Hostname: page-component-77c89778f8-7drxs Total loading time: 0 Render date: 2024-07-19T07:39:18.394Z Has data issue: false hasContentIssue false
  • English
  • Français

Guideline for Prevention of Intravascular-Device–Related Infections

Published online by Cambridge University Press:  02 January 2015

Michele L. Pearson  and
Hospital Infection Control Practices Advisory Committee
Michele L. Pearson*
Affiliation:
Public Health Service, US Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Hospital Infections Program, Mailstop E69, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Atlanta, GA 30333
Get access Rights & Permissions [Opens in a new window]

Extract

The “Guideline for Prevention of Intravascular Device-Related Infections” is designed to reduce the incidence of intravascular device-related infections by providing an over view of the evidence for recommendations considered prudent by consensus of Hospital Infection Control Practices Advisor y Committee (HICPAC) members. This two-part document updates and replaces the previously published Centers for Disease Control's (CDC) Guideline for Intravascular Infections (Am J Infect Control 1983;11:183-199). Part I, “Intravascular Device-Related Infections: An Over view” discusses many of the issues and controversies in intravascular-device use and maintenance. These issues include definitions and diagnosis of catheter-related infection, appropriate barrier precautions during catheter insertion, inter vals for replacement of catheters, intravenous (IV) fluids and administration sets, catheter-site care, the role of specialized IV personnel, and the use of prophylactic antimi-crobials, flush solutions, and anticoagulants. Part II, “Recommendations for Prevention of Intravascular Device-Related Infections” provides consensus recommendations of the HICPAC for the prevention and control of intravascular device-related infections. A working draft of this document also was reviewed by experts in hospital infection control, internal medicine, pediatrics, and intravenous therapy. However, all recommendations contained in the guideline may not reflect the opinion of all reviewers.

Type
Special Report
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 7 , July 1996 , pp. 438 - 473
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Smith, RL, Meixler, SM, Simberkoff, MS. Excess mortality in critically ill patients with nosocomial bloodstream infections. Chest 1991;100:164–167.CrossRefGoogle ScholarPubMed
2. Martin, MA, Pfaller, MA, Wenzel, RP. Coagulase-negative staphylococcal bacteremia. Mortality and hospital stay. Ann Intern Med 1989;110:9–16.Google Scholar
3. Haley, RW, Schaberg, DR, Von Allmen, SD, McGowan, JE Jr. Estimating the extra charges and prolongation of hospitalization due to nosocomial infections: a comparison of methods. J Infect Dis 1980;141:248–257.Google Scholar
4. Pittet, D, Tarara, D, Wenzel, RP. Nosocomial bloodstream infection in critically ill patients: excess length of stay, extra costs, and attributable mortality. JAMA 1994;271:1598–1601.Google Scholar
5. Arnow, PM, Quimosing, EM, Brech, M. Consequences of intravascular catheter sepsis. Clin Infect Dis 1993;16:778–784.Google Scholar
6. Maki, DG. Infections due to infusion therapy. In: Bennett, JV, Brachman, PS, eds. Hospital Infections. 3rd ed. Boston, MA: Little, Brown and Co; 1992.Google Scholar
7. Jarvis, WR, Edwards, JR, Culver, DH, et al. Nosocomial infection rates in adult and pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Am J Med 1991;91(suppl 3B):185S–191S.CrossRefGoogle ScholarPubMed
8. Gantz, NM, Presswood, GM, Goldbert, R, Doern, G. Effects of dressing type and change interval on intravenous therapy complication rates. Diagn Microbiol Infect Dis 1984;2:325–332.CrossRefGoogle ScholarPubMed
9. Ena, J, Cercenado, E, Martinez, D, Bouza, E. Cross-sectional epidemiology of phlebitis and catheter-related infections. Infect Control Hosp Epidemiol 1992;13:15–20.Google Scholar
10. Craven, DE, Lichtenberg, A, Kunches, LM, et al. A randomized study comparing a transparent polyurethane dressing to a dry gauze dressing for peripheral intravenous catheter sites. Am J Inject Control 1985;6:361–366.CrossRefGoogle ScholarPubMed
11. Tager, IB, Ginsberg, MB, Ellis, SE, et al. An epidemiologic study of the risks associated with peripheral intravenous catheters. Am J Epidemiol 1983;118:839–851.Google Scholar
12. Maki, DG, Ringer, M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. A randomized controlled trial. Ann Intern Med 1991;114:845–854.CrossRefGoogle ScholarPubMed
13. Hoffmann, KK, Western, SA, Kaiser, DL, Wenzel, RP, Groschel, DH. Bacterial colonization and phlebitis-associated risk with transparent polyurethane film for peripheral intravenous site dressings. Am J Infect Control 1988;16:101–106.CrossRefGoogle ScholarPubMed
14. Smallman, L, Burdon, DW, Alexander-Williams, J. The effect of skin preparation and care on the incidence of superficial thrombophlebitis. Br J Surg 1980;67:861–862.CrossRefGoogle ScholarPubMed
15. Collin, J, Collin, C, Constable, FL, Johnston, ID. Infusion thrombophlebitis and infection with various cannulas. Lancet 1975;2:150–153.Google Scholar
16. Larson, E, Hargiss, C. A decentralized approach to maintenance of intravenous therapy. Am J Infect Control 1984;12:177–186.CrossRefGoogle ScholarPubMed
17. Gardner, RM, Schwartz, R, Wong, HC, Burke, JP. Percutaneous indwelling radial-artery catheters for monitoring cardiovascular function. Prospective study of the risk of thrombosis and infection. N Engl J Med 1974;290:1227–1231.CrossRefGoogle ScholarPubMed
18. Samsoondar, W, Freeman, JB, Coultish, I, Oxley, C. Colonization of intravascular catheters in an intensive care unit. Am J Surg 1985;149:730–732.CrossRefGoogle Scholar
19. Raad, I, Umphrey, J, Khan, A, Truett, LJ, Bodey, GP. The duration of placement as a predictor of peripheral and pulmonary arterial catheter infections. J Hosp Infect 1993;23:17–26.CrossRefGoogle ScholarPubMed
20. Band, JD, Maki, DG. Infections caused by arterial catheters used for hemodynamic monitoring. Am J Med 1979;67:735–741.Google Scholar
21. Thomas, F, Burke, JP, Parker, J, et al. The risk of infection related to radial vs femoral sites for arterial catheterization. Crit Care Med 1983;11:807–812.Google Scholar
22. Maki, DG, McCormick, RD, Uman, SJ, Wirtanen, GW. Septic endarteritis due to intra-arterial catheters for cancer chemotherapy. Cancer 1979;44:1228–1240.Google Scholar
23. Mermel, LA, Parenteau, S, Tow, SM. The risk of midline catheterization in hospitalized patients. A prospective study. Ann Intern Med 1995;123:841–844.CrossRefGoogle ScholarPubMed
24. Maki, DG. Reactions associated with midline catheters for intravenous access. Ann Intern Med 1995;123:884–886.CrossRefGoogle ScholarPubMed
25. Fontaine, PJ. Performance of a new softening expanding midline catheter in home intravenous therapy patients. J Intraven Nurs 1991;14:91–99.Google ScholarPubMed
26. Rogan, DH. Allergic-type reaction to a Landmark catheter. J Intraven Nurs 1993;16:118.Google Scholar
27. Briars, G. Adverse reactions to elastomeric intravenous catheters in adolescents with cystic fibrosis. Lancet 1993;342:118.CrossRefGoogle ScholarPubMed
28. Blum, DY. Untoward events associated with use of midterm IV devices. J Intraven Nurs 1995;18:116–119.Google Scholar
29. Harwood, IR, Greene, LM, Kozakowski-Koch, JA, Rasor, JS. New peripherally inserted midline catheter: a better alternative for intravenous antibiotic therapy in patients with cystic fibrosis. Pediatr Pulmonol 1992;12:233–239.Google Scholar
