Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- 101 Prevention of Nosocomial Infection in Staff and Patients
- 102 Percutaneous Injury: Risks and Management
- 103 Hospital-Acquired Fever
- 104 Transfusion-Related Infection
- 105 Intravascular Catheter-Related Infections
- 106 Infections Associated with Urinary Catheters
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
105 - Intravascular Catheter-Related Infections
from Part XIII - Nosocomial Infection
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- 101 Prevention of Nosocomial Infection in Staff and Patients
- 102 Percutaneous Injury: Risks and Management
- 103 Hospital-Acquired Fever
- 104 Transfusion-Related Infection
- 105 Intravascular Catheter-Related Infections
- 106 Infections Associated with Urinary Catheters
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Central venous catheter (CVC) use is primarily directed to secure a vascular access for fluids, medications, blood products, total parenteral nutrition (TPN), and hemodialysis. Their use is not limited only to inpatients but also to the outpatient settings. The national nosocomial infection surveillance system reported that the rate of catheter-related bloodstream infection (CRBSI) ranges from 2.1 to 30.2 BSIs per 1000 vascular catheter days. More than 80 000 CRBSIs are estimated to occur annually in the intensive care units (ICUs) in the United States with an attributable mortality ranging from 12% to 25%. In the initially ill patient, the direct implication of CRBSI is an extension of hospital stay by an average of 6 to 7 days; the added cost ranges from $28 690 to $56 167 per each individual episode in ICU patients.
PATHOGENESIS
Colonization is universal after insertion of a CVC, can occur as early as 1 day after insertion, and is quantitatively independent of a catheter-related infection. Electron microscopy studies of catheter surfaces show that adherent microorganisms can be found in either a free-floating form or sessile form embedded in a bioifilm.
The dynamic process of adherence is the result of the interaction of three factors: the intrinsic properties of the catheter, microbial factors, and host-derived proteins. The physical characteristics of the catheter, such as surface irregularities and charge difference, facilitate bacterial adherence.
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- Chapter
- Information
- Clinical Infectious Disease , pp. 755 - 760Publisher: Cambridge University PressPrint publication year: 2008