Skip to main content

Prevention of Central Venous Catheter-related Infection in the Intensive Care Unit

  • Chapter

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 2010))

Abstract

In the USA, more than five million patients require central venous access each year. Unfortunately, central venous access can be associated with adverse events that are hazardous to patients and expensive to treat. Infection remains the main complication of intravascular catheters in critically ill patients. Catheter-related bloodstream infections have been reported to occur in 3 to 8 % of inserted catheters and are the first cause of nosocomial bloodstream infection in intensive care units (ICUs), with 80,000 cases annually at a cost of $300 million to $2.3 billon [1]. Additional financial costs may be as high as $30,000 per survivor, including one extra week in the ICU and two to three additional weeks in the hospital. Attributable mortality rates range from 0 to 35 %, depending on the degree of control for severity of illness.

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

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

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

    CAS  PubMed  Google Scholar 

  2. O’Grady NP, Alexander M, Dellinger EP, et al. (2002) Guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol 23: 759–769

    Article  PubMed  Google Scholar 

  3. Herrmann M, Lai QJ, Albrecht RM, Mosher DF (2003) Adhesion of Staphylococcus aureus to surface-bound platelets: role of fibrinogen/fibrin and platelet integrins. J Infect Dis 167: 312–322

    Google Scholar 

  4. Centers for Disease Control and Prevention (2001) Issues in healthcare settings: CDC’s 7 Healthcare Safety Challenges. Available at: http://www.cdc.gov/ncidod/dhqp/about_challenges. html. Accessed November 26, 2009

    Google Scholar 

  5. Berenholtz SM, Pronovost PJ, Lipsett PA, et al (2004) Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med 32: 2014–2020

    Article  PubMed  Google Scholar 

  6. Warren, DK, Zack JE, Mayfield JL, et al (2004) The effect of an education programme on the incidence of central venous catheter-associated bloodstream infection in a medical ICU. Chest 126: 1612–1618

    Article  PubMed  Google Scholar 

  7. Eggimann P, Harbarth S, Constantin MN, Touveneau S, Chevrolet JC, Pittet D (2000) Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 355: 1864–1868

    Article  CAS  PubMed  Google Scholar 

  8. L’Hériteau F, Olivier M, Maugat S (2007) Impact of a five-year surveillance of central venous catheter infections in the REACAT intensive care unit network in France. J Hosp Infect 66: 123–129

    Article  Google Scholar 

  9. Yilmaz G, Koksal I, Aydin K, Caylan R, Sucu N, Aksoy F (2007) Risk factors of catheterrelated bloodstream infections in parenteral nutrition catheterization. J Parenter Enteral Nutr 31: 284–287

    Article  Google Scholar 

  10. Zingg W, Imhof A, Maggiorini M, Stocker R, Keller E, Ruef C (2009) Impact of a prevention strategy targeting hand hygiene and catheter care on the incidence of catheter-related bloodstream infections. Crit Care Med 37: 2167–2173

    Article  PubMed  Google Scholar 

  11. Barsuk JH, Cohen ER, Feinglass J, McGaghie WC, Wayne DB (2009) Use of simulation-based education to reduce catheter-related bloodstream infections. Arch Intern Med 169: 1420–1423

    Article  PubMed  Google Scholar 

  12. Soifer NE, Borzak S, Edlin BR, Weinstein RA (1998) Prevention of peripheral venous catheter complications with an intravenous therapy team: a randomized controlled trial. Arch Intern Med 158: 473–477

    Article  CAS  PubMed  Google Scholar 

  13. Puntis JW, Holden CE, Smallman S, Finkel Y, George RH, Booth IW (1991) Staff training: a key factor in reducing intravascular catheter sepsis. Arch Dis Child 66: 335–337

    Article  CAS  PubMed  Google Scholar 

  14. Fridkin SK, Pear SM, Williamson TH, Galgiani JN, Jarvis WR (1996) The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 17: 150–158

    Article  CAS  PubMed  Google Scholar 

  15. Alonso-Echanove J, Edwards JR, Richards MJ, et al (2003) Effect of nurse staffing and antimicrobial-impregnated central venous catheters on the risk for bloodstream infections in intensive care units. Infect Control Hosp Epidemiol 24: 916–925

    Article  PubMed  Google Scholar 

  16. Maki DG, Ringer M (1991) Risk factors for infusion-related phlebitis with small peripheral venous catheters: a randomized controlled trial. Ann Intern Med 114: 845–854

    CAS  PubMed  Google Scholar 

  17. Sheth NK, Franson TR, Rose HD, Buckmire FL, Cooper JA, Sohnle PG (1983) Colonization of bacteria on polyvinyl chloride and Teflon intravascular catheters in hospitalized patients. J Clin Microbiol 18: 1061–1063

    CAS  PubMed  Google Scholar 

  18. Halton KA, Cook DA, Whitby M, Paterson DL, Graves N (2009) Cost effectiveness of antimicrobial catheters in the intensive care unit: addressing uncertainty in the decision. Crit Care 13: R35

    Article  PubMed  Google Scholar 

  19. Raad I, Buzaid A, Rhyne J (1997) Minocycline and ethylenediaminetetraacetate for the prevention of recurrent vascular catheter infections. Clin Infect Dis 25: 149–151

    Article  CAS  PubMed  Google Scholar 

  20. Ramritu P, Halton K, Collignon P (2008) A systematic review comparing the relative effectiveness of antimicrobial-coated catheters in intensive care units. Am J Infect Control 36: 104–117

    Article  PubMed  Google Scholar 

  21. Kalfon P, de Vaumas C, Samba D (2007) Comparison of silver-impregnated with standard multi-lumen central venous catheters in critically ill patients. Crit Care Med 35: 1032–1039

    Article  PubMed  Google Scholar 

  22. Hockenhull JC, Dwan KM, Smith GW (2009) The clinical effectiveness of central venous catheters treated with anti-infective agents in preventing catheter-related bloodstream infections: a systematic review. Crit Care Med 37: 702–712

    Article  CAS  PubMed  Google Scholar 

  23. Dezfulian C, Lavelle J, Nallamothu BK, Kaufman SR, Saint S (2003) Rates of infection for single-lumen versus multilumen central venous catheters: a meta-analysis. Crit Care Med 31: 2385–2390

    Article  PubMed  Google Scholar 

  24. Merrer J, De Jonghe B, Golliot F; French Catheter Study Group in Intensive Care (2001) Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 286: 700–707

    Google Scholar 

  25. Ruesch S, Walder B, Tramér MR (2002) Complications of central venous catheters: internal jugular versus subclavian access — a systematic review. Crit Care Med 30: 454–460

    Article  PubMed  Google Scholar 

  26. Parienti JJ, Thirion M, Mégarbane B, et al (2008) Femoral vs jugular venous catheterization and risk of nosocomial events in adults requiring acute renal replacement therapy: a randomized controlled trial. JAMA 299: 2413–2422

    Article  CAS  PubMed  Google Scholar 

  27. Randolph AG, Cook DJ, Gonzales CA, Pribble CG (1996) Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature. Crit Care Med 24: 2053–2058

    Article  CAS  PubMed  Google Scholar 

  28. Karakitsos D, Labropoulos N, De Groot E (2006) Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care 10: R162

    Article  PubMed  Google Scholar 

  29. Raad II, Hohn DC, Gilbreath BJ, et al (1994) Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 15: 231–238

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  31. Balamongkhon B, Thamlikitkul V (2007) Implementation of chlorhexidine gluconate for central venous catheter site care at Siriraj Hospital, Bangkok, Thailand. Am J Infect Control 35: 585–588

    Article  PubMed  Google Scholar 

  32. Parienti JJ, du Cheyron D, Ramakers M, et al (2004) Alcoholic povidone-iodine to prevent central venous catheter colonization: a randomized unit-crossover study. Crit Care Med 32: 708–713

    Article  CAS  PubMed  Google Scholar 

  33. Mimoz O, Villeminey S, Ragot S (2007) Chlorhexidine-based antiseptic solution versus alcohol-based povidone-iodine for central venous catheter care. Arch Intern Med 167: 2066–2072

    Article  CAS  PubMed  Google Scholar 

  34. Spafford PS, Sinkin RA, Cox C (1994) Prevention of central venous catheter-related coagulase-negative staphylococcal sepsis in neonates. J Pediatr 125: 259–263

    Article  CAS  PubMed  Google Scholar 

  35. Kacica MA, Horgan MJ, Ochoa L, Sandler R, Lepow ML, Venezia RA (1994) Prevention of gram-positive sepsis in neonates weighing less than 1500 g. J Pediatr 125: 253–258