30. Weeks-Lozano, H. Clinical evaluation of Per-Q-Cath for both pediatric and adult home infusion therapy. J Intraven Nurs 1991;14:249–256.Google ScholarPubMed
31. Lee, RB, Buckner, M, Sharp, KW. Do multilumen catheters increase central venous catheter sepsis compared to singlelumen catheters? J Trauma 1988;28:1472–1475.CrossRefGoogle ScholarPubMed
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 1986;121:591–594.CrossRefGoogle ScholarPubMed
33. Yeung, C, May, J, Hughes, R. Infection rate for single-lumen vs triple-lumen subclavian catheters. Infect Control Hosp Epidemiol 1988;9:154–158.Google Scholar
34. 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 of catheters. Am J Med 1988;84:667–672.Google Scholar
35. McCarthy, MC, Shives, JK, Robison, RJ, Broadie, TA. Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. J Parenter Enteral Nutr 1987;11:259–262.Google Scholar
36. Clark-Christoff, N, Watters, VA, Sparks, W, Snyder, P, Grant, JP. Use of triple-lumen subclavian catheters for administration of total parenteral nutrition. J Parenter Enteral Nutr 1992;16:403–407.Google Scholar
37. Farkas, JC, Liu, N, Bleriot, JP, Chevret, S, Goldstein, FW, Carlet, J. Single- versus triple-lumen central catheter-related sepsis: a prospective randomized study in a critically ill population. Am J Med 1992;93:277–282.CrossRefGoogle Scholar
38. Prager, RL, Silva, J. Colonization of central venous catheters. South Med J 1984;77:458–461.Google Scholar
39. Brun-Buisson, C, Abrouk, F, Legrand, P, Huet, Y, Larabi, S, Rapin, M. Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. Arch Intern Med 1987;147:873–877.Google Scholar
40. Collignon, PJ, Soni, N, Pearson, IY, Woods, WP, Munro, R, Sorrell, TC. Is semiquantitative culture of central vein catheter tips useful in the diagnosis of catheter-associated bacteremia? J Clin Microbiol 1986;24:532–535.CrossRefGoogle ScholarPubMed
41. Richet, H, Hubert, B, Nitemberg, G, et al. Prospective multicenter study of vascular catheter-related complications and risk factors for positive central-catheter cultures in intensive care unit patients. J Clin Microbiol 1990;28:2520–2525.Google Scholar
42. Snydman, DR, Gorbea, HF, Pober, BR, Majka, JA, Murray, SA, Perry, SK. Predictive value of surveillance skin cultures in total parenteral nutrition. Lancet 1982;2:1185–1188.Google Scholar
43. 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 1989;149:1139–1143.CrossRefGoogle Scholar
44. Sitzmann, JV, Townsend, TR, Siler, MC, Bartlett, JG. Septic and technical complications of central venous catheterization: a prospective study of 200 consecutive patients. Ann Surg 1985;202:766–770.Google Scholar
45. Conly, JM, Grieves, K, Peters, B. A prospective, randomized study comparing transparent and dry gauze dressings for central venous catheters. J Infect Dis 1989;159:310–319.Google Scholar
46. Armstrong, CW, Mayhall, CG, Miller, KB, et al. Prospective study of catheter replacement and other risk factors for infection of hyperalimentation catheters. J Infect Dis 1986;154:808–816.Google Scholar
47. Mermel, LA, Stolz, SM, Maki, DG. Surface antimicrobial activity of heparin-bonded and antiseptic impregnated vascular catheters. J Infect Dis 1993;167:920–924.CrossRefGoogle ScholarPubMed
48. 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(suppl 3B):197S–205S.Google Scholar
49. Rello, J, Coll, P, Net, A, Prats, G. Infection of pulmonary artery catheters. Epidemiologic characteristics and multivariate analysis of risk factors. Chest 1993;103:132–136.Google Scholar
50. Singh, S, Nelson, N, Acosta, I, Check, FE, Puri, VK. Catheter colonization and bacteremia with pulmonary and arterial catheters. Crit Care Med 1982;10:736–739.Google Scholar
51. Maki, DG, Stolz, SS, Wheeler, S, Mermel, LA. A prospective, randomized trial of gauze and two polyurethane dressings for site care of pulmonary artery catheters: implications for catheter management. Crit Care Med 1992;22:1729–1737.CrossRefGoogle Scholar
52. Pinilla, JC, Ross, DF, Martin, T, Crump, H. Study of the incidence of intravascular catheter infection and associated septicemia in critically ill patients. Crit Care Med 1983;11:21–25.CrossRefGoogle ScholarPubMed
53. Senagore, A, Waller, JD, Bonnell, BW, Bursch, LR, Scholten, DJ. Pulmonary artery catheterization: a prospective study of internal jugular and subclavian approaches. Crit Care Med 1987;15:35–37.Google Scholar
54. Solomon, SL, Alexander, H, Eley, JW, et al. Nosocomial fungemia in neonates associated with intravascular pressure-monitoring devices. Pediatr Infect Dis J 1986;5:680–685.Google Scholar
55. Maki, DG, Hassemer, CA. Endemic rate of fluid contamination and related septicemia in arterial pressure monitoring. Am J Med 1981;70:733–738.Google Scholar
56. Phillips, I, Eykyn, S, Curtis, MA, Snell, JJ. Pseudomonas cepacia (multivorans) septicemia in an intensive care unit. Lancet 1971;1:375–377.Google Scholar
57. Gahrn-Hansen, B, Alstrup, P, Dessau, R, et al. Outbreak of infection with Achromobacter xylosoxidanis from contaminated intravascular pressure transducers. J Hosp Infect 1988;12:1–6.Google Scholar
58. Villarino, ME, Jarvis, WR, O’Hara, C, Bresnahan, J, Clark, N. Epidemic of Serratia marcescens bacteremia in a cardiac intensive care unit. J Clin Microbiol 1989;27:2433–2436.Google Scholar
59. Hekker, TA, van Overhagen, W, Schneider, AJ. Pressure transducers: an overlooked source of sepsis in the intensive care unit. Intensive Care Med 1990;16:511–512.CrossRefGoogle ScholarPubMed
60. Mermel, LA, Maki, DG. Epidemic bloodstream infections from hemodynamic pressure monitoring: signs of the times. Infect Control Hosp Epidemiol 1989;10:47–53.Google Scholar
61. Thomas, A, Lalitha, MK, Jesudason, MV, John, S. Transducer related Enterobacter cloacae sepsis in post-operative cardiotho- racic patients. J Hosp Infect 1993;25:211–214.Google Scholar
62. Weinstein, RA, Emori, TG, Anderson, RL, Stamm, WE. Pressure transducers as a source of bacteremia after open heart surgery. Report of an outbreak and guidelines for prevention. Chest 1976;69:338–344.Google Scholar
63. Weinstein, RA, Stamm, WE, Kramer, L, Corey, L. Pressure monitoring devices: overlooked source of nosocomial infection. JAMA 1976;236:936–938.CrossRefGoogle ScholarPubMed
64. Buxton, AE, Anderson, RL, Klimek, J, Quintiliani, R. Failure of disposable domes to prevent septicemia acquired from contaminated pressure transducers. Chest 1978;74:508–513.CrossRefGoogle ScholarPubMed
65. Donowitz, LG, Marsik, FJ, Hoyt, JW, Wenzel, RP. Serratia marcescens bacteremia from contaminated pressure transducers. JAMA 1979;242:1749–1751.Google Scholar
66. Maki, DG, Martin, WT. Nationwide epidemic of septicemia caused by contaminated infusion products, IV: growth of microbial pathogens in fluids for intravenous infection. J Infect Dis 1975;131:267–272.CrossRefGoogle Scholar
67. Beck-Sagué, CM, Jarvis, WR. Epidemic bloodstream infections associated with pressure transducers: a persistent problem. Infect Control Hosp Epidemiol 1989;10:54–59.CrossRefGoogle ScholarPubMed
68. Fisher, MC, Long, SS, Roberts, EM, Dunn, JM, Balsara, RK. Pseudomonas maltophilia bacteremia in children undergoing open heart surgery. JAMA 1981;246:1571–1574.CrossRefGoogle ScholarPubMed
69. Stamm, WE, Colella, JJ, Anderson, RL, Dixon, RE. Indwelling arterial catheters as a source of nosocomial bacteremia―an outbreak caused by FlavobacteHum species. N Engl J Med 1975;292:1099–1102.Google Scholar
70. Shinozaki, T, Deane, RS, Mazuzan, JE, Hamel, AJ, Hazelton, D. Bacterial contamination of arterial lines. JAMA 1983;249:223–225.Google Scholar
71. Ducharme, FM, Gauthier, M, Lacroix, J, Lafleur, L. Incidence of infection related to arterial catheterization in children: a prospective study. Crit Care Med 1988;16:272–276.CrossRefGoogle ScholarPubMed
72. Luskin, RL, Weinstein, RA, Nathan, C, Chamberlin, WH, Kabins, SA. Extended use of disposable pressure transducers. A bacteriologic evaluation. JAMA 1986;255:916–920.Google Scholar
73. O’Malley, MK, Rhame, FS, Cerra, FB, MCComb, RC. Value of routine pressure monitoring system changes after 72 hours of use. Crit Care Med 1994;22:1424–1430.Google Scholar
74. Ryder, MA. Peripheral access options. Surg Oncol Clin N Am 1995;4:395–427.Google Scholar
75. Raad, I, Davis, S, Becker, M, et al. Low infection rate and long durability of nontunneled silastic catheters. A safe cost-effective alternative for long-term venous access. Arch Intern Med 1993;153:1791–1796.Google Scholar
76. Noble, WC. Skin microbiology: coming of age. J Med Microbiol 1984;17:1–12.Google Scholar
77. Roth, RR, James, WD. Microbial ecology of the skin. Ann Rev Microbiol 1988;42:441–446.Google Scholar
78. Lam, S, Scannell, R, Roessler, D, Smith, MA. Peripherally inserted central venous catheters in an acute-care hospital. Arch Intern Med 1994;154:1833–1837.CrossRefGoogle Scholar
79. Loughran, SC, Borzatta, M. Peripherally inserted central catheters: a report of 2,506 catheter days. J Parenter Enteral Nutr 1995;19:133–136.Google Scholar
80. Abi-Nader, JA. Peripherally inserted central venous catheters in critical care patients. Heart Lung 1993;22:428–434.Google Scholar
81. Merrell, SW, Peatross, BG, Grossman, MD, Sullivan, JJ, Harker, WG. Peripherally inserted central venous catheters. Low-risk alternatives for ongoing vascular access. West J Med 1994;160:25–30.Google Scholar
82. Goodwin, ML, Carlson, I. The peripherally inserted central catheter. A retrospective look at three years of insertions. J Intraven Nurs 1993;16:92–103.Google Scholar
83. Cardella, JF, Fox, PS, Lawler, JB. Interventional radiologic placement of peripherally inserted central catheters. J Vasc Interv Radiol 1993;4:653–660.Google Scholar
84. Andrews, JC, Marx, MV, Williams, DM, Sproat, I, WalkerAndrews, SC. The upper arm approach for placement of peripherally inserted central catheters for protracted venous access. Am J Roentgenol 1992;158:427–429.Google Scholar
85. James, L, Bledsoe, L, Hardaway, LC. A retrospective look at tip location and complications of peripherally inserted central venous lines. J Intraven Nurs 1993;16:104–109.Google Scholar
86. Abraham, JL, Mullen, JL. A prospective study of prolonged central venous access in leukemia. JAMA 1982;248:2868–2873.CrossRefGoogle Scholar
87. Pessa, ME, Howard, RJ. Complications of Hickman-Broviac catheters. Surg Gynecol Obstet 1985;161:257–260.Google Scholar
88. Rannem, T, Ladefoged, K, Tvede, M, Lorentzen, JE, Jarnum, S. Catheter-related septicemia in patients receiving home par-enteral nutrition. Scand J Gastroenterol 1986;21:455–460.Google Scholar
89. Darbyshire, PJ, Weightman, NC, Speller, DC. Problems associated with indwelling central venous catheters. Arch Dis Child 1985;60:129–134.Google Scholar
90. Shulman, RJ, Smith, EO, Rahman, S, Gardner, P, Reed, T, Mahoney, D. Single- vs double-lumen central venous catheters in pediatric oncology patients. Am J Dis Child 1988;142:893–895.Google Scholar
91. Shapiro, ED, Wald, ER, Nelson, KA, Spiegelman, KN. Broviac catheter-related bacteremia in oncology patients. Am J Dis Child 1982;136:679–681.Google Scholar
92. Weightman, NC, Simpson, EM, Speller, DC, Mott, MG, Oakhill, A. Bacteremia related to indwelling central venous catheters: prevention, diagnosis, and treatment. Eur J Clin Microbiol Infect Dis 1988;7:125–129.Google Scholar
93. Schuman, ES, Winters, V, Gross, GF, Hayes, JF. Management of Hickman catheter sepsis. Am J Surg 1985;149:627–628.Google Scholar
94. Press, OW, Ramsey, PG, Larson, EB, Fefer, A, Hickman, RO. Hickman catheter infections in patients with malignancies. Medicine 1984;63:189–200.Google Scholar
95. Andrivet, P, Bacquer, A, Ngoc, CV, et al. Lack of clinical benefit from subcutaneous tunnel insertion of central venous catheters in immunocompromised patients. Clin Infect Dis 1994;18:199–206.Google Scholar
96. Howell, PB, Walter, PE, Donowitz, GR, Farr, BM. Risk factors for infection of adult patients with cancer who have tunneled central venous catheters. Cancer 1995;75:1367–1375.3.0.CO;2-Z>CrossRefGoogle Scholar
97. McDowell, HP, Hart, CA, Martin, J. Implantable subcutaneous venous catheters. Arch Dis Child 1986;61:1037–1038.Google Scholar
98. Brickner, H, Saeter, G. Fifty-five patient years’ experience with a totally implanted system for intravenous chemotherapy. Cancer 1986;57:1124–1129.Google Scholar
99. Wurzel, CL, Halom, K, Feldman, JG, Rubin, LG. Infection rates of Broviac-Hickman catheters and implantable venous devices. Am J Dis Child 1988;142:536–540.Google Scholar
100. Pegues, D, Axelrod, P, McClarren, C, et al. Comparison of infections in Hickman and implanted port catheters in adult solid tumor patients. J Surg Oncol 1992;49:156–162.Google Scholar
101. Gyves, J, Ensminger, W, Niederhuber, J, et al. A totally-implanted injection port system for blood sampling and chemotherapy administration. JAMA 1984;251:2538–2541.Google Scholar
102. Lokich, JJ, Bothe, AJ, Benotti, P, Moore, C. Complications and management of implanted venous access catheters. J Clin Oncol 1985;3:710–717.Google Scholar
103. Kappers-Klunne, MC, Degener, JE, Stijnen, T, Abels, J. Complications from long-term indwelling central venous catheters in hematologic malignancy patients with special reference to infection. Cancer 1989;64:1747–1752.Google Scholar
104. Carde, P, Cosset-Delaigue, MF, Laplanche, A, Chareau, I. Classical external indwelling central venous catheter versus total implanted venous access systems for chemotherapy administration: a randomized trial in 100 patients with solid tumors. Eur J Cancer Clin Oncol 1989;25:939–944.Google Scholar
105. Groeger, JS, Lucas, AB, Thaler, HT, et al. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 1993;119:1168–1174.Google Scholar
106. Khoury, MD, Lloyd, LR, Burrows, J, Berg, R, Yap, J. A totally implanted venous access system for the delivery of chemotherapy. Cancer 1985;56:1231–1234.Google Scholar
107. van der Pijl, H, Frissen, PH. Experience with a totally implantable venous access device (Port-A-Cath) in patients with AIDS. AIDS 1992;6:709–713.CrossRefGoogle ScholarPubMed
108. Banerjee, SN, Emori, TG, Culver, DH, et al. Secular trends in nosocomial primary bloodstream infection in the United States, 1980-1989. National Nosocomial Infections Surveillance System. Am J Med 1991;91(suppl 3B):86S–89S.Google Scholar
109. Stillman, RI, Wenzel, RP, Donowitz, LC. Emergence of coagulase negative staphylococci as major nosocomial bloodstream pathogens. Am J Infect Control 1987;8:108–112.Google Scholar
110. Morrison, AJ Jr, Freer, CV, Searcy, MA, Landry, SM, Wenzel, RP. Nosocomial bloodstream infections: secular trends in a statewide surveillance program in Virginia. Am J Infect Control 1986;7:550–553.Google Scholar
111. Schaberg, DR, Culver, DH, Gaynes, RP. Major trends in the microbial etiology of nosocomial infection. Am J Med 1991;91(suppl 3B):72S–75S.CrossRefGoogle ScholarPubMed
112. Dougherty, SH. Pathobiology of infection in prosthetic devices. Rev Infect Dis 1988;10:1102–1117.Google Scholar
113. Freeman, J, Goldmann, DA, Smith, NE, Sidebottom, DG, Epstein, MF, Platt, R. Association of intravenous lipid emulsion and coag-ulase-negative staphylococcal bacteremia in neonatal intensive care units. N Engl J Med 1990;323:301–308.Google Scholar
114. Jarvis, WR, Martone, WJ. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29(suppl A):19–24.CrossRefGoogle ScholarPubMed
115. Dugdal, DC, Ramsey, PG. Staphylococcus aureus bacteremia patients with Hickman catheters. Am J Med 1990;89:137–141.Google Scholar
116. Libman, H, Arbeit, RD. Complications associated with Staphylococcus aureus bacteremia. Arch Intern Med 1984;144:541–545.Google Scholar
117. 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 1992;11:675–682.Google Scholar
118. Centers for Disease Control and Prevention. Nosocomial enterococci resistant to vancomycin—United States, 1989-1993. MMWR 1993;42:597–599.Google Scholar
119. Karanfil, LV, Murphy, M, Josephson, A, et al. A cluster of van-comycin-resistant Enterococcus faecium in an intensive care unit. Infect Control Hosp Epidemiol 1992;13:195–200.Google Scholar
120. Morris, JG Jr, Shay, DK, Hebden, JN, et al. Enterococci resistant to multiple antimicrobial agents, including vancomycin. Establishment of endemicity in a university medical center.Google Scholar
121. Boyce, JM, Opal, SM, Chow, JW, et al. Outbreak of multidrug- resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:1148–1153.Google Scholar
122. Shay, DK, Maloney, SA, Montecalvo, M, et al. Epidemiology and mortality risk of vancomycin-resistant enterococcal bloodstream infections. J Infect Dis 1995;172:993–1000.Google Scholar
123. Handwerger, S, Raucher, B, Altarac, D, et al. Nosocomial outbreak due to Enterococcus faecium highly resistant to van-comycin, penicillin, and gentamicin. Clin Infect Dis 1993;16:750–755.Google Scholar
124. Rubin, LG, Tucci, V, Cercenado, E, Eliopoulos, G, Isenberg, HD. Vancomycin-resistant Enterococcus faecium in hospitalized children. Infect Control Hosp Epidemiol 1992;13:700–705.Google Scholar
125. Montecalvo, MA, Horowitz, H, Gedris, C, et al. Outbreak of van-comycin-, ampicillin-, and aminoglycoside-resistant Enterococcus faecium in an adult oncology unit. Antimicrob Agents Chemother 1994;38:1363–1367.Google Scholar
126. Frieden, TR, Munsiff, SS, Low, DE, et al. Emergence of van-comycin-resistant enterococci in New York City. Lancet 1993;342:76–79.Google Scholar
127. Boyle, JF, Soumakis, SA, Rendo, A, et al. Epidemiologic analysis and genotypic characterization of a nosocomial outbreak of vancomycin-resistant enterococci. J Clin Microbiol 1993;31:1280–1285.Google Scholar
128. Edmond, MB, Ober, JF, Weinbaum, DL, et al. Vancomycin-resis-tant Enterococcus faecium bacteremia: risk factors for infection. Clin Infect Dis 1995;20:1126–1133.Google Scholar
129. Livornese, LL Jr, Dias, S, Samel, C, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 1992;117:112–116.Google Scholar
130. Moellering, RCJ. Enterococcal infections in patients treated with moxalactam. Rev Infect Dis 1982;4(suppl):708S–711S.Google Scholar
131. Yu, VL. Enterococcal superinfection and colonization after therapy with moxalactam, a new broad-spectrum antibiotic. Ann Intern Med 1981;94:784–785.Google Scholar
132. Feliciano, DV, Gentry, LO, Bitondo, CG, et al. Single agent cephalosporin prophylaxis for penetrating abdominal trauma. Results and comment on the emergence of the enterococcus. Am J Surg 1986;152:674–681.Google Scholar
133. Pallares, R, Dick, R, Wenzel, RP, Adams, JR, Nettleman, MD. Trends in antimicrobial utilization at a tertiary teaching hospital during a 15-year period (1978-1992). Infect Control Hosp Epidemiol 1993;14:376–382.Google Scholar
134. Ena, J, Dick, RW, Jones, RN, Wenzel, RP. The epidemiology of intravenous vancomycin usage in a university hospital. A 10- year study. JAMA 1993;269:598–602.Google Scholar
135. Beck-Sagué, CM, Jarvis, WR. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 19801990. J Infect Dis 1993;167:1247–1251.Google Scholar
136. Voss, A, Hollis, RJ, Pfaller, MA, Wenzel, RP, Doebbeling, BN. Investigation of the sequence of colonization and candidemia in nonneutropenic patients. J Clin Microbiol 1994;32:975–980.Google Scholar
137. Pfaller, MA, Cabezudo, I, Hollis, R, Huston, B, Wenzel, RP. The use of biotyping and DNA fingerprinting in typing Candida albi-cans from hospitalized patients. Diagn Microbiol Infect Dis 1990;13:481–489.Google Scholar
138. Reagan, DR, Pfaller, MA, Hollis, RJ, Wenzel, RP. Characterization of the sequence of colonization and nosocomial candidemia using DNA fingerprinting and a DNA probe. J Clin Microbiol 1990;28:2733–2738.Google Scholar
139. Moro, ML, Maffei, C, Manso, E, Morace, G, Polonelli, L, Biavasco, F. Nosocomial outbreaks of systemic candidosis associated with parenteral nutrition. Infect Control Hosp Epidemiol 1990;11:27–35.Google Scholar
140. Sherertz, RJ, Gledhill, KS, Hampton, KD, et al. Outbreak of Candida bloodstream infections associated with retrograde medication administration in a neonatal intensive care unit. J Pediatr 1992;120:455–461.Google Scholar
141. Weems, JJ, Chamberland, ME, Ward, J, Willy, M, Padnye, AA, Solomon, SL. Candida parapsilosis fungemia associated with parenteral nutrition and contaminated blood pressure transducers. J Clin Microbiol 1987;1925:1029–1032.Google Scholar
142. Phelps, M, Ayliffe, GA, Babb, JR. An outbreak of candidiasis in a special care baby unit: the use of a resistogram typing method. J Hosp Infect 1986;7:13–20.Google Scholar
143. Vaudry, WL, Tierney, AJ, Wenman, WM. Investigation of systemic Candida albicans infections in a neonatal intensive care unit. J Infect Dis 1988;158:1375–1379.Google Scholar
144. Burnie, JP, Odds, FC, Lee, W, Webster, C, Williams, JD. Outbreak of systemic Candida albicans in an intensive care unit caused by cross infection. Br Med J [Clin Res Ed] 1985;290:746–748.Google Scholar
145. Finkelstein, R, Reinhertz, G, Hashman, N, Merzbach, D. Outbreak of Candida tropicalis fungemia in a neonatal intensive care unit. Infect Control Hosp Epidemiol 1993;14:587–590.Google Scholar
146. Lee, W, Burnie, JP, Matthews, RC, Oppenheim, BO, Damani, NN. Hospital outbreaks with yeasts. J Hosp Infect 1991;18(suppl A):237–249.Google Scholar
147. Isenberg, HD, Tucci, V, Cintron, F, Singer, C, Weinstein, GS, Tyras, DH. Single source outbreak of Candida tropicalis complicating coronary bypass surgery. J Clin Microbiol 1989;27:2426–2428.Google Scholar
148. Hunter, PR, Harrison, GA, Fraser, CA. Cross infection and diversity of Candida albicans strain carriage in patients and nursing staff on an intensive care unit. J Med Vet Mycol 1990;28:317–325.Google Scholar
149. Burnie, JP. Candida and hands. J Hosp Infect 1986;8:1–4.Google Scholar
150. Doebbeling, BN, Hollis, RJ, Isenberg, HD, Wenzel, RP, Pfaller, MA. Restriction fragment analysis of a Candida tropicalis outbreak of sternal wound infections. J Clin Microbiol 1991;29:1268–1270.Google Scholar
151. Burnie, JP, Lee, W, William, JD, Matthews, RC, Odds, FC. Control of an outbreak of systemic Candida albicans . Br Med J [Clin Res Ed ] 1985;291:1092–1093.Google Scholar
152. Maki, DG, Rhame, FS, Mackel, DC, Bennett, JV. Nationwide epidemic of septicemia caused by contaminated intravenous products. Am J Med 1976;60:471–485.Google Scholar
153. Centers for Disease Control. Nosocomial bacteremia associated with intravenous fluid therapy. MMWR 1971;20(suppl 9):81–82.Google Scholar
154. Snydman, DR, Pober, BR, Murray, SA, Gorbea, HF, Majka, JA, Perry, LK. Predictive value of surveillance skin cultures in total parenteral nutrition-related infection. Prospective epidemiologic study using semiquantitative cultures. Lancet 1982:1385–1388.Google Scholar
155. Kelsey, MC, Gosling, M. A comparison of the morbidity associated with occlusive and non-occlusive dressings applied to peripheral intravenous devices. J Hosp Infect 1984;5:313–321.Google Scholar
156. Bjornson, HS, Colley, R, Bower, RH, Duty, VP, Schwartz-Fulton, JT, Fischer, JE. Association between microorganism growth at the catheter insertion site and colonization of the catheter in patients receiving total parenteral nutrition. Surgery 1982;92:720–727.Google Scholar
157. Cooper, GL, Hopkins, CC. Rapid diagnosis of intravascular catheter-associated infection by direct gram staining of catheter segments. N Engl J Med 1985;312:1142–1147.Google Scholar
158. deCicco, M, Chiaradia, V, Veronesi, A, et al. Source and route of microbial colonization of parenteral nutrition catheters. Lancet 1989;2:1258–1261.Google Scholar
159. Capell, S, Linares, J, Sitges-Serra, A. Catheter sepsis due to coagulase-negative staphylococci in patients on total parenteral nutrition. Eur J Clin Microbiol Infect Dis 1986;5:40–42.Google Scholar
160. Salzman, MB, Isenberg, HD, Shapiro, JF, Lipsitz, PJ, Rubin, LG. A prospective study of the catheter hub as the portal of entry for microorganisms causing catheter-related sepsis in neonates. J Infect Dis 1993;167:487–490.Google Scholar
161. Peters, G, Locci, R, Pulverer, G. Adherence and growth of coagulase-negative staphylococci on surfaces of intravenous catheters. J Infect Dis 1982;146:479–482.Google Scholar
162. Linares, J, Sitges-Serra, A, Garau, J, Perez, JL, Martin, R. Pathogenesis of catheter sepsis: a prospective study with quantitative and semiquantitative cultures of catheter hub and segments. J Clin Microbiol 1985;21:357–360.Google Scholar
163. Sitges-Serra, A, Linares, J, Perez, JL, Jaurrieta, E, Lorente, L. A randomized trial on the effect of tubing changes on hub contamination and catheter sepsis during parenteral nutrition. J Parenter Enteral Nutr 1985;9:322–325.Google Scholar
164. Raad, I, Costerton, W, Sabharwal, U, et al. Ultrastructural analysis of indwelling vascular catheters: a quantitative relationship between luminal colonization and duration of placement. J Infect Dis 1993;168:400–407.Google Scholar
165. Pettigrew, RA, Lang, SDR, Haydock, DA, Parry, BR, Bremner, DA, Hill, GL. Catheter-related sepsis in patients on intravenous nutrition: a prospective study of quantitative catheter cultures and guidewire changes for suspected sepsis. Br J Surg 1985;72:52–55.Google Scholar
166. Maki, DG, Anderson, RL, Shulman, JA. In-use contamination of intravenous infusion fluid. Appl Microbiol 1974;28:778–784.Google Scholar
167. Sheth, NK, Rose, HD, Franson, TR, Buckmire, FL, Cooper, JA, Sohnle, PG. Colonization of bacteria on polyvinyl chloride and Teflon catheters in hospitalized patients. J Clin Microbiol 1983;18:1061–1063.Google Scholar
168. Hogt, AH, Dankert, J, Feijen, J. Encapsulation, slime production, and surface hydrophobicity of coagulase-negative staphy- lococci. FEMS Microbiol Lett 1983;18:211–215.Google Scholar
169. Ashkenazi, S, Weiss, E, Drucker, MM. Bacterial adherence to intravenous catheters and needles and its influence by cannula type and bacterial surface hydrophobicity. J Lab Clin Med 1986;107:136–140.Google Scholar
170. Peters, G, Locci, R, Pulverer, G. Microbial colonization of prosthetic devices, II: scanning electron microscopy of naturally infected intravenous catheters. Zentralbl Bakteriol 1981;173:293–299.Google Scholar
171. Locci, R, Peters, G, Pulverer, G. Microbial colonization of prosthetic devices, I: microtopographical characteristics of intravenous catheters as detected by scanning microscopy. Zentralbl Bakteriol 1981;173:285–292.Google Scholar
172. Stillman, RM, Soliman, F, Garcia, L, et al. Etiology of catheter-associated sepsis: correlation with thrombogenicity. Arch Surg 1977;112:1497–1502.Google Scholar
173. Herrmann, M, Vaudaux, PE, Pittet, D, et al. Fibronectin, fibrinogen, and laminin act as mediators of adherence of clinical staphylococcal isolates to foreign material. J Infect Dis 1988;158:693–701.Google Scholar
174. Vaudaux, P, Suzuki, R, Waldvogel, FA, Morgenthaler, JJ, Nydegger, UE. Foreign body infection: role of fibronectin as a ligand for the adherence of Staphylococcus aureus . J Infect Dis 1984;150:546–553.Google Scholar
175. Gristina, AG. Biomaterial-centered infection: microbial adhesion versus tissue integration. Science 1987;237:1588–1595.CrossRefGoogle ScholarPubMed
176. Johnson, GM, Lee, DA, Regelmann, WE, Gray, ED, Peters, G, Quie, PG. Interference with granulocyte function by Staphylococcus epidermidis slime. Infect Immun 1986;54:13–20.Google Scholar
177. Gray, ED, Peters, G, Verstegen, M, Regelmann, WE. Effect of extracellular slime substance from Staphylococcus epidermidis on the human cellular immune response. Lancet 1984;1:365–367.Google Scholar
178. Farber, BF, Kaplan, MH, Clogston, AG. Staphylococcus epider-midis extracted slime inhibits the antimicrobial action of gly- copeptide antibiotics. J Infect Dis 1990;161:37–40.Google Scholar
179. Branchini, ML, Pfaller, MA, Rhine-Chalberg, J, Frempong, T, Isenberg, HD. Genotypic variation in slime production among blood and catheter isolates of Candida parapsilosis . J Clin Microbiol 1994;32:452–456.Google Scholar
180. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.Google Scholar
181. Maki, DG, Weise, CE, Sarafin, HW. A semiquantitative culture method for identifying intravenous catheter-related infection. N Engl J Med 1977;296:1305–1309.Google Scholar
182. Zufferey, J, Rime, B, Francioli, P, Bille, J. Simple method for rapid diagnosis of catheter-associated infection by direct acridine orange staining of catheter tips. J Clin Microbiol 1988;26:175–177.Google Scholar
183. Cleri, DJ, Corrado, ML, Seligman, SJ. Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis 1987;141:781–786.Google Scholar
184. Sherertz, RJ, Raad, II, Belani, A, et al. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol 1990;28:76–82.Google Scholar
185. Raad, II, Sabbagh, MF, Rand, KH, Sherertz, RJ. Quantitative tip culture methods and the diagnosis of central venous catheter-related infections. Diagn Microbiol Infect Dis 1992;15:13–20.Google Scholar
186. Fan, ST, Teoh-Chan, CH, Lau, KF. Evaluation of central venous catheter sepsis by differential quantitative culture. Eur J Clin Microbiol Infect Dis 1989;8:142–144.Google Scholar
187. Armstrong, CW, Mayhall, CG, Miller, KB, et al. Clinical predictors of infection of central venous catheters used for total parenteral nutrition. Infect Control Hosp Epidemiol 1990;11:71–78.Google Scholar
188. Wing, EJ, Norden, CW, Shadduck, RK, Winkelstein, A. Use of quantitative bacteriologic techniques to diagnose catheter- related sepsis. Arch Intern Med 1979;139:482–483.Google Scholar
189. Raucher, HS, Hyatt, AC, Barzilai, A, et al. Quantitative blood cultures in the evaluation of septicemia in children with Broviac catheters. J Pediatr 1984;104:29–33.Google Scholar
190. Flynn, PM, Shenep, JL, Stokes, DC, Barrett, FF. In situ management of confirmed central venous catheter-related bacteremia. Pediatr Infect Dis J 1987;6:729–734.CrossRefGoogle ScholarPubMed
191. Ruderman, JW, Morgan, MA, Klein, AH. Quantitative cultures in the diagnosis of sepsis in infants with umbilical Broviac catheters. J Pediatr 1988;112:748–751.Google Scholar
192. Bansmer, G, Keith, D, Tesluk, H. Complications following use of indwelling catheters of inferior vena cava. JAMA 1958;167:1606–1611.Google Scholar
193. Phillips, RW, Eyre, JD. Septic thrombophlebitis with septicemia. N Engl J Med 1958;259:729–731.Google Scholar
194. Indar, R. The dangers of indwelling polyethylene cannulae in deep veins. Lancet 1959;1:284–286.Google Scholar
195. McNair, TJ, Dudley, HA. The local complications of intravenous therapy. Lancet 1959;2:365–368.Google Scholar
196. Crane, C. Venous interruption of septic thrombophlebitis. N Engl J Med 1960;262:947–951.Google Scholar
197. Horowitz, HW, Dworkin, BM, Savino, JA, Byrne, DW, Pecora, NA. Central catheter-related infections: comparison of pulmonary artery catheters and triple lumen catheters for the delivery of hyperalimentation in a critical care setting. J Parenter Enteral Nutr 1990;14:558–592.Google Scholar
198. Maki, DG, Ringer, M. Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. Gauze, a transparent polyurethane dressing, and an iodophor- transparent dressing. JAMA 1987;258:2396–2403.Google Scholar
199. Maki, DG, Goldmann, DA, Rhame, FS. Infection control in intravenous therapy. Ann Intern Med 1973;79:867–887.Google Scholar
200. Collins, RN, Braun, PA, Zinner, SH, Kass, EH. Risk of local and systemic infection with polyurethane intravenous catheters. A prospective study of 213 catheterizations. N Engl J Med 1968;279:340–343.Google Scholar
201. Band, JD, Maki, DG. Steel needles used for intravenous therapy. Morbidity in patients with hematologic malignancy. Arch Intern Med 1980;140:31–34.Google Scholar
202. Tully, JL, Friedland, GH, Baldini, LM, Goldman, DA. Complications of intravenous therapy with steel needles and Teflon catheters. A comparative study. Am J Med 1981;70:702–706.Google Scholar
203. Mitchell, A, Atkins, S, Royle, GT, Kettlewell, MG. Reduced catheter sepsis and prolonged catheter life using a tunneled silicone rubber catheter for total parenteral nutrition. Br J Surg 1982;69:420–422.Google Scholar
204. Raad, II, Hohn, DC, Gilbreath, BJ, et al. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 1994;15:231–238.Google Scholar
205. Maki, DG. Yes, Virginia, aseptic technique is very important: maximal barrier precautions during insertion reduce the risk of central venous catheter-related bacteremia. Infect Control Hosp Epidemiol 1994;15:227–230.Google Scholar
206. Miller, JJ, Venus, B, Mathru, M. Comparison of the sterility of long-term central venous catheterization using single-lumen, triple-lumen, and pulmonary artery catheters. Crit Care Med 1984;12:634–637.Google Scholar
207. Ullman, RF, Gurevich, I, Schoch, PE, Cunha, BA. Colonization and bacteremia related to duration of triple-lumen intravascular catheter placement. Am J Infect Control 1990;18:201–207.Google Scholar
208. Cobb, DK, High, KP, Sawyer, RG, et al. A controlled trial of scheduled replacement of central venous and pulmonary artery catheters. N Engl J Med 1992;327:1062–1068.Google Scholar
209. Michel, LA, Bradpiece, HA, Randour, P, Pouthier, F. Safety of central venous catheter change over a guidewire for suspected catheter-related sepsis: a prospective randomized trial. Int Surg 1988;73:180–186.Google Scholar
210. Newsome, HH Jr, Armstrong, CW, Mayhall, CG, et al. Mechanical complications from insertion of subclavian venous feeding catheters: comparison of de novo percutaneous venipuncture to change of catheter over guidewire. J Parenter Enteral Nutr 1984;8:560–562.Google Scholar
211. Eyer, S, Brummitt, C, Crossley, K, Siegel, R, Cerra, F. Catheter-related sepsis: prospective, randomized study of three different methods of long-term catheter maintenance. Crit Care Med 1990;18:1073–1079.Google Scholar
212. Snyder, RH, Archer, FJ, Endy, T, et al. Catheter infection. A comparison of two catheter maintenance techniques. Ann Surg 1988;208:651–653.Google Scholar
213. Snydman, DR, Donnelly-Reidy, M, Perry, LK, Martin, WJ. Intravenous tubing containing burettes can be safely changed at 72-hour intervals. Infect Control 1987;8:113–116.Google Scholar
214. Josephson, A, Gombert, ME, Sierra, MF, Karanfil, LV, Tansino, GF. The relationship between intravenous fluid contamination and the frequency of tubing replacement. Infect Control 1985;6:367–370.Google Scholar
215. Maki, DG, Botticelli, JT, LeRoy, ML, Thielke, TS. Prospective study of replacing administration sets for intravenous therapy at 48- vs 72-hour intervals. 72 hours is safe and cost-effective. JAMA 1987;258:1777–1781.Google Scholar
216. Melley, MA, Meng, HC, Schaffner, W. Microbial growth in lipid emulsions used in parenteral nutrition. Arch Surg 1975;110:1479–1481.Google Scholar
217. Jarvis, WR, Highsmith, AK. Bacterial growth and endotoxin production in lipid emulsion. J Clin Microbiol 1984;19:17–20.CrossRefGoogle ScholarPubMed
218. Crocker, KS, Noga, R, Filibeck, DJ, et al. Microbial growth comparisons of five commercial parenteral lipid emulsions. J Parenter Enteral Nutr 1984;8:391–395.Google Scholar
219. Keammerer, D, Mayhall, CG, Hall, GO, Pesko, LJ, Thomas, RB. Microbial growth patterns in intravenous fat emulsions. Am J Hosp Pharm 1983;40:1650–1653.Google Scholar
220. McArthur, BJ, Hargiss, C, Schoenknecht, FD. Stopcock contamination in an ICU. Am J Nurs 1975;75:96–97.Google Scholar
221. Walrath, JM, Abbott, NK, Caplan, E, Scalan, E. Stopcock: bacterial contamination in invasive monitoring systems. Heart Lung 1979;8:100–104.Google Scholar
222. Inoue, Y, Nezu, R, Matsuda, H, et al. Prevention of catheter-related sepsis during parenteral nutrition: effect of a new connection device. J Parenter Enteral Nutr 1992;16:581–585.Google Scholar
223. Crow, S, Conrad, SA, Chaney-Rowell, C, King, JW. Microbial contamination of arterial infusions used for hemodynamic monitoring: a randomized trial of contamination with sampling through conventional stopcocks versus a novel closed system. Infect Control Hosp Epidemiol 1989;10:557–561.Google Scholar
224. Gorbea, HF, Snydman, DR, Delaney, A, Stockman, J, Martin, WJ. Intravenous tubing with burettes can be safely changed at 48hour intervals. JAMA 1984;251:2112–2115.CrossRefGoogle ScholarPubMed
225. Maki, DG. Sepsis arising from extrinsic contamination of the infusion and measures for control. In: Phillips, I, Meers, PD, D’AArcy, PF, eds. Microbiological Hazards of Innfusion Therappy. Lancaster, England: MTP Press; 1976:99–143.Google Scholar
226. Ayliffe, GA, Babb, JR, Davies, JG, Lilly, HA. Hand disinfection: a comparison of various agents in laboratory and ward studies. J Hosp Infect 1988;11:226–243.Google Scholar
227. Rotter, M, Koller, W, Wewalka, G. Povidone-iodine and chlorhexidine gluconate-containing detergents for disinfection of hands. J Hosp Infect 1980;1:149–158.Google Scholar
228. Maki, DG, Ringer, M, Alvarado, CJ. Prospective randomized trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 1991;338:339–343.Google Scholar
229. Shapiro, JM, Bond, EL, Garman, JK. Use of a chlorhexidine dressing to reduce microbial colonization of epidural catheters. Anesthesiology 1990;73:625–631.Google Scholar
230. Strand, CL, Wajsbort, RR, Sturmann, K. Effect of iodophor vs iodine tincture skin preparation on blood culture contamination rate. JAMA 1993;269:1004–1006.Google Scholar
231. Moran, JM, Atwood, RP, Rowe, MI. A clinical and bacteriologic study of infections associated with venous cutdowns. N Engl J Med 1965;272:554–560.Google Scholar
232. Norden, CW. Application of antibiotic ointment to the site of venous catheterization—a controlled trial. J Infect Dis 1969;120:611–615.Google Scholar
233. Zinner, SH, Denny-Brown, BC, Braun, P, Burke, JP, Toala, P, Kass, EH. Risk of infection with indwelling intravenous catheters: effect of application of antibiotic ointment. J Infect Dis 1969;120:616–619.Google Scholar
234. Jarrad, MM, Freeman, JB. The effects of antibiotic ointments and antiseptics on the skin flora beneath subclavian catheter dressings during intravenous hyperalimentation. J Surg Res 1977;22:520–526.Google Scholar
235. Maki, DG, Band, JD. A comparative study of polyantibiotic and iodophor ointment in prevention of vascular catheter-related infection. Am J Med 1981;70:739–744.Google Scholar
236. Flowers, RH III, Schwenzer, KJ, Kopel, RF, Fisch, MJ, Tucker, SI, Farr, BM. Efficacy of an attachable subcutaneous cuff for the prevention of intravascular catheter-related infection. A randomized, controlled trial. JAMA 1989;261:878–883.Google Scholar
237. Reagan, DR, Doebbeling, BN, Pfaller, MA, et al. Elimination of coincident Staphylococcus aureus nasal and hand carriage with intranasal application of mupirocin calcium ointment. Ann Intern Med 1991;114:101–106.CrossRefGoogle ScholarPubMed
238. Hill, RL, Fisher, AP, Ware, RJ, Wilson, S, Casewell, MW. Mupirocin for the reduction of colonization of internal jugular cannulae—a randomized controlled trial. J Hosp Infect 1990;15:311–321.Google Scholar
239. Smith, MD, Sanghrijka, M, Lock, S. Mupirocin-resistant Staphylococcus aureus . Lancet 1987;2:1471–1473.Google Scholar
240. Smith, GE, Kennedy, CT. Staphylococcus aureus resistant to mupirocin. J Antimicrob Chemother 1988;21:141–142.Google Scholar
241. Noble, WC, Rahman, M, Cookson, B, Phillips, I. Transferable mupirocin-resistance. J Antimicrob Chemother 1988;22:771–772.Google Scholar
242. Katich, M, Band, J. Local infection of the intravenous-cannulae wound associated with transparent dressings. J Infect Dis 1985;151:971–972.Google Scholar
243. Dickerson, N, Horton, P, Smith, S, Rose, RC III. Clinically significant central venous catheter infections in a community hospital: association with type of dressing. J Infect Dis 1989;160:720–721.Google Scholar
244. Powell, C, Regan, C, Fabri, PJ, Ruberg, RL. Evaluation of Op-Site catheter dressings for parenteral nutrition: a prospective, randomized study. J Parenter Enteral Nutr 1982;6:43–46.Google Scholar
245. Ricard, P, Martin, R, Marcoux, JA. Protection of indwelling vascular catheters: incidence of bacterial contamination and catheter-related sepsis. Crit Care Med 1985;13:541–543.Google Scholar
246. Young, GP, Alexeyeff, M, Russell, DM, Thomas, RJ. Catheter sepsis during parenteral nutrition: the safety of long-term Op-Site dressings. J Parenter Enteral Nutr 1988;12:365–370.Google Scholar
247. Maki, DG, Stolz, S, Wheeler, S. A prospective, randomized, three-way clinical comparison of a novel, highly-permeable polyurethane dressing with 206 Swan Ganz pulmonary artery catheters: Op-Site IV 3000 vs Tegaderm vs gauze and Tape, I: cutaneous colonization under the dressing, catheter-related infection. In: Maki, DG, ed. Improving Catheter Site Care. London, England: Royal Society of Medicine Services; 1991.Google Scholar
248. Hoffmann, KK, Weber, DJ, Samsa, GP, Rutala, WA. Transparent polyurethane film as an intravenous catheter dressing: a meta- analysis of the infection risks. JAMA 1992;267:2072–2076.Google Scholar
249. Quinlan, A. In vivo assessment of microbial proliferation under Op-Site IV 3000, Tegaderm and Tegaderm Plus, with and without serum. In: Proceedings and Abstracts of the 3rd International Meeting of the Hospital Infection Society. London, England: Hospital Infection Society.Google Scholar
250. Babycos, CR, Barracos, A, Mancuso, J, Turner-Marse, T. Collodion as a safe, cost-effective dressing for central venous catheters. South Med J 1990;83:1286–1288.Google Scholar
251. Rusho, WJ, Batt, JN. Effect of filtration on complications of postoperative intravenous therapy. Am J Hosp Pharm 1979;36:1355–1356.Google Scholar
252. Allcutt, DA, Lort, D, McCollum, CN. Final inline filtration for intravenous infusions: a prospective hospital study. Br J Surg 1983;70:111–113.Google Scholar
253. Falchuk, KH, Peterson, L, McNeil, BJ. Microparticulate-induced phlebitis. Its prevention by inline filtration. N Engl J Med 1985;312:78–82.Google Scholar
254. Maddox, RR, John, JF Jr, Brown, LL, Smith, CE. Effect of inline filtration on postinfusion phlebitis. Clin Pharm 1983;2:58–61.Google Scholar
255. Turco, SJ, Davis, NM. Particulate matter in intravenous infusion fluids—phase 3. Am J Hosp Pharm 1973;30:611–613.Google Scholar
256. Baumgartner, TG, Schmidt, GL, Thakker, KM, et al. Bacterial endotoxin retention by inline intravenous filters. Am J Hosp Pharm 1986;43:681–684.Google Scholar
257. Butler, DL, Munson, JM, Deluca, PP. Effect of inline filtration on the potency of low-dose drugs. Am J Hosp Pharm 1980;37:935–941.Google Scholar
258. Freeman, JB, Litton, AA. Preponderance of gram-positive infections during parenteral alimentation. Surg Gynecol Obstet 1974;139:905–908.Google Scholar
259. Maki, DG, Cobb, L, Garman, JK, Shapiro, JM, Ringer, M, Helgerson, RB. An attachable silver-impregnated cuff for prevention of infection with central venous catheters: a prospective randomized multicenter trial. Am J Med 1988;85:307–314.Google Scholar
260. Groeger, JS, Lucas, AB, Coit, D, et al. A prospective, randomized evaluation of the effect of the silver impregnated subcutaneous cuffs for preventing tunneled chronic venous access catheter infections in cancer patients. Ann Surg 1993;218:206–210.Google Scholar
261. Trooskin, SZ, Donetz, AP, Harvey, RA, Greco, RS. Prevention of catheter sepsis by antibiotic bonding. Surgery 1985;97:547–551.Google Scholar
262. Bach, A. Bohrer, H, Motsch, J, Martin, E, Geiss, HK, Sonntag, HG. Prevention of bacterial colonization of intravenous catheters by antiseptic impregnation of polyurethane polymers. J Antimicrob Chemother 1994;33:969–978.Google Scholar
263. Raad, I, Darouiche, R, Hachem, R, Mansouri, M, Bodey, GP. The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J Infect Dis 1996;173:418–424.Google Scholar
264. Sherertz, RJ, Forman, DM, Soloman, DD. Efficacy of dicloxacillin-coated polyurethane catheters in preventing subcutaneous Staphylococcus aureus infection in mice. Antimicrob Agents Chemother 1989;33:1174–1178.Google Scholar
265. Greenfeld, JI, Sampath, L, Popilskis, SJ, Brunnert, Sr, Stylianos, S, Modak, S. Decreased bacterial adherence and biofilm formation on chlorhexidine and silver sulfadiazine-impregnated central venous catheters implanted in swine. Crit Care Med 1995;23:894–900.Google Scholar
266. Sherertz, RJ, Carruth, A, Hampton, AA, Byron, MP, Solomon, DD. Efficacy of antibiotic-coated catheters in preventing subcutaneous Staphylococcus aureus infection in rabbits. J Infect Dis 1993;167:98–106.Google Scholar
267. Carruth, WA, Byron, MP, Solomon, DD, et al. Subcutaneous, catheter-related inflammation in a rabbit model correlates with peripheral vein phlebitis in human volunteers. J Biomed Mater Res 1994;28:259–267.Google Scholar
268. Kamal, GD, Pfaller, MA, Rempe, LE, Jebson, PJ. Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. JAMA 1991;265:2364–2368.Google Scholar
269. Nelson, DB, Kien, CL, Mohr, B, Frank, S, Davis, SD. Dressing changes by specialized personnel reduce infection rates in patients receiving central venous parenteral nutrition. J Parenter Enteral Nutr 1986;10:220–222.Google Scholar
270. Faubion, WC, Wesley, JR, Khaldi, N, Silva, J. Total parenteral nutrition catheter sepsis: impact of the team approach. J Parenter Enteral Nutr 1986;10:642–645.Google Scholar
271. Tomford, JW, Hershey, CO, McLaren, CE, Porter, DK, Cohen, DI. Intravenous therapy team and peripheral venous catheter-associated complications. A prospective control study. Arch Intern Med 1984;144:1191–1194.Google Scholar
272. Bock, SN, Lee, RE, Fisher, B, et al. A prospective randomized trial evaluating prophylactic antibiotics to prevent triple-lumen catheter-related sepsis in patients treated with immunotherapy. J Clin Oncol 1990;8:161–169.Google Scholar
273. Al-Sibai, MB. The value of prophylactic antibiotics during insertion of long-term indwelling silastic right atrial catheters in cancer patients. Cancer 1987;60:1891–1895.Google Scholar
274. Ranson, MR, Oppenheim, BA, Jackson, A, Kamthan, AG, Scarffe, JH. Double-blind placebo controlled study of vancomycin prophylaxis for central venous catheter insertion in cancer patients. J Hosp Infect 1990;15:95–102.Google Scholar
275. McKee, R, Dunsmuir, R, Whitby, M, Garden, OJ. Does antibiotic prophylaxis at the time of catheter insertion reduce the incidence of catheter-related sepsis in intravenous nutrition? J Hosp Infect 1985;6:419–425.Google Scholar
276. Spafford, PS, Sinkin, RA, Cox, C, Reubens, L, Powell, KR. Prevention of central venous catheter-related coagulase-nega-tive staphylococcal sepsis in neonates. J Pediatr 1994;125:259–263.Google Scholar
277. Kacica, MA, Horgan, MJ, Ochoa, L, Sander, R, Lepow, ML, Venezia, RA. Prevention of gram-positive sepsis in neonates weighing less than 1500 grams. J Pediatr 1994;125:253–258.Google Scholar
278. Schwartz, C, Henrickson, KJ, Roghmann, K, Powell, K. Prevention of bacteremia attributed to luminal colonization of tunneled central venous catheters with vancomycin-susceptible organisms. J Clin Oncol 1990;8:1591–1597.Google Scholar
279. Raad, II, Luna, M, Khalil, SA, Costerton, JW, Lam, C, Bodey, GP. The relationship between the thrombotic and infectious complications of central venous catheters. JAAMA 1994;271(13):1014–1016.Google Scholar
280. Ashton, J, Gibson, V, Summers, S. Effects of heparin versus saline solution on intermittent infusion device irrigation. Heart Lung 1990;19:608–612.Google Scholar
281. Weber, DR. Is heparin really necessary in the lock and, if so, how much? Drugs Intelligence and Clinical Pharmacy Annals of Pharmacotherapy 1991;25:399–407.Google Scholar
282. Root, JL, McIntyre, OR, Jacobs, NJ, Daghlian, CP. Inhibitory effect of disodium EDTA upon the growth of Staphylococcus epider-midis in vitro: relation to infection prophylaxis of Hickman catheters. Antimicrob Agents Chemother 1988;32:1627–1631.Google Scholar
283. Passannate, A, Macik, BG. Case report: the heparin flush syndrome: a cause of iatrogenic hemorrhage. Am J Med Sci 1988;296:71–73.Google Scholar
284. Heeger, PS, Backstrom, JT. Heparin flushes and thrombocytopenia. Ann Intern Med 1986;105:143. Letter.Google Scholar
285. Rhodes, GR, Dixon, RH, Silver, D. Heparin induced thrombocy-topenia with thrombotic and hemorrhagic manifestations. Surg Gynecol Obstet 1973;136:406–416.Google Scholar
286. Garrelts, JC. White clot syndrome and thrombocytopenia: reasons to abandon heparin IV lock flush solution. Clin Pharm 1992;11:797–799.Google Scholar
287. Silver, D, Kapsch, DN, Tsoi, EK. Heparin-induced thrombocy-topenia, thrombosis, and hemorrhage. Ann Surg 1983;198:301–306.Google Scholar
288. Sketch, MH, Cale, M, Mohiuddin, SM, Booth, RW. Use of per- cutaneously inserted venous catheters in coronary care units. Chest 1972;62:684–689.Google Scholar
289. Bassan, MM, Sheikh-Hamad, D. Prevention of lidocaine-infusion phlebitis by heparin and hydrocortisone. Chest 1983;84:439–441.Google Scholar
290. Daniell, HW. Heparin in the prevention of infusion phlebitis. A double-blind controlled study. JAMA 1973;226:1317–1321.Google Scholar
291. Makarewicz, PA, Freeman, JB, Fairfull-Smith, R. Prevention of superficial phlebitis during parenteral nutrition. Am J Surg 1986;151:126–129.Google Scholar
292. Wright, A, Hecker, JF, Lewis, GB. Use of transdermal glyceryl trinitrate to reduce failure of intravenous infusion due to phlebitis and extravasation. Lancet 1985;2:1148–1150.Google Scholar
293. Khawaja, HT, Campbell, MS, Weaver, PC. Effect of transdermal glyceryl trinitrate on the survival of peripheral intravenous infusions: a double-blind prospective clinical study. Br J Surg 1988;75:1212–1215.Google Scholar
294. Woodhouse, CR. Movelat in the prevention of infusion thrombophlebitis. Br Med J 1979;1:454–455.Google Scholar
295. O'Brien, BJ, Buxton, MJ, Khawaja, HT. An economic evaluation of transdermal glycerly trinitrate in the prevention of intravenous infusion failure. J Clin Epidemiol 1990;43:757–763.Google Scholar
296. Adams, KS, Zehrer, CL, Thomas, W. Comparison of a needleless system with conventional heparin locks. Am J Infect Control 1993;21:263–269.Google Scholar
297. Danzig, LE, Short, L, Collins, K, et al. Bloodstream infections associated with a needleless intravenous infusion system and total parenteral nutrition. JAMA 1995;273:1862–1864.Google Scholar
298. Larson, EL, Cheng, G, Choo, JTE, Merz, W. In vitro survival of skin flora in heparin locks and needleless valve infusion devices. Heart Lung 1993;22:459–462.Google Scholar
299. Longfield, R, Longfield, J, Smith, LP, Hyams, KC, Strohmer, ME. Multidose medication vial sterility: an in-use study and a review of the literature. Am J Infect Control 1984;5:165–169.Google Scholar
300. Kothari, T, Reyes, MP, Brooks, N, Brown, MJ, Lerner, AM. Pseudomonas cepacia septic arthritis due to intra-articular injections of methylprednisolone. Can Med Assoc J 1977;116:1230–1235. Letter.Google Scholar
301. Nakashima, AK, Highsmith, AK, Martone, WJ. Survival of Serratia marcescens in benzalkonium chloride and in multiple-dose medication vials: relationship to epidemic septic arthritis. J Clin Microbiol 1987;25:1019–1021.Google Scholar
302. Alter, MJ, Ahtone, J, Maynard, JE. Hepatitis B virus transmission associated with a multiple-dose vial in a hemodialysis unit. Ann Intern Med 1983;99:330–333.Google Scholar
303. Highsmith, AK, Greenhood, R, Allen, JR. Growth of nosocomial pathogens in multiple-dose parenteral medication vials. J Clin Microbiol 1982;15:1024–1028.Google Scholar
304. Lehmann, CR. Effect of refrigeration on bactericidal activity of four multiple-dose injectable drug products. Am J Hosp Pharm 1977;34:1196–1200.Google Scholar
305. Llop, JM, Mangues, I, Perez, JL, Lopez, P, Tubau, M. Staphylococcus saprophyticus sepsis related to total parenteral nutrition admixtures contamination. J Parenter Enteral Nutr 1993;17:575–577.Google Scholar
306. Degleux, G, Le Coutour, X, Hecquard, C, Oblin, I. Septicemia caused by contaminated parenteral nutrition pouches: the refrigerator as an unusual cause. J Parenter Enteral Nutr 1991;15:474–475.Google Scholar
307. Scheckelhoff, DJ, Mirtallo, JM, Ayers, LW, Visconti, JA. Growth of bacteria and fungi in total parenteral nutrient admixtures. Am J Hosp Pharm 1986;43:73–77.Google Scholar
308. Goldmann, DA, Martin, WT, Worthington, JW. Growth of bacteria and fungi in total parenteral nutrition solutions. Am J Surg 1973;126:314–318.Google Scholar
309. D'Angio, RG, Riechers, KC, Gilsforf, RB, Constantino, JM. Effect of the mode of lipid administration on parenteral nutrition-related infections. Ann Pharmacother 1992;26:14–17.Google Scholar
310. Vasilakis, AA, Apelgren, KN. Answering the fat emulsion question: three in one admixture vs conventional total parenteral nutrition in a