4.3 Review

Diagnosis and prevention of catheter-related infections

Journal

CURRENT OPINION IN CRITICAL CARE
Volume 13, Issue 5, Pages 563-571

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCC.0b013e3282efa03f

Keywords

catheter-related infection; diagnosis; prevention

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Purpose of review To highlight the major advances in diagnosing and preventing catheter-related infections published in research articles published between March 2004 and May 2007. Recent findings The challenge remains to make the diagnosis of cathete r- related infection with good accuracy without catheter removal. The differential time to obtain positive qualitative blood culture appeared to be the most accurate available technique. Many catheter- related bloodstream infections are preventable. Simple interventions are often useful and multimodal programs are very efficacious, particularly in the intensive care setting. For long-term catheter-related bloodstream infection prevention, patient education appeared promising. Interesting evidence suggested that anticoagulant, by decreasing the biofilm formation, could decrease the risk of infection. For short-term central venous catheter-related infections research is ongoing on antiseptic dressings. Antiseptic lock appeared promising for preventing long-term central venous catheter bloodstream infections. Summary Nowadays, multimodal programs of catheter infection prevention are efficacious, Levels of catheter- related bloodstream infection of more than one or two per 1000 catheter-days are usually only found in the intensive care unit. It is a prerequisite to evaluate the cost-effectiveness of new techniques of prevention. As catheter-related bloodstream infections become rarer, strategies limiting unnecessary removal of catheters need to be developed and tested.

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