    Article  CAS  PubMed  Google Scholar 

  36. Randolph AG, Cook DJ, Gonzales CA, Brun-Buisson C (1998) Tunneling short-term central venous catheters to prevent catheter-related infection: a meta-analysis of randomized, controlled trials. Crit Care Med 26: 1452–1457

    Article  CAS  PubMed  Google Scholar 

  37. Ho KM, Litton E (2006) Use of chlorhexidine-impregnated dressing to prevent vascular and epidural catheter colonization and infection: a meta-analysis. J Antimicrob Chemother 58: 281–287

    Article  CAS  PubMed  Google Scholar 

  38. Timsit JF, Schwebel C, Bouadma L, et al (2009) Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA 301: 1231–1241

    Article  CAS  PubMed  Google Scholar 

  39. Maki DG, Botticelli JT, LeRoy ML, Thielke TS (1987) Prospective study of replacing administration sets for intravenous therapy at 48-vs 72-hour intervals: 72 hours is safe and costeffective. JAMA 258: 1777–1781

    Article  CAS  PubMed  Google Scholar 

  40. Raad I, Hanna HA, Awad A, et al (2001) Optimal frequency of changing intra-venous administration sets: is it safe to prolong use beyond 72 hours? Infect Control Hosp Epidemiol 22: 136–139

    Article  CAS  PubMed  Google Scholar 

  41. Band JD, Maki DG (1979) Safety of changing intravenous delivery systems at longer than 24-hour intervals. Ann Intern Med 91: 173–178

    CAS  PubMed  Google Scholar 

  42. Gillies D, O’Riordan L, Wallen M, Rankin K, Morrison A, Nagy S (2004) Timing of intravenous administration set changes: a systematic review. Infect Control Hosp Epidemiol 25: 240–250

    Article  PubMed  Google Scholar 

  43. Sitges-Serra A, Linares J, Perez JL, Jaurrieta E, Lorente L (1985) A randomized trial on the effect of tubing changes on hub colonization and catheter sepsis during parenteral nutrition. JPEN J Parenter Enteral Nutr 9: 322–325

    Article  CAS  PubMed  Google Scholar 

  44. Salzman MB, Isenberg HD, Rubin LG (1993) Use of disinfectants to reduce microbial contamination of hubs of vascular catheters. J Clin Microbiol 31: 475–479

    CAS  PubMed  Google Scholar 

  45. Khalifa R, Dahyot-Fizelier C, Laksiri L (2008) Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients. Intensive Care Med 34: 1820–1826

    Article  PubMed  Google Scholar 

  46. Cobb DK, High KP, Sawyer RG (1992) A controlled trial of scheduled replacement of central venous and pulmonary artery catheter. N Engl J Med 327: 1062–1068

    CAS  PubMed  Google Scholar 

  47. Cook D, Randolph A, Kemerman P, et al (1997) Central venous catheter replacement strategies: A systematic review of the literature. Crit Care Med 25: 1417–1424

    Article  CAS  PubMed  Google Scholar 

  48. Zakrzewska-Bode A, Muytjens HL, Liem KD, Hoogkamp-Korstanje JA (1995) Mupirocin resistance in coagulase-negative staphylococci, after topical prophylaxis for the reduction of colonization of central venous catheters. J Hosp Infect 31: 189–193

    Article  CAS  PubMed  Google Scholar 

  49. Randolph AG, Cook DJ, Gonzales CA, Andrew M (1998) Benefit of heparin in central venous and pulmonary artery catheters: a meta-analysis of randomized controlled trials. Chest 113: 165–171

    Article  CAS  PubMed  Google Scholar 

  50. Pronovost P, Needham D, Berenholtz S (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355: 2725–2732

    Article  CAS  PubMed  Google Scholar 

  51. Timsit JF (2007) Diagnosis and prevention of catheter-related infections. Curr Opin Crit Care 13: 563–571

    Article  PubMed  Google Scholar 

  52. Mermel LA, Farr BM, Sherertz RJ et al (2001) Guidelines for the management of intravascular catheter-related infections. Infect Control Hosp Epidemiol 22: 222–242

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Frasca, D., Dahyot-Fizelier, C., Mimoz, O. (2010). Prevention of Central Venous Catheter-related Infection in the Intensive Care Unit. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 2010. Yearbook of Intensive Care and Emergency Medicine, vol 2010. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-10286-8_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-10286-8_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-10285-1

  • Online ISBN: 978-3-642-10286-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics