Skip to main content
SpringerLink
Log in

Hospital-Acquired Catheter-Related Bloodstream Infection Prevention

  • Chapter
  • First Online:
Nursing in Critical Care Setting

  • 2381 Accesses

Abstract

Intravascular catheters are widely used in ICU, both for monitoring and therapeutic purposes (fluid, drugs, parenteral nutrition, blood and blood components administration, hemodialysis, and renal replacement therapy). Among indwelling catheter complications, infections represent probably the most challenging one and account for increased length of hospitals and ICU stay, costs, and related mortality. Several guidelines have been edited and disseminated to allow a more homogeneous and evidence-based approach to intravascular catheter management. Nurses apply these approaches in daily interventions, such as catheter dressing, hub disinfection, and line replacement. Whenever an intravascular catheter is in place, a team approach should always be adopted, including the daily evaluation for catheter need. Adherence to guidelines should be monitored, and educational interventions are provided to staff. Therefore, each team should identify and promote the application of bundled interventions for catheter management.

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

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D, Sepsis Occurrence in Acutely Ill Patients Investigators. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006;34(2):344–53.

    Article  PubMed  Google Scholar 

  2. Stevens V, Geiger K, Concannon C, Nelson RE, Brown J, Dumyati G. Inpatient costs, mortality and 30-day re-admission in patients with central-line-associated bloodstream infections. Clin Microbiol Infect. 2014;20(5):O318–24. https://doi.org/10.1111/1469-0691.12407.

    Article  PubMed  CAS  Google Scholar 

  3. Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, Browne J, Prieto J, Wilcox M, UK Department of Health. Epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;86(Suppl 1):S1–70. https://doi.org/10.1016/S0195-6701(13)60012-2.

    Article  PubMed  Google Scholar 

  4. O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S, Healthcare Infection Control Practices Advisory Committee. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4 Suppl 1):S1–34. https://doi.org/10.1016/j.ajic.2011.01.003.

    Article  PubMed  Google Scholar 

  5. Shah H, Bosch W, Thompson KM, Hellinger WC. Intravascular catheter-related bloodstream infection. Neurohospitalist. 2013;3(3):144–51. https://doi.org/10.1177/1941874413476043.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Timsit JF. Diagnosis and prevention of catheter-related infections. Curr Opin Crit Care. 2007;13(5):563–71. https://doi.org/10.1097/MCC.0b013e3282efa03f.

    Article  PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention. NHSN Patient Safety Component Manual. https://www.cdc.gov/nhsn/pdfs/validation/2016/pcsmanual_2016.pdf. Accessed 28 Apr 2016.

  8. Timsit JF, Dubois Y, Minet C, Bonadona A, Lugosi M, Ara-Somohano C, Hamidfar-Roy R, Schwebel C. New challenges in the diagnosis, management, and prevention of central venous catheter-related infections. Semin Respir Crit Care Med. 2011;32(2):139–50. https://doi.org/10.1055/s-0031-1275526.

    Article  PubMed  Google Scholar 

  9. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, Raad II, Rijnders BJ, Sherertz RJ, Warren DK. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(1):1–45. https://doi.org/10.1086/599376.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Bekeris LG, Tworek JA, Walsh MK, Valenstein PN. Trends in blood culture contamination: a College of American Pathologists Q-tracks study of 356 institutions. Arch Pathol Lab Med. 2005;129(10):1222–5. https://doi.org/10.1043/1543-2165(2005)129[1222:TIBCCA]2.0.CO;2.

    Article  PubMed  Google Scholar 

  11. Garcia RA, Spitzer ED, Beaudry J, Beck C, Diblasi R, Gilleeny-Blabac M, Haugaard C, Heuschneider S, Kranz BP, McLean K, Morales KL, Owens S, Paciella ME, Torregrosa E. Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central line-associated bloodstream infections. Am J Infect Control. 2015;43(11):1222–37. https://doi.org/10.1016/j.ajic.2015.06.030.

    Article  PubMed  Google Scholar 

  12. Self WH, Mickanin J, Grijalva CG, Grant FH, Henderson MC, Corley G, Blaschke Ii DG, McNaughton CD, Barrett TW, Talbot TR, Paul BR. Reducing blood culture contamination in community hospital emergency departments: a multicenter evaluation of a quality improvement intervention. Acad Emerg Med. 2014;21(3):274–82. https://doi.org/10.1111/acem.12337.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Washer LL, Chenoweth C, Kim HW, Rogers MA, Malani AN, Riddell J 4th, Kuhn L, Noeyack B Jr, Neusius H, Newton DW, Saint S, Flanders SA. Blood culture contamination: a randomized trial evaluating the comparative effectiveness of 3 skin antiseptic interventions. Infect Control Hosp Epidemiol. 2013;34(1):15–21. https://doi.org/10.1086/668777.

    Article  PubMed  Google Scholar 

  14. Maiwald M, Chan ES. The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. PLoS One. 2012;7(9):e44277. https://doi.org/10.1371/journal.pone.0044277.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Kim NH, Kim M, Lee S, Yun NR, Kim KH, Park SW, Kim HB, Kim NJ, Kim EC, Park WB, Oh MD. Effect of routine sterile gloving on contamination rates in blood culture: a cluster randomized trial. Ann Intern Med. 2011;154(3):145–51. https://doi.org/10.7326/0003-4819-154-3-201102010-00003.

    Article  PubMed  Google Scholar 

  16. Clinical and laboratory Standards Institute (CLSI). Principles and procedures for blood cultures: approved guideline. CLSI document M47-a. Wayne (PA): Clinical and Laboratory Standards Institute; 2007.

    Google Scholar 

  17. Schifman RB, Strand CL, Meier FA, Howanitz PJ. Blood culture contamination: a College of American Pathologists Q-probes study involving 640 institutions and 497134 specimens from adult patients. Arch Pathol Lab Med. 1998;122(3):216–21.

    PubMed  CAS  Google Scholar 

  18. De Keukeleire S, Wybo I, Naessens A, Echahidi F, Van der Beken M, Vandoorslaer K, Vermeulen S, Piérard D. Anaerobic bacteraemia: a 10-year retrospective epidemiological survey. Anaerobe. 2016;39:54–9. https://doi.org/10.1016/j.anaerobe.2016.02.009.

    Article  PubMed  Google Scholar 

  19. Mermel LA. What is the predominant source of intravascular catheter infections? Clin Infect Dis. 2011;52:211–2. https://doi.org/10.1093/cid/ciq108.

    Article  PubMed  Google Scholar 

  20. Bouza E, Alvarado N, Alcala L, et al. A randomized and prospective study of 3 procedures for the diagnosis of catheter-related bloodstream infection without catheter withdrawal. Clin Infect Dis. 2007;44:820–6. https://doi.org/10.1086/511865.

    Article  PubMed  Google Scholar 

  21. Rijnders BJ, Peetermans WE, Verwaest C, Wilmer A, Van Wijngaerden E. Watchful waiting versus immediate catheter removal in ICU patients with suspected catheter-related infection: a randomized trial. Intensive Care Med. 2004;30(6):1073–80. https://doi.org/10.1007/s00134-004-2212-x.

    Article  PubMed  Google Scholar 

  22. Lorente L, Martín MM, Vidal P, Rebollo S, Ostabal MI, Solé-Violán J, Working Group on Catheter Related Infection Suspicion Management of GTEIS/SEMICYUC. Should central venous catheter be systematically removed in patients with suspected catheter related infection? Crit Care. 2014;18(5):564. https://doi.org/10.1186/s13054-014-0564-3.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tacconelli E, Smith G, Hieke K, Lafuma A, Bastide P. Epidemiology, medical outcomes and costs of catheter-related bloodstream infections in intensive care units of four European countries: literature- and registry-based estimates. J Hosp Infect. 2009;72(2):97–103. https://doi.org/10.1016/j.jhin.2008.12.012.

  24. NNIS System. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1990-may 1999, issued June 1999. A report from the NNIS system. Am J Infect Control. 1999;27(6):520–32.

    Article  Google Scholar 

  25. Safdar N, O’Horo JC, Maki DG. Arterial catheter-related bloodstream infection: incidence, pathogenesis, risk factors and prevention. J Hosp Infect. 2013;85(3):189–95. https://doi.org/10.1016/j.jhin.2013.06.018.

    Article  PubMed  CAS  Google Scholar 

  26. Safdar N, Maki DG. The pathogenesis of catheter-related bloodstream infection with noncuffed short-term central venous catheters. Intensive Care Med. 2004;30(1):62–7. https://doi.org/10.1007/s00134-003-2045-z.

    Article  PubMed  Google Scholar 

  27. Blot F, Chachaty E, Raynard B, Antoun S, Bourgain JL, Nitenberg G. Mechanisms and risk factors for infection of pulmonary artery catheters and introducer sheaths in cancer patients admitted to an intensive care unit. J Hosp Infect. 2001;48(4):289–97. https://doi.org/10.1053/jhin.2001.1014.

  28. Mermel LA, McCormick RD, Springman SR, Maki DG. The pathogenesis and epidemiology of catheter-related infection with pulmonary artery swan-Ganz catheters: a prospective study utilizing molecular subtyping. Am J Med. 1991;91(3B):197S–205S.

    Article  CAS  PubMed  Google Scholar 

  29. Safdar N, Kluger DM, Maki DG. A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, noncuffed central venous catheters: implications for preventive strategies. Medicine (Baltimore). 2002;81(6):466–79.

    Article  Google Scholar 

  30. Lindsay D, von Holy A. Bacterial biofilms within the clinical setting: what healthcare professionals should know. J Hosp Infect. 2006;64(4):313–25. https://doi.org/10.1016/j.jhin.2006.06.028.

    Article  PubMed  CAS  Google Scholar 

  31. Marrie TJ, Costerton JW. Scanning and transmission electron microscopy of in situ bacterial colonization of intravenous and intraarterial catheters. J Clin Microbiol. 1984;19:687–93.

    PubMed  PubMed Central  CAS  Google Scholar 

  32. Hansen S, Schwab F, Schneider S, Sohr D, Gastmeier P, Geffers C. Time-series analysis to observe the impact of a centrally organized educational intervention on the prevention of central-line-associated bloodstream infections in 32 German intensive care units. J Hosp Infect. 2014;87(4):220–6. https://doi.org/10.1016/j.jhin.2014.04.010.

    Article  PubMed  CAS  Google Scholar 

  33. Pronovost P. Interventions to decrease catheter-related bloodstream infections in the ICU: the keystone intensive care unit project. Am J Infect Control. 2008;36(10):S171.e1–5. https://doi.org/10.1016/j.ajic.2008.10.008.

    Article  Google Scholar 

  34. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, Sexton B, Hyzy R, Welsh R, Roth G, Bander J, Kepros J, Goeschel C. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355(26):2725–32. https://doi.org/10.1056/NEJMoa061115.

    Article  PubMed  CAS  Google Scholar 

  35. Palomar M, Álvarez-Lerma F, Riera A, Díaz MT, Torres F, Agra Y, Larizgoitia I, Goeschel CA, Pronovost PJ, Bacteremia Zero Working Group. Impact of a national multimodal intervention to prevent catheter-related bloodstream infection in the ICU: the Spanish experience. Crit Care Med. 2013;41(10):2364–72. https://doi.org/10.1097/CCM.0b013e3182923622.

    Article  PubMed  Google Scholar 

  36. Parienti JJ, Mongardon N, Mégarbane B, Mira JP, Kalfon P, Gros A, Marqué S, Thuong M, Pottier V, Ramakers M, Savary B, Seguin A, Valette X, Terzi N, Sauneuf B, Cattoir V, Mermel LA, du Cheyron D, 3SITES Study Group. Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 2015;373(13):1220–9. https://doi.org/10.1056/NEJMoa1500964.

    Article  PubMed  CAS  Google Scholar 

  37. Parienti JJ, du Cheyron D, Timsit JF, Traoré O, Kalfon P, Mimoz O, Mermel LA. Meta-analysis of subclavian insertion and nontunneled central venous catheter-associated infection risk reduction in critically ill adults. Crit Care Med. 2012;40(5):1627–34. https://doi.org/10.1097/CCM.

    Article  PubMed  Google Scholar 

  38. Mimoz O, Lucet JC, Kerforne T, Pascal J, Souweine B, Goudet V, Mercat A, Bouadma L, Lasocki S, Alfandari S, Friggeri A, Wallet F, Allou N, Ruckly S, Balayn D, Lepape A, Timsit JF, CLEAN trial investigators. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet. 2015;386(10008):2069–77. https://doi.org/10.1016/S0140-6736(15)00244-5.0b013e31823e99cb.

    Article  PubMed  CAS  Google Scholar 

  39. Ullman AJ, Cooke ML, Mitchell M, Lin F, New K, Long DA, Mihala G, Rickard CM. Dressings and securement devices for central venous catheters (CVC). Cochrane Database Syst Rev. 2015;9:CD010367. https://doi.org/10.1002/14651858.CD010367.pub2.

    Article  Google Scholar 

  40. Webster J, Gillies D, O’Riordan E, Sherriff KL, Rickard CM. Gauze and tape and transparent polyurethane dressings for central venous catheters. Cochrane Database Syst Rev. 2011;9:003827. https://doi.org/10.1002/14651858.CD003827.pub2.

    Article  Google Scholar 

  41. Gavin NC, Webster J, Chan RJ, Rickard CM. Frequency of dressing changes for central venous access devices on catheter-related infections. Cochrane Database Syst Rev. 2016;2:CD009213. https://doi.org/10.1002/14651858.CD009213.pub2.

    Article  PubMed  Google Scholar 

  42. Günther SC, Schwebel C, Hamidfar-Roy R, Bonadona A, Lugosi M, Ara-Somohano C, Minet C, Potton L, Cartier JC, Vésin A, Chautemps M, Styfalova L, Ruckly S, Timsit JF. Complications of intravascular catheters in ICU: definitions, incidence and severity. A randomized controlled trial comparing usual transparent dressings versus new-generation dressings (the ADVANCED study). Intensive Care Med. 2016;42(11):1753–65. https://doi.org/10.1007/s00134-016-4582-2.

  43. Loveday HP, Wilson JA, Prieto J, Wilcox MH. epic3: revised recommendation for intravenous catheter and catheter site care. J Hosp Infect. 2016;92(4):346–8. https://doi.org/10.1016/j.jhin.2015.11.011.

    Article  PubMed  CAS  Google Scholar 

  44. Ullman AJ, Cooke ML, Gillies D, Marsh NM, Daud A, McGrail MR, O’Riordan E, Rickard CM. Optimal timing for intravascular administration set replacement. Cochrane Database Syst Rev. 2013;9:CD003588. https://doi.org/10.1002/14651858.CD003588.pub3.

    Article  Google Scholar 

  45. Lucchini A, Angelini S, Losurdo L, Giuffrida A, Vanini S, Elli S, Cannizzo L, Gariboldi R, Bambi S, Fumagalli R. The impact of closed system and 7 days intravascular administration set replacement on catheter related infections in a general intensive care unit: a before-after study. Assist Inferm Ric. 2015;34(3):125–33. https://doi.org/10.1702/2038.22138.

    Article  PubMed  Google Scholar 

  46. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA, Gervasio JM, Sacks GS, Roberts PR, Compher C, Society of Critical Care Medicine, American Society for Parenteral and Enteral Nutrition. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (a.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159–211. https://doi.org/10.1177/0148607115621863.

    Article  PubMed  CAS  Google Scholar 

  47. Opilla M. Epidemiology of bloodstream infection associated with parenteral nutrition. Am J Infect Control. 2008;36:S173.e5–8.

    Article  Google Scholar 

  48. Turpin RS, Canada T, Rosenthal V, Nitzki-George D, Liu FX, Mercaldi CJ, Pontes-Arruda A, IMPROVE Study Group. Bloodstream infections associated with parenteral nutrition preparation methods in the United States: a retrospective, large database analysis. JPEN J Parenter Enteral Nutr. 2012;36(2):169–76. https://doi.org/10.1177/0148607111414714.

    Article  PubMed  Google Scholar 

  49. Melly MA, Meng HC, Schaffner W. Microbial growth in lipid emulsions used in parenteral nutrition. Arch Surg. 1975;110(12):1479–81.

    Article  CAS  PubMed  Google Scholar 

  50. Pontes-Arruda A, Liu FX, Turpin RS, Mercaldi CJ, Hise M, Zaloga G. Bloodstream infections in patients receiving manufactured parenteral nutrition with vs without lipids: is the use of lipids really deleterious? JPEN J Parenter Enteral Nutr. 2012;36(4):421–30. https://doi.org/10.1177/0148607111420061.

    Article  PubMed  CAS  Google Scholar 

  51. McCleary EJ, Tajchman S. Parenteral nutrition and infection risk in the intensive care unit: a practical guide for the bedside clinician. Nutr Clin Pract. 2016;31(4):476–89. https://doi.org/10.1177/0884533616653808.

    Article  PubMed  CAS  Google Scholar 

  52. Lockman JL, Heitmiller ES, Ascenzi JA, Berkowitz I. Scrub the hub! Catheter needleless port decontamination. Anesthesiology. 2011;114:958. https://doi.org/10.1097/ALN.0b013e3182054bd1.

    Article  PubMed  Google Scholar 

  53. Simmons S, Bryson C, Porter S. “Scrub the hub”: cleaning duration and reduction in bacterial load on central venous catheters. Crit Care Nurs Q. 2011;34:31–5. https://doi.org/10.1097/CNQ.0b013e3182048073.

    Article  PubMed  Google Scholar 

  54. Rupp ME, Yu S, Huerta T, et al. Adequate disinfection of a split-septum needleless intravascular connector with a 5-second alcohol scrub. Infect Control Hosp Epidemiol. 2012;33:661–5. https://doi.org/10.1086/666337.

    Article  PubMed  Google Scholar 

  55. Hadaway L. Needleless connectors for IV catheters. Am J Nurs. 2012;112(11):32–44.; quiz 45. https://doi.org/10.1097/01.NAJ.0000422253.72836.c1.

    Article  PubMed  Google Scholar 

  56. Moureau NL, Flynn J. Disinfection of needleless connector hubs: clinical evidence systematic review. Nurs Res Pract. 2015;2015:796762. https://doi.org/10.1155/2015/796762.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Macias JH, Arreguin V, Munoz JM, Alvarez JA, Mosqueda JL, Macias AE. Chlorhexidine is a better antiseptic than povidone iodine and sodium hypochlorite because of its substantive effect. Am J Infect Control. 2013;41(7):634–7. https://doi.org/10.1016/j.ajic.2012.10.002.

    Article  PubMed  CAS  Google Scholar 

  58. Kamboj M, Blair R, Bell N, Son C, Huang YT, Dowling M, Lipitz-Snyderman A, Eagan J, Sepkowitz K. Use of disinfection cap to reduce central-line-associated bloodstream infection and blood culture contamination among hematology-oncology patients. Infect Control Hosp Epidemiol. 2015;36(12):1401–8. https://doi.org/10.1017/ice.2015.219.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lai NM, Chaiyakunapruk N, Lai NA, O’Riordan E, Pau WS, Saint S. Catheter impregnation, coating or bonding for reducing central venous catheter-related infections in adults. Cochrane Database Syst Rev. 2016;3:CD007878. https://doi.org/10.1002/14651858.CD007878.pub3.

    Article  PubMed  Google Scholar 

  60. Bonne S, Mazuski JE, Sona C, Schallom M, Boyle W, Buchman TG, Bochicchio GV, Coopersmith CM, Schuerer DJ. Effectiveness of minocycline and rifampin vs Chlorhexidine and silver sulfadiazine-impregnated central venous catheters in preventing central line-associated bloodstream infection in a high-volume academic intensive care unit: a before and after trial. J Am Coll Surg. 2015;221(3):739–47. https://doi.org/10.1016/j.jamcollsurg.2015.05.013.

    Article  PubMed  Google Scholar 

  61. Institute for Healthcare Improvement. How-to guide: preventing central-line associated bloodstream infection. http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventCentralLineAssociatedBloodstreamInfection.aspx. Accessed 28 Apr 2016.

  62. Theodoro D, Olsen MA, Warren DK, McMullen KM, Asaro P, Henderson A, Tozier M, Fraser V. Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices. Acad Emerg Med. 2015;22(9):1048–55. https://doi.org/10.1111/acem.12744.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Jeong IS, Park SM, Lee JM, Song JY, Lee SJ. Effect of central line bundle on central line-associated bloodstream infections in intensive care units. Am J Infect Control. 2013;41(8):710–6. https://doi.org/10.1016/j.ajic.2012.10.010.

    Article  PubMed  Google Scholar 

  64. Tang HJ, Lin HL, Lin YH, Leung PO, Chuang YC, Lai CC. The impact of central line insertion bundle on central line-associated bloodstream infection. BMC Infect Dis. 2014;14:356. https://doi.org/10.1016/j.jhin.2008.12.012.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Osorio J, Álvarez D, Pacheco R, Gómez CA, Lozano A. Implementation of an insertion bundle for preventing central line-associated bloodstream infections in an intensive care unit in Colombia. Rev Chil Infectol. 2013;30(5):465–73. https://doi.org/10.4067/S0716-10182013000500001.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Anesthesia and Intensive Care Unit, University Hospital S. Maria della Misericordia, Udine, Italy

    Irene Comisso

  2. General Intensive Care Unit, San Gerardo Hospital, ASST Monza, University of Milano-Bicocca, Milan, Italy

    Alberto Lucchini

Authors
  1. Irene Comisso
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alberto Lucchini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Irene Comisso or Alberto Lucchini .

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Comisso, I., Lucchini, A. (2018). Hospital-Acquired Catheter-Related Bloodstream Infection Prevention. In: Nursing in Critical Care Setting. Springer, Cham. https://doi.org/10.1007/978-3-319-50559-6_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-50559-6_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50558-9

  • Online ISBN: 978-3-319-50559-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation