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Critical Care Infectious Diseases Textbook pp 573–585Cite as

Catheter-Related Bloodstream Infections in Total Parenteral Nutrition

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Abstract

Early after the introduction of intravenous feeding (TPN) it became clear that one of the most serious complications of this new modality treatment was bacteremia arising from the central venous catheter or the infusion devices or mixtures administered. Initial papers on this topic properly reflect the efforts by pioneers of TPN to make it a safe treatment for prolonged periods of time [1, 2]. Strategies to prevent catheter-related bloodstream infections (CRBI) in patients on TPN met, however, with different success due to the fact that at that time the pathogenesis of these infections was incompletely understood. Endemics of CRBI due to coagulase negative staphylococci were reported during the late 1970s and early 1980s from several parts of the world [3–6].

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References

  1. Holm I, Wretlind A. Prophylaxis against the infection and septicemia in parenteral nutrition via central intravenous catheter. Acta Chir Scand 141:173, 1975.

    PubMed  CAS  Google Scholar 

  2. Sanderson I, Deitel M. Intravenous hyperalimentation without sepsis. Surg Gynecol Obstet 136:577, 1973.

    PubMed  CAS  Google Scholar 

  3. Forse RA, Dixon C, Bernard K, Martínez L, McLean APH, Meakins JL. Staphylococcus epidermidis: An important pathogen. Surgery 86:507, 1979.

    PubMed  CAS  Google Scholar 

  4. Sitges-Serra A, Puig P, Jaurrieta E, Garau J, Alastrue A, Sitges-Creus A. Catheter sepsis due to Staphylococcus epidermidis during parenteral nutrition. Surg Gynecol Obstet 151:481, 1980.

    PubMed  CAS  Google Scholar 

  5. Deitel M, Krajden S, Saldanha CF, Gregory WD, Fuksa M, Cantwell E. An outbreak of Staphylococcus epidermidis septicemia. JPEN 7:569, 1983.

    Article  CAS  Google Scholar 

  6. Garden OJ, Sim AJW. A comparison of tunnelled and non-tunnelled catheters: A prospective study of complications during parenteral feeding. Clin Nutr 2:51, 1983.

    Article  PubMed  CAS  Google Scholar 

  7. Sitges-Serra A. Parenteral mutrition and the surgical patient. Presses Agronomiques. Brussels, 1999.

    Google Scholar 

  8. Mughal MM. Complications of intravenous feeding catheters. Br J Surg 76:15, 1989.

    Article  PubMed  CAS  Google Scholar 

  9. Sitges-Serra A, Pi-Suñer T, Garcés JM, Segura M. Pathogenesis and prevention of catheter-related septicemia. Am J Infect Control 23:310, 1995.

    Article  PubMed  CAS  Google Scholar 

  10. León Regidor MA, León C, Mateu A, Olaechea P, Insausti JM, Martínez Pellús A, González V, lópez V, Alvarez B y GEIRCI. Infecciones relacionadas con cateteres intravasculares en el paciente crítico. Estudio Multicéntrico. Medicina Intensiva 17:531, 1993.

    Google Scholar 

  11. Crane Ch. Venous interruption for septic thrombophlebitis. N Engl J Med 262:947, 1960.

    Article  PubMed  CAS  Google Scholar 

  12. Maki DG. Pathogenesis, prevention and management of infections due to intravascular devices used for infusion therapy. In Bisno AL, Waldvogel FA (eds). Infections associated with indwelling medical devices. Washington DC: American Society for Microbiology, 1989: 171

    Google Scholar 

  13. Raad II, Hohn DC, Gilbreath J, Suleiman N, Hill LA, Bruso PA, Marts K, Mansfiel P, Bodey GP. Prevention of central venous catheter-related infections by using maximal sterile barrier precaustions during insertion. Inf Control Hosp Epidemiol 15:231, 1994.

    Article  CAS  Google Scholar 

  14. Maki DG. Infections due to infusion therapy. In Benett JV, Brachman PS (eds). Hospital infections. Boston: Little, Brown, 1992: 849.

    Google Scholar 

  15. Sitges-Serra A, Liñares J, Garau J. Catheter sepsis: The clue is the hub. Surgery 97:355, 1985.

    PubMed  CAS  Google Scholar 

  16. Liñares J, Sitges-Serra A, Garau J, Pérez JL, Martín R. Pathogenesis of catheter sepsis: a prospective study using quantitative and semiquantitaive cultures of catheter hub and segments. J Clin Microbiol 21:357, 1985.

    PubMed  Google Scholar 

  17. Stotter AT, Ward H, Waterfield AH, Hilton J, Sim AJ. Junctional care: the key to prevention of cahteter sepsis in intravenous feeding. JPEN J Parenter Nutr 11:159, 1987.

    CAS  Google Scholar 

  18. Cicco M, Panarello G, Chiaradia V, Fracasso A, Veronesi A, Testa V, Santini G, Tesio F. Source and routed of microbial colonisation of parenteral nutrition catheters. Lancet 2:1258, 1989.

    Article  PubMed  Google Scholar 

  19. Salzman MK, Isenberg HD, Shapiro JF, Lipsitz PJ, Rubin LG. A prospective study of the catheter-related sepsis in neonates. J Infect Dis 167:487, 1993.

    Article  PubMed  CAS  Google Scholar 

  20. Tan TQ, Musser JM, Shulman RJ, Mason EO Jr, Mahoney DH Jr, Kaplan SL. Molecular epidemiology of coagulase-negative Staphylococcus blood isolates from neonates with persistent bacteremia and children with central venou catheter infections. J Infect Dis 169:1393, 1994.

    Article  PubMed  CAS  Google Scholar 

  21. Segura M, Lladó L, Guirao X, Piracés M, Herms R, Alia C, Sitges-Serra A. A prospective study of a new protocol for in situ diagnosis of central venous catheter related bacteriemia. Clin Nutr 12:103, 1993.

    Article  PubMed  CAS  Google Scholar 

  22. Lewis WJ, Sherertz RJ. Microbial interactions with catheter material. Nutrition 13(Suppl.):5S, 1997.

    Article  PubMed  CAS  Google Scholar 

  23. Vaudaux P, Pittet D, Haeberli A, Lerch PG, Morgenthaler JJ, Proctor RA, Waldvogel FA, Lew DP. Fibronectin is more active than fibrin or fibrinogen in promoting Staphylococcus aureus adherence to inserted intravascular catheters. J Infect Dis 167:633, 1993.

    Article  PubMed  CAS  Google Scholar 

  24. Jeppson R, Johansson M, Tengborn J. Bacterial growth properties in refrigerated all-in-one TPN mixtures. Clin Nutr 6:25, 1987.

    Article  Google Scholar 

  25. Weil DC, Arnow PM. Safety of refrigerated storage of admixed parenteral fluids. J Clin Microbiol 26:1787, 1988.

    PubMed  CAS  Google Scholar 

  26. Moro ML, Franco E, Cozzi A. The central venous catheter-related infections study group. Risk factors for central venous catheter-related infections in surgical and intensive care patients. Inf Control Hosp Epidemiol 15:253, 1994.

    Article  CAS  Google Scholar 

  27. Richet H, Hubert B, Nitemberg G, Andremont A, Buu-Hoi A, Ourbak P, Galicier C, Veron M, Boisivon A, Bouvier AM, Ricome JC, Wolff MA, Pean Y, Berardi L, Bourdain JL, Hautefort B, Laaban JP, Tillant D. Prospective multicenter study of vascular-catheter-related complications and risk factors for positive central-catheter cultures in intensive care unit patients. J Clin Microbiol 28:2520, 1990.

    PubMed  CAS  Google Scholar 

  28. Hilton E, Haslett TM, Borenstein MT, Tucci V, Isenberg HD, Singer C. Central catheter infections: Single versus triple-lumen catheters. Influence of guide wires on infection rates when used for replacement catheters. Am J Med 84:667, 1988.

    Article  PubMed  CAS  Google Scholar 

  29. Hoffmann KK, Weber DJ, Samsa GP, Rutala W. Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection risks. JAMA 267:2072, 1992.

    Article  PubMed  CAS  Google Scholar 

  30. Clark-Christoff N, Watters VA, Sparks W, Snyder P, Grant JP. Use of triple-lumen catheters for administration of total parenteral nutrition. JPEN 16:403, 1992.

    Article  CAS  Google Scholar 

  31. McCarthy MC, Shives JK, Robison RJ, Broadie TA. Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. JPEN 11:259, 1987.

    Article  CAS  Google Scholar 

  32. Pemberton LB, Lyman B, Lander V, Covinsky J. Sepsis from triple- vs single-lumen catheters during total parenteral nutrition in surgical or critically ill patients. Arch Surg 121:591, 1986.

    Article  PubMed  CAS  Google Scholar 

  33. Gil RT, Kruse JA, Thill-Baharozian MC, Carlson RW. Triple- vs single-lumen central venous catheters. A prospective study in a critically ill population. Arch Intern Med 149:1139, 1989.

    Article  PubMed  CAS  Google Scholar 

  34. Savage AP, Picard M, Hopkins CC, Malt RA. Complications and survival of multilumen central venous catheters used for total parenteral nutrition. Br J Surg 80:1287, 1993.

    Article  PubMed  CAS  Google Scholar 

  35. Farkas JC, Liu N, Bleriot JP, Chevret S, Goldsterin FW, Carlet J. Single- versus triple-lumen central catheter-related sepsis: a prospective randomized study in a critically ill population. Am J Med 93:277, 1992.

    Article  PubMed  CAS  Google Scholar 

  36. Freeman J, Goldmann DA, Smith NE, Sidebottom DG, Epstein MF, Piatt R. Association of intravenous lipid emulsion and coagulase-negative staphylococcal bacteremia in neonatal intensive care units. N Engl J Med 323:301, 1991.

    Article  Google Scholar 

  37. Pérez JL, Liñares J, Pallarés R, Sitges-Serra A, Martín R. Lipid emulsions and bacteremia in the neonatal intensive care unit (letter). N Engl J Med 324:267, 1991.

    Article  Google Scholar 

  38. Widmer AF. IV-related infections. In Wenzel RP (ed). Prevention and control of nosocomial infections. Baltimore: Williams and Wilkins 1993:556.

    Google Scholar 

  39. Arnow PM, Quimosing EM, Beach M. Consequences of intravascular catheter sepsis. Clin Infect Dis 16:778, 1993.

    Article  PubMed  CAS  Google Scholar 

  40. Ladefoged K, Efsen F, Krogh Christoffersen J, Jarnum S. Long-term parenteral nutrition II. Catheter-related complications. Scand J Gastroenterol 16:913, 1981.

    Article  PubMed  CAS  Google Scholar 

  41. Freund HR. Chemical phlebothrombosis of large veins. A not uncommon complication of total parenteral nutrition. Arch Surg 116:1220, 1981.

    Article  PubMed  CAS  Google Scholar 

  42. De Cicco M, Matovic M, Balestreri L, Panarello G, Fanmtin D, Morassut S, Testa V. Central venous thrombosis: an early and frequent complication in cancer patients bearing long-term silastic catheters. A prospective study. Thromb Res 86:101, 1997.

    Article  PubMed  Google Scholar 

  43. Fowler VG Jr, Li J, Corey GR, Boley J, Marr KA, Gopal AK, Kong LK, Gottlieb G, Donovan CL, Sexton DJ, Ryan T. Role of echocardiography in evaluation of patients with Staphylococcus aureus bacteremia: experience in 103 patients. J Am Coll Cardiol 30:1072, 1997.

    Article  PubMed  Google Scholar 

  44. Lamas CC, Eykyn SJ. Hospital acquired native valve endocarditis: analysis of 22 cases presenting over 11 years. Heart 79:442, 1998.

    PubMed  CAS  Google Scholar 

  45. Sherertz RJ, Heard SO, Raad II. Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies. J Clin Microbiol 35:641, 1997.

    PubMed  CAS  Google Scholar 

  46. Brun-Buisson CH, Abrouk F, Legrand P, Huet Y, Larabi S, Rapin M. Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. Arch Int Med 147:873, 1987.

    Article  CAS  Google Scholar 

  47. Kelly M, Wciorka LR, McConico S, Peterson LR. Sonicated vascular catheter tip cultures. Quantitative association with catheter related sepsis and the non-utility of an adjuvant cytocentrifuge Gram stain. Am J Clin Pathol 105:210, 1996.

    PubMed  CAS  Google Scholar 

  48. Siegman-Igra Y, Anglim AM, Shapiro DE, Adal KA, Strain BA, Farr BM. Diagnosis of vascular catheter-related bloodstream infection: a metaanalysis. J Clin Microbiol 35:928, 1997.

    PubMed  CAS  Google Scholar 

  49. Maki DG, Alvarado CJ. The role of the clinical microbiology laboratory in diagnosis of infusion-related sepsis. Clin Microbiol Newsletter 4:89, 1982.

