiquantitative culture of central vein catheter tips useful in the diagnosis of catheter-associated bacteremia? J Clin Microbiol 24:532–535.PubMedGoogle Scholar
  19. 19.
    Moyer MA, Edwards LD, Farley L. 1983. Comparative culture methods on 101 intravenous catheters. Arch Intern Med 143:66–69.PubMedCrossRefGoogle Scholar
  20. 20.
    Snydman DR, Murray SA, Kornfeld SJ, Majka JA, Ellis CA. 1982. Total parenteral nutrition-related infections: Prospective epidemiologic study using semiquantitative methods. Am J Med 73:695–699.PubMedCrossRefGoogle Scholar
  21. 21.
    Hampton AA, Sherertz RJ. 1988. Vascular-access infections in hospitalized patients. Surg Clin North Am 68:57–71.PubMedGoogle Scholar
  22. 22.
    Cleri DJ, Corrado ML, Seligman SJ. 1980. Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis 141:781–786.PubMedCrossRefGoogle Scholar
  23. 23.
    Bjornson HS, Colley R, Bower RH, Duty VP, Schwartz-Fulton JT, Fisher JE. 1982. Association between microorganism growth at the catheter insertion site and colonization of the catheter in patients receiving total parenteral nutrition. Surgery 92:720–726.PubMedGoogle Scholar
  24. 24.
    Brun-Buisson C, Abrouk F, Legrand P, Huet Y, Larabi S, Rapin M. 1987. Diagnosis of central venous catheter-related sepsis: Critical level of quantitative tip cultures. Arch Intern Med 147:873–877.PubMedCrossRefGoogle Scholar
  25. 25.
    Sherertz RJ, Raad II, Balani A, Koo L, Rand K. 1990. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol 28:76–82.PubMedGoogle Scholar
  26. 26.
    Raad II, Sabbagh MF, Rand KH, Sherertz RJ. 1991. Quantitative tip culture methods and the diagnosis of central venous catheter-related infections. Diagn Microbiol Infect Dis 15:13–20.CrossRefGoogle Scholar
  27. 27.
    Raad I, Costerton JW, Sabharwal U, Sacilowski M, Anaissie E, Bodey GP. 1993. Ultrastructural analysis of indwelling vascular catheters: A quantitative relationship between luminal colonization and duration of placement. J Infect Dis 168:400–407.PubMedCrossRefGoogle Scholar
  28. 28.
    Raad I, Davis S, Becker M, Hohn D, Houston D, Umphrey J, Bodey GP. 1993. Low infection rate and long durability of nontunneled silastic catheters. Arch Intern Med 153:1791–1796.PubMedCrossRefGoogle Scholar
  29. 29.
    Markus S, Buday S. 1989. Culturing indwelling central venous catheters in situ. Infect Surg—: 157–162.Google Scholar
  30. 30.
    Wing EJ, Norden CW, Shadduck RK, Winkelstein A. 1979. Use of quantitative bacteriologic techniques to diagnose catheter-related sepsis. Arch Intern Med 139:482–483.PubMedCrossRefGoogle Scholar
  31. 31.
    Flynn PM, Shenep JL, Barret FF. 1988. Differential quantitation with a commercial blood culture tube for diagnosis of catheter-related infection. J Clin Microbiol 26:1045–1046.PubMedGoogle Scholar
  32. 32.
    Raucher HS, Hyatt AC, Barzilai A, Harris MB, Weiner MA, LeLeiko NS, Hodes DS. 1984. Quantitative blood cultures in the evaluation of septicemia in children with Broviac catheters. J Pediatr 104:29–33.PubMedCrossRefGoogle Scholar
  33. 33.
    Flynn PM, Shenep JL, Stokes DC, Barrett FF. 1987. In situ management of confirmed central venous catheter-related bacteremia. Pediatr Infect Dis J 6:729–734.PubMedCrossRefGoogle Scholar
  34. 34.
    Mosca R, Curtas S, Forbes B, Meguid MM. 1987. The benefits of isolator cultures in the management of suspected catheter sepsis. Surgery 102:718–723.PubMedGoogle Scholar
  35. 35.
    Armstrong CW, Mayhall G, Miller KB, Newsome HH Jr, Sugerman HJ, Dalton HP, Hall GO, Hunsberger S. 1990. Clinical predictors of infection of central venous catheters used for total parenteral nutrition. Infect Control Hosp Epidemiol 11:71–78.PubMedCrossRefGoogle Scholar
  36. 36.
    Paya CV, Guerra L, March HM, Farnell MB, Washington J II, Thompson RL. 1989. Limited usefulness of quantitative culture of blood drawn through the device for diagnosis of intravascular-device-related bacteremia. J Clin Microbiol 27:1431–1433.PubMedGoogle Scholar
  37. 37.
    Cooper GL, Hopkins CC. 1985. Rapid diagnosis of intravascular catheter-associated infection by direct gram staining of catheter segments. N Engl J Med 312:1142–1147.PubMedCrossRefGoogle Scholar
  38. 38.
    Zufferey J, Rime B, Francidi P, Bille J. 1988. Simple method for rapid diagnosis of catheter-associated infection by direct acridine orange staining of catheter tips. J Clin Microbiol 26:175–177.PubMedGoogle Scholar
  39. 39.
    Coutlee F, Lemieux C, Paradis JF. 1988. Value of direct catheter staining in the diagnosis of intravascular catheter-related infection. J Clin Microbiol 26:1088–1090.PubMedGoogle Scholar
  40. 40.
    Collignon P, Chan R, Munro R. 1987. Rapid diagnosis of intravascular catheter-related sepsis. Arch Intern Med 147:1609–1612.PubMedCrossRefGoogle Scholar
  41. 41.
    Snydman DR, Pober BR, Murray Sa, Gorbea HF, Majka JA, Perry LK. 1982. Predictive value of surveillance skin cultures in total-parenteral-nutrition-related infection. Lancet 8312:1385–1388.CrossRefGoogle Scholar
  42. 42.
    Cercenado E, Ena J, Rodriguez-Creixems M, Romero I, Bouza E. 1990. A conservative procedure for the diagnosis of catheter-related infections. Arch Intern Med 150:1417–1420.PubMedCrossRefGoogle Scholar
  43. 43.
    Maki DG. 1988. Sources of infection with central venous catheters in an ICU: A prospective study. In: Program and Abstracts of the 28th Interscience Conference on Antimicrobial Agents and Chemotherapy. Los Angeles, abstract no. 269 p 157.Google Scholar
  44. 44.
    Levy RS, Goldstein J. 1970. Value of a topical antibiotic ointment in reducing bacterial colonization of percutaneous venous catheters. J Albert Einstein Med Cent 18:67–70.Google Scholar
  45. 45.
    Maki DG, Band JD. 1981. A comparative study of polyantibiotic and iodophor ointments in prevention of vascular catheter-related infection. Am J Med 70:739–744.PubMedCrossRefGoogle Scholar
  46. 46.
    Maki DG, Ringer M, Alvarado CJ. 1991. Prospective randomized trial of povidoneiodine, alcohol, and Chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 338:339–343.PubMedCrossRefGoogle Scholar
  47. 47.
    Conly JM, Grieves K, Peters B. 1989. A prospective, randomized study comparing transparent and dry gauze dressings for central venous catheters. J Infect Dis 159:310–318.PubMedCrossRefGoogle Scholar
  48. 48.
    Dixon RE, Kaslow RA, Macket DC, Fulkerson CC, Mallison GF. 1976. Aqueous quaternary ammonium antiseptics and disinfectants. Use and misuse. JAMA 236:2415–2417.PubMedCrossRefGoogle Scholar
  49. 49.
    Frank MJ, Schaffner W. 1976. Contaminated aqueous benzalkonium chloride. An unnecessary hospital infection hazard. JAMA 236:2418–2419.PubMedCrossRefGoogle Scholar
  50. 50.
    Sitges-Serra A, Puig P, Linares J, Perez JL, Farrero N, Juarrieta E, Garau J. 1984. Hub colonization as the initial step in an outbreak of catheter-related sepsis due to coagulase negative staphylococci during parenteral nutrition. J Parenter Enter Nutr 8:668–672.CrossRefGoogle Scholar
  51. 51.
    Sitges-Serra A, Linares J, Perez JL, Jaurrieta E, Lorente L. 1985. A randomized trial on the effect of tubing changes on hub contamination and catheter sepsis during parenteral nutrition. J Parenter Enter Nutr 9:322–325.CrossRefGoogle Scholar
  52. 52.
    Linares J, Sitges-Serra A, Garau J, Perez JL, Martin R. 1985. Pathogenesis of catheter sepsis: A prospective study with quantitative and semiquantitative cultures of catheter hub and segments. J Clin Microbiol 21:357–360.PubMedGoogle Scholar
  53. 53.
    Salzman MB, Isenberg HD, Shapiro JF, Lipsitz PJ, Rubin LG. 1993. A prospective study of the catheter hub as the portal of entry for microorganisms causing catheter-related sepsis in neonates. J Infect Dis 167:487–490.PubMedCrossRefGoogle Scholar
  54. 54.
    Anaissie EJ, Raad I, Samonis G, Kontoyiannis DP, Rosenbaum B, Bodey GP, Sabharwal U, Costerton JW. 1991. Universal colonization of central venous catheters (CVCs) and low risk of hematogenous seeding. In: Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, abstract no. 1063, p 276.Google Scholar
  55. 55.
    Kovacevich DS, Faubion WC, Bender JM, Schaberg DR, Wesley JR. 1986. Association of parenteral nutrition catheter sepsis with urinary tract infections. J Parenter Enter Nutr 10:639–641.CrossRefGoogle Scholar
  56. 56.
    Pettigren RA, Lang DSR, Haycock DA, Parry BR, Bremner DA, Hill GL. 1985. Catheter-related sepsis in patients on intravenous nutrition: A prospective study of quantitative catheter cultures and guideline changes for suspected sepsis. Br J Surg 72:52–55.CrossRefGoogle Scholar
  57. 57.
    Centers for Disease Control. 1971. Nosocomial bacteremia associated with intravenous fluid therapy. MMWR 20(Suppl 9):1–2.Google Scholar
  58. 58.
    Maki DG, Martin WT. 1975. Nationwide epidemic of septicemia caused by contamined infusion products. Growth of microbial pathogens in fluids for intravenous infection. J Infect Dis 131:267–272.PubMedCrossRefGoogle Scholar
  59. 59.
    Maki DG, Rhame FS, Mackel DC, Bennett JV. 1976. Nationwide epidemic of septicemia caused by contaminated intravenous products. Am J Med 60:471–485.PubMedCrossRefGoogle Scholar
  60. 60.
    Jarvis WR, Highsmith AK. 1984. Bacterial growth and endotoxin production in lipid emulsion. J Clin Microbiol 19:17–20.PubMedGoogle Scholar
  61. 61.
    Dankner WM, Spector SA, Fierer J. 1987. Malassezia fungemia in neonates and adults: Complication of hyperalimentation. Rev Infect Dis 9:743–837.PubMedCrossRefGoogle Scholar
  62. 62.
    Plouffe JF, Brown DG, Silva J Jr, Eck T, Stricof RL, Fekety FR Jr. 1977. Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions. Arch Intern Med 137:1686–1689.PubMedCrossRefGoogle Scholar
  63. 63.
    Brismar R, Hardstedt C, Jacobson S. 1981. Diagnosis of thrombosis by catheter phlebography after prolonged central venous catheterization. Ann Surg 194:779–783.PubMedCrossRefGoogle Scholar
  64. 64.
    Ahmed N, Payne RF. 1976. Thrombosis after central venous cannulation. Med J Aust 1:217.PubMedGoogle Scholar
  65. 65.
    Herrmann M, Vaudaux PE, Pittet D, Auckenthaler R, Lew PD, Schumacher-Perdreau F, Peters G, Waldvogel FA. 1988. Fibronectin, fibrinogen, and laminin act as mediators of adherence of clinical staphylococcal isolates to foreign material. J Infect Dis 158:693–701.PubMedCrossRefGoogle Scholar
  66. 66.
    Vaudaux P, Pittet D, Haeberli A, Huggler E, Nydegger UE, Lew DP, Waldrogel FA. 1989. Host factors selectively increase staphylococcal adherence on inserted catheters: A role for fibronectin and fibrinogen or fibrin. J Infect Dis 160:865–875.PubMedCrossRefGoogle Scholar
  67. 67.
    Vadaux P, Pittet D, Haeberli A, Lerch PG. Morgenthaler JJ, Proctor RA, Waldvogel FA, Lew DP. 1993. Fibronectin is more active than fibrin or fibrinogen in promoting Staphylococcus aureus adherence to inserted intravascular catheters. J Infect Dis 167:633–641.CrossRefGoogle Scholar
  68. 68.
    Christensen GD, Simpson WA, Bisno AL, Beachey EH. 1982. Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surfaces. Infect Immun 37:318–326.PubMedGoogle Scholar
  69. 69.
    Christensen GD, Simpson WA, Younger JJ, Baddour LM, Barrett FF, Melton DM, Beachey EH. 1985. Adherence of coagulase-negative staphylococci to plastic tissue culture plates: A quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol 22:996–1006.PubMedGoogle Scholar
  70. 70.
    Falcieri E, Vaudaux P, Huggler E, Lew D, Waldvogel F. 1987. Role of bacterial exopolymers and host factors on adherence and phagocytosis of Staphylococcus aureus in foreign body infection. J Infect Dis 155:524–531.PubMedCrossRefGoogle Scholar
  71. 71.
    Costerton JW, Irvin RT, Cheng KJ. 1981. The bacterial glycocalyx in nature and disease. Annu Rev Microbiol 35:299–324.PubMedCrossRefGoogle Scholar
  72. 72.
    Davenport DS, Massanari RM, Pfaller MA, Bale MJ, Streed SA, Hierholzer WJ Jr. 1986. Usefulness of a test for slime production as a marker for clinically significant infections with coagulase-negative staphylococci. J Infect Dis 153:332–339.PubMedCrossRefGoogle Scholar
  73. 73.
    Sheth NK, Franson TR, Sohnle PG. 1985. Influence of bacterial adherence to intravascular catheters on in vitro antibiotic susceptibility. Lancet 2:1266–1268.PubMedCrossRefGoogle Scholar
  74. 74.
    Farber BF, Kaplan MH, Clogstron AG. 1990. Staphylococcus epidermidis extracted slime inhibits the antimicrobial action of glycopeptide antibiotics. J Infect Dis 161:37–40.PubMedCrossRefGoogle Scholar
  75. 75.
    Costerton JW, Lappin-Scott HM. 1989. Behavior of bacteria in biofilms. Am Soci Microbiol News 55:650–654.Google Scholar
  76. 76.
    Sheth NK, Franson TR, Rose HD, Buckmire FL, Cooper JA, Sohnle PG. 1983. Colonization of bacteria on polyvinyl chloride and Teflon intravascular catheter in hospitalized patients. J Clin Microbiol 18:1061–1063.PubMedGoogle Scholar
  77. 77.
    Rotrosen D, Calderone RA, Edwards JE Jr. 1986. Adherence of Candida species to host tissues and plastic surfaces. Rev Infect Dis 8:73–85.PubMedCrossRefGoogle Scholar
  78. 78.
    Benezra D, Kiehn TE, Gold GWM, Brown AE, Turnbull ADM, Armstrong D. 1988. Prospective study of infections in indwelling central venous catheters using quantitative blood cultures. Am J Med 85:495–498.PubMedCrossRefGoogle Scholar
  79. 79.
    Elting LS, Bodey GP. 1990. Septicemia due to Xanthomonas species and non-aeruginosa Pseudomonas species: Increasing incidence of catheter-related infections. Medicine 69:296–306.PubMedCrossRefGoogle Scholar
  80. 80.
    Band JD, Maki DG. 1979. Infections caused by arterial catheters used for hemodynamic monitoring. Am J Med 67:735–741.PubMedCrossRefGoogle Scholar
  81. 81.
    Shinozaki T, Deane RS, Mazuzan JE Jr, Hamel AJ, Hazelton D. 1983. Bacterial contamination of arterial lines. JAMA 249:223–225.PubMedCrossRefGoogle Scholar
  82. 82.
    Thomas F, Burke JP, Parker J, Orme JF Jr, Gardner RM, Clemmer TP, Hill GA, MacFarlane P. 1983. The risk of infection related to radial vs. femoral sites for arterial catheterization. Crit Care Med 11:807–812.PubMedCrossRefGoogle Scholar
  83. 83.
    Mermel LA, McCormick RD, Springman SR, Maki DG. 1991. The pathogenesis and epidemiology of catheter-related infection with pulmonary artery Swan-Ganz catheters: A prospective study utilizing molecular subtyping. Am J Med 91(Suppl 3B):197S–205S.PubMedCrossRefGoogle Scholar
  84. 84.
    Michel L, Marsh M, McMichan JC, Southorn PA, Brewer NS. 1981. Infection of pulmonary artery catheters in critically ill patients. JAMA 245:1032–1036.PubMedCrossRefGoogle Scholar
  85. 85.
    Norwood SH, Jenkins G. 1990. An evaluation of triple-lumen catheter infections using a guidewire exchange technique. J Trauma 30:706–712.PubMedCrossRefGoogle Scholar
  86. 86.
    Linder LE, Curelaru I, Gustavsson B, Hansson HA, Stenqvist O, Wojciechowski J. 1984. Material thrombogenicity in central venous catheterization: A comparison between soft, antebrachial catheters of silicone elastomer and polyurethane. J Parenter Enter Nutr 8:399–406.CrossRefGoogle Scholar
  87. 87.
    Wolfe BM, Ryder MA, Nishikawa RA, Halsted CH, Schmidt BF, 1986. Complications of parenteral nutrition. Am J Surg 152:93–99.PubMedCrossRefGoogle Scholar
  88. 88.
    Pemberton LB, Lyman B, Lander V, Covinsky J. 1986. Sepsis from triple vs. single-lumen catheters during total parenteral nutrition in surgical or critically ill patients. Arch Surg 121:591–594.PubMedGoogle Scholar
  89. 89.
    Appelgran KN. 1987. Triple-lumen catheters: Technological advance or setback? Arch Surg 53:113–116.Google Scholar
  90. 90.
    Hilton E, Haslett TM, Borenstein MT, Tucci V, Isenberg HD, Singer C. 1988. Central catheter infections: Single vs. triple-lumen catheters—influence of guidelines on infection rates when used for replacement of catheters. Am J Med 84:667–672.PubMedCrossRefGoogle Scholar
  91. 91.
    Yeung C, May J, Hughes R. 1988. Infection rate for single-lumen vs. triple-lumen subclavian catheters. Infect Control Hosp Epidemiol 9:154–158.PubMedCrossRefGoogle Scholar
  92. 92.
    Mantese VA, German DS, Kruminski DL, et al. 1987. Colonization and sepsis from triple-lumen catheters in critically ill patients. Am J Surg 154:597–601.PubMedCrossRefGoogle Scholar
  93. 93.
    Powell C, Fabri PJ, Kudsk KA. 1988. Risk of infection accompanying the use of single-lumen vs, double-lumen subclavian catheters: A prospective randomized study. J Parenter Enter Nutr 12:127–129.CrossRefGoogle Scholar
  94. 94.
    MacCarthy MC, Shives JK, Robison RJ, Broadie TA. 1987. Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. J Parenter Enter Nutr 11:259–262.CrossRefGoogle Scholar
  95. 95.
    Farkas JC, Liu N, Bleriot JP, Chevret S, Goldstein FW, Carlet J. 1992. Single-versus triple-lumen central catheter-related sepsis: A prospective randomized study in a critically ill population. Am J Med 93:277–282.PubMedCrossRefGoogle Scholar
  96. 96.
    Senagore A, Waller JD, Bonell BW, Bursch LR, Scholten DJ. 1987. Pulmonary artery catheterization: A prospective study of internal jugular and subclavian approaches. Crit Care Med 15:35–37.PubMedCrossRefGoogle Scholar
  97. 97.
    Craven DE, Lichtenberg DA, Kunches LM, McDonough AT, Gonzalez MI, Heeren TC, McCabe WR. 1985. A randomized study comparing a transparent polyurethane dressing to a dry gauze dressing for peripheral intravenous catheter sites. Infect Control 6:361–366.PubMedGoogle Scholar
  98. 98.
    Katich M, Band J. 1985. Local infection of the intravenous-cannulae wound associated with transparent dressings. J Infect Dis 151:971–972.PubMedCrossRefGoogle Scholar
  99. 99.
    Hoffmann KK, Weber DJ, Samsa GP, Rutala WA. 1992. Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection rates. JAMA 167:2072–2076.CrossRefGoogle Scholar
  100. 100.
    Armstrong CW, Mayhall CG, Miller KB, Newsome HH Jr, Sugerman HJ, Dalton HP, Hall GO, Gennings C. 1986. Prospective study of catheter replacement and other risk factors for infection of hyperalimentation catheters. J Infect Dis 154:808–816.PubMedCrossRefGoogle Scholar
  101. 101.
    Sitzmann JV, Townsend TR, Siler MC, Bartlett JG. 1985. Septic and technical complications of central venous catheterization: A prospective study of 200 consecutive patients. Ann Surg 202:766–770.PubMedCrossRefGoogle Scholar
  102. 102.
    Moran JM, Atwood RP, Rowe MI. 1965. A clinical and bacteriologic study of infections associated with venous cutdowns. N Engl J Med 272:554–558.PubMedCrossRefGoogle Scholar
  103. 103.
    Faubion WC, Wesley JR, Khalidi N, Silva J. 1986. Total parenteral nutrition catheter sepsis: Impact of the team approach. J Parenter Enter Nutr 10:642–645.CrossRefGoogle Scholar
  104. 104.
    Nelson DB, Kien CL, Mohr B, Frank S, Davis SD. 1986. Dressing changes by specialized personnel reduce infection rates in patients receiving central venous parenteral nutrition. J Parenter Enter Nutr 10:220–222.CrossRefGoogle Scholar
  105. 105.
    Clementi E, Marie O, Arlet G, Villiers S, Boudaoud S, Falkman H, Jacob L, Paulen R, Eurin B, Douard MC. 1991. Usefulness of an attachable silver-impregnated cuff for prevention of catheter-related sepsis (CRS)? In: Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, abstract no. 460, p 175.Google Scholar
  106. 106.
    Groeger JS, Lucas AB, Coit D, Exelby P, La Quaglia M, Brown AE, Turnbull A, et al. 1993. A prospective randomized evaluation of silver-impregnated subcutaneous cuffs for preventing tunneled chronic venous access catheter infections in cancer patients. Ann Surg 218:206–210.PubMedCrossRefGoogle Scholar
  107. 107.
    Schwartz C, Henrickson KJ, Roghmann K, Powell K. 1990. Prevention of bacteremia attributed to luminal colonization of tunneled central venous catheters with vancomycin-susceptible organisms. J Clin Oncol 8:1591–1597.PubMedGoogle Scholar
  108. 108.
    Kamal GD, Pfaller MA, Rempe LE, Jebson PJR. 1991. Reduced intravascular catheter infection by antibiotic bonding. JAMA 265:2364–2368.PubMedCrossRefGoogle Scholar
  109. 109.
    Maki, Wheller SJ, Stolz SM, Mermel LA. 1991. Clinical trial of a novel antiseptic central venous catheter. In: Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, abstract no. 461, p 176.Google Scholar
  110. 110.
    Mermel LA, McCormick RD, Springman SR, Maki DG. 1991. The pathogenesis and epidemiology of catheter-related infection with pulmonary artery Swan-Ganz catheters: A prospective study utilizing molecular subtyping. Am J Med 91(Suppl 3B):197–205.CrossRefGoogle Scholar
  111. 111.
    Raad II, Hohn DC, Gilbreath BJ, Suleiman N, Hill LA, Bruso PA, Marts K, Mansfield PF, Bodey GP. 1994. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 15:231–238.PubMedCrossRefGoogle Scholar
  112. 112.
    Bozetti F, Terno G, Bonfanti G, Scarpa D, Scotti A, Ammatuna M, Bonalumi MG. 1983. Prevention and treatment of central venous catheter sepsis by exchange via guidewire: A prospective controlled trial. Ann Surg 198:48–52.CrossRefGoogle Scholar
  113. 113.
    Gregory JA, Schiller WR. 1985. Subclavian catheter changes every third day in high risk patients. Am Surg 51:534–536.PubMedGoogle Scholar
  114. 114.
    Pettigrew RA, Lang SDR, Haydock DA, Parry BR, Bremner DA, Hill GL. 1985. Catheter-related sepsis in patients on intravenous nutrition: A prospective study of quantitative catheter cultures and guidewire changes for suspected sepsis. Br J Surg 72:52–55.PubMedCrossRefGoogle Scholar
  115. 115.
    Eyer S, Brummitt C, Crossley K, Siegel R, Cerra F. 1990. Catheter-related sepsis: Prospective, randomized study of three methods of long-term catheter maintenance. Crit Care Med 18:1073–1079.PubMedCrossRefGoogle Scholar
  116. 116.
    Cobb DK, High KP, Sawyer RG, Sable CA, Adams RB, Lindley D, Pruett TL, Schwenzer KJ, Farr BM. 1992. A controlled trial of scheduled replacement of central venous and pulmonary-artery catheters. N Engl J Med 327:1062–1068.PubMedCrossRefGoogle Scholar
  117. 117.
    Olson ME, Lam K, Bodey GP, King EG, Costerton JW. 1992. Evaluation of strategies for central venous catheter placement. Crit Care Med 20:797–804.PubMedCrossRefGoogle Scholar
  118. 118.
    Fraschini G, Raad I, Bruso P, Wang Z. 1992. Urokinase prophylaxis of central venous ports reduces infectious and thrombotic complications. In: Program and Abstracts of 3rd International Symposium: Supportive Care in Cancer, Bruges, Belgium, p C50:84.Google Scholar
  119. 119.
    Allcutt DA, Lort D, McCollum CN. 1983. Final inline filtration for intravenous infusions: A prospective hospital study. Br J Surg 70:111–113.PubMedCrossRefGoogle Scholar
  120. 120.
    Rusho WJ, Bair JN. 1979. Effect of filtration complications of postoperative intravenous therapy. Am J Hosp Pharm 36:1355–1356.PubMedGoogle Scholar
  121. 121.
    Josephson A, Gombert ME, Sierra MF, Karantil LV, Transino GF. 1985. The relationship between intravenous fluid contamination and the frequency of tubing replacement. Infect Control 6:367–370.PubMedGoogle Scholar
  122. 122.
    Maki DG, Ringer M. 1987. Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. JAMA 258:2396–2403.PubMedCrossRefGoogle Scholar
  123. 123.
    Raad II, Vartivarian S, Khan A, Bodey GP. 1991. Catheter-related infections caused by Mycobacterium fortuitum complex: 15 cases and review. Rev Infect Dis 13:1310–1319.CrossRefGoogle Scholar
  124. 124.
    Strinden WD, Helgerson RB, Maki DG. 1985. Candida septic thrombosis of the great central veins associated with central catheters. Ann Surg 202:653–658.PubMedCrossRefGoogle Scholar
  125. 125.
    Pollack PF, Kadden M, Byrne WJ, Fonkalsrud EW, Ament ME. 1981. One hundred patient years’ experience with the Broviac silastic catheter for central venous nutrition. J Parenter Enter Nutr 5:32–36.CrossRefGoogle Scholar
  126. 126.
    Ladefoged K, Efsen F, Krogh Christofferson J, Jarnum S. 1981. Long-term parenteral nutrition in catheter-related complications. Scand J Gastroenterol 16:913–919.PubMedCrossRefGoogle Scholar
  127. 127.
    Riella MC, Scribner BH. 1976. Five years’ experience with a right atrial catheter for prolonged parenteral nutrition at home. Surg Gynecol Obstet 143:205–208.PubMedGoogle Scholar
  128. 128.
    Raad I, Davis S, Khan A, Tarrand J, Bodey GP. 1992. Catheter removal affects recurrence of catheter-related coagulase-negative staphylococci bacteremia (CRCNSB). Infect Control Hosp Epidemiol 13:215–221.PubMedCrossRefGoogle Scholar
  129. 129.
    Mylotte JM, McDermott C. 1987. Staphylococcus aureus bacteremia caused by infected intravenous catheters. Am J Infect Control 15:1–6.PubMedCrossRefGoogle Scholar
  130. 130.
    Bentley DW, Lepper MH. 1968. Septicemia related to indwelling venous catheters. JAMA 206:1749–1752.PubMedCrossRefGoogle Scholar
  131. 131.
    Miramanoff RO, Glauser MP. 1982. Endocarditis during Staphylococcus aureus septicemia in a population of non-drug addicts. Arch Intern Med 142:1311–1313.CrossRefGoogle Scholar
  132. 132.
    Libman H, Arbeit RD. 1984. Complications associated with Staphylococcus aureus bacteremia. Arch Intern Med 144:541–545.PubMedCrossRefGoogle Scholar
  133. 133.
    Rawson D, Rimland D, Johnson J. 1979. Nosocomial staphylococcal bacteremia: A highly fatal disease. Clin Res 27:753.Google Scholar
  134. 134.
    Maradona JA, Carton JA, Alonso JL, Carcaba V, Nuno FJ, Arribas JM. 1990. Nosocomial Staphylococcus aureus bacteremia: A study of 156 consecutive adult patients. In: Program and Abstracts of the 2nd International Conference of the Hospital Infection Society. London: Academic Press, 1990.Google Scholar
  135. 135.
    Raad I, Sabbagh MF. 1992. Optimal duration of therapy of catheter-related Staphylococcus aureus bacteremia: A study of 55 cases and review. Rev Infect Dis 14:75–82.CrossRefGoogle Scholar
  136. 136.
    Watanakunakorn C, Baird IM. 1977. Staphylococcus aureus bacteremia and endocarditis associated with a removable infected intravenous device. Am J Med 63:253–256.PubMedCrossRefGoogle Scholar
  137. 137.
    Cluff LE, Reynolds RC, Page DL, Breckenridge JL. 1968. Staphylococcal bacteremia and altered host resistance. Ann Intern Med 69:859–873.PubMedGoogle Scholar
  138. 138.
    Dugdale DC, Ramsey PG. 1990. Staphylococcus aureus bacteremia in patients with Hickman catheters. Am J Med 89:137–141.PubMedCrossRefGoogle Scholar
  139. 139.
    Snydman DR, Sullivan B, Gill M, Gould JA, Parkinson DR, Atkins MB. 1990. Nosocomial sepsis associated with interleukin-2. Ann Intern Med 112:102–107.PubMedGoogle Scholar
  140. 140.
    Raad I, Narro J, Khan A, Tarrand J, Vartivarian S, Bodey GP. 1992. Serious complications of vascular catheter-related Staphylococcus aureus bacteremia in cancer patients. Eur J Clin Microbiol Infect Dis 11:675–682.PubMedCrossRefGoogle Scholar
  141. 141.
    Eppes SC, Troutman JL, Gutman LT. 1989. Outcome of treatment of candidemia in children whose central venous catheters were removed or retained. Pediatr Infect Dis J 8:99–104.PubMedCrossRefGoogle Scholar
  142. 142.
    Martino P, Micozzi A, Venditti M, Gentile G, Girmenia C, Raccah R, Santilli S, Alessandri N, Mandelli F. 1990. Catheter-related right-sided endocarditis in bone marrow transplant recipients. Rev Infect Dis 12:250–257.PubMedCrossRefGoogle Scholar
  143. 143.
    Riebel W, Frantz N, Adelstein D, Spagnuolo PJ. 1986. Corynebacterium JK. A cause of nosocomial device-related infection. Rev Infect Dis 8:42–49.PubMedCrossRefGoogle Scholar
  144. 144.
    Young VM, Meyers WF, Moody MR, Schimpff SC. 1981. The emergence of coryneform bacteria as a cause of nosocomial infections in compromised hosts. Am J Med 70:646–650.PubMedCrossRefGoogle Scholar
  145. 145.
    Clarke DE, Raffin TA. 1990. Infectious complications of indwelling long-term central venous catheters. Chest 97:966–972.PubMedCrossRefGoogle Scholar
  146. 146.
    Kiehn TE, Armstrong D. 1990. Changes in the spectrum of organisms causing bacteremia and fungemia in immunocompromised patients due to venous access devices. Eur J Clin Microbiol Infect Dis 9:869–872.PubMedCrossRefGoogle Scholar
  147. 147.
    Banerjee C, Bustamante CI, Wharton R, Talley E, Wade JC. 1988. Bacillus infections in patients with cancer. Arch Intern Med 148:1769–1774.PubMedCrossRefGoogle Scholar
  148. 148.
    Saleh RA, Schorin MA. 1987. Bacillus spp. sepsis associated with Hickman catheters in patients with neoplastic disease. Pediatr Infect Dis J 6:851–856.PubMedCrossRefGoogle Scholar
  149. 149.
    Cotton DJ, Gill VJ, Marshall DJ, Gress J, Thaler M, Pizzo PA. 1987. Clinical features and therapeutic interventions in 17 cases of Bacillus bacteremia in an immunosuppressed patient population. J Clin Microbiol 25:672–674.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1995

Authors and Affiliations

  • Issam I. Raad
  • Giuseppe Fraschini

There are no affiliations available

Personalised recommendations