    Article  Google Scholar 

  50. Liñares J, Domínguez MA, Martin R. Current laboratory techniques in the diagnosis of catheter-related infections. Nutrition 13(Suppl.):10S, 1997.

    Article  PubMed  Google Scholar 

  51. Blot F, Nitenberg G, Chachaty E, Raynard B, Germann N, Antoun S, Laplanche A, Brun-Buisson C, Tancrede C. Diagnosis of catheter-related bacteraemia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures. Lancet 354:1071, 1999.

    Article  PubMed  CAS  Google Scholar 

  52. Atela I, Coll P, Rello J, Quintana E, Barrio J, March F, Sánchez F, Barraquer P, Ballús J, Cotura A, Prats G. Serial surveillance cultures of skin and catheter hub specimens from critically ill patients with central venous catheters: Molecular epidemiology of infection and implications for clinical management and research. J Clin Microbiol 35:1784, 1997.

    PubMed  CAS  Google Scholar 

  53. Capdevila JA. Catheter-related infecion: An update on diagnosis, treatment and prevention. Int J Infect Dis 2:230, 1998.

    Article  PubMed  CAS  Google Scholar 

  54. Sitges-Serra A, Girvent M. Catheter-related bloodstream infections. World J. Surg 23:589, 1999.

    Article  PubMed  Google Scholar 

  55. Ehni WF, Reller LB. Short-course therapy for catheter-associated Staphylococcus aureus bacteremia. Arch Intern Med 149:533, 1989.

    Article  PubMed  CAS  Google Scholar 

  56. Malanoski GJ, Samore MH, Pefanis A, Karchmer AW. Staphylococcus aureus catheter-associated bacteremia. Minimal effective therapy and unusual infectious complications associated with arterial sheath catheters. Arch Intern Med 155:1161, 1995.

    Article  PubMed  CAS  Google Scholar 

  57. Raad I, Narro J, Khan A, Tarrand J, Vartivarian S, Bodey GP. Serious complications of vascular catheter-related Staphylococcus aureus bacteremia in cancer patients. Eur J Clin Microbiol Infect Dis 11:675, 1992.

    Article  PubMed  CAS  Google Scholar 

  58. Sitges-Serra A, Hernández R, Maestro S, Pi-Suñer T, Garcés JM, Segura M. Prevention of catheter sepsis: the hub. Nutrition 13(Suppl.):30S, 1997.

    Article  PubMed  CAS  Google Scholar 

  59. Maki DG, Ringer M, Alvarado CJ. Prospective randomised trial of povidone-iodine, alcohol, and clorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 338:339, 1991.

    Article  PubMed  CAS  Google Scholar 

  60. Sitges-Serra A, Liñares J, Pérez JL, Jaurrieta E, Lorente L. A randomised trial on the effect of tubing changes on hub contamination and catheter sepsis during parenteral nutrition. J Parent Enter Nutr 9:322, 1985.

    Article  CAS  Google Scholar 

  61. Levin A, Mason AJ, Jindal KK, Fong IW, Goldstein MB. Prevention of hemodialysis subclavian vein catheter infections with topical povidone-iodine. Kidney Int 40:934, 1991.

    Article  PubMed  CAS  Google Scholar 

  62. Hoffmann KK, Weber DJ, Samsa GP, Rutala W. Transparent polyuretane film as an intravenous catheter dressing. JAMA 267:2072, 1992.

    Article  PubMed  CAS  Google Scholar 

  63. Hanrahan TO, Irving MH. The role of home parenteral nutrition in the management of intestinal failure — report of 400 cases. Clin Nutr 11:331, 1992.

    Article  Google Scholar 

  64. Halpin DP, O’Byrne P, MaEntee G, Hennessy ThPJ, Stephens RB. Effect of a betadine connection shield on central venous catheter sepsis. Nutrition 7:33, 1991.

    PubMed  CAS  Google Scholar 

  65. Brismar B, Jordahl L, Nystrom B, Petterson N. Bacterial contamination of intravenous line side ports of different designs. Clin Nutr 6:31, 1987.

    Article  Google Scholar 

  66. Snydman DR, Murray SA, Kornfeld EJ, Majka J A, Ellis CA. Total parenteral nutrition-related infections. Am J Med 73:695, 1982.

    Article  PubMed  CAS  Google Scholar 

  67. Pearson ML, the Hospital Infection Control Practices Advisory Committee. Guideline for prevention of intravascular-device-related infections. Infect Control Hosp Epidemiol 17:438, 1996.

    Article  PubMed  CAS  Google Scholar 

  68. Inoue Y, Nezu R, Matsuda H, Fujii M, Nakai S, Wasa M, Takagi Y, Okada A. Prevention of catheter-related sepsis during parenteral nutrition: effect of a new connection device. JPEN 16:581, 1992.

    Article  CAS  Google Scholar 

  69. Segura M, Alvarez F, Tellado JM, Jiménez-Farreres J, Oms L, Rello J, Baró T, Sánchez R, Morera A, Mariscal D, Marrugat J, Sitges-Serra A. A clinical trial on the prevention of catheter-related sepsis using a new hub model. Ann Surg 223:363, 1996.

    Article  PubMed  CAS  Google Scholar 

  70. Kamal GD, Pfaller MA, Rempe LE, Jebson PJ. Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. JAMA 265:2364, 1991.

    Article  PubMed  CAS  Google Scholar 

  71. Pemberton LB, Ross V, Cuddy P, Kremer H, Fessler T, McGurk E. No differences in catheter sepsis between standard and antiseptic central venous catheters. A prospective randomized trial. Arch Surg 131:986, 1996.

    Article  PubMed  CAS  Google Scholar 

  72. Heard SO, Wagle M, Vijayakumar E, McLean S, Brueggemann A, Napolitano LM, Edwards LP, O’Connell FM, Puyana JC, Doern G. Influence of triple-lumen central venous catheter coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia. Arch Int Med 158:81, 1998.

    Article  CAS  Google Scholar 

  73. Tenneberg S, Lieser M, McCurdy B, Boomer G, Howington E, Newman C, Wolf I. A prospective randomized trial of an antibiotic and antiseptic-coated central venous catheter in the prevention of catheter related infections. Arch Surg 132:1348, 1997.

    Article  Google Scholar 

  74. Ciresi DL, Albrecht RM, Volkers PA, Scholten DJ. Failure of antiseptic bonding to prevent central venous catheter-related infection and sepsis. Am Surg 62:641, 1996.

    PubMed  CAS  Google Scholar 

  75. Maki DG, Stolz SM, Wheeler S, Mermel LA. Prevention of central venous catheter-ralated bloodstream infection by use of an antiseptic-impregnated catheter. Ann Int Med 127:257, 1997.

    Article  PubMed  CAS  Google Scholar 

  76. Sherertz RJ, Heard SO, Raad II, Gentry L, Bowton D, Scuderi P, Hu, J, Carruth W, Satishchandra B, Pepe J, Mosenthal A, Burke T, Dupuis J. Gamma radiation-sterilized, triple lumen catheters coated with a low concentration of clorhexidine were not efficacious at preventing catheter infections in intensive care unit patients. Antimicrob Agents Chemother 40:1995, 1996.

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  78. Veentra DL, Saint S, Sullivan SD. Cost-effectiveness of antiseptic impregnated central venous catheters for the prevention of catheter-related bloodstream infections. JAMA 282:554, 1999.

    Article  Google Scholar 

  79. Terazawa E, Nagase K, Masue T, Niwa Y, Fukao I, Shimonaka H, Yokoi T, Kondoh N, Dohi S. Anaphylactic shock associated with a central venous catheter impregnated with chlorhexidine and silver sulfadiazine. Masui 47:556, 1998.

    PubMed  Google Scholar 

  80. 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, 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. Ann Int Med 127:267, 1997.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Meritxell Girvent
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  2. Antonio Sitges-Serra
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Editor information

Editors and Affiliations

  1. Hospital Universitari Joan XXIII, Tarragona, Spain

    Jordi Rello M.D., Ph.D.

  2. University Rovira & Virgili, Tarragona, Spain

    Jordi Rello M.D., Ph.D.

  3. Corporacio Sanitaria Parc Tauli, Sabadell, Barcelona, Spain

    Jordi Valles M.D., Ph.D.

  4. Washington University School of Medicine, St. Louis, Missouri, USA

    Marin H. Kollef M.D.

  5. Barnes-Jewish Hospital, St. Louis, Missouri, USA

    Marin H. Kollef M.D.

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Girvent, M., Sitges-Serra, A. (2001). Catheter-Related Bloodstream Infections in Total Parenteral Nutrition. In: Rello, J., Valles, J., Kollef, M.H. (eds) Critical Care Infectious Diseases Textbook. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1679-8_34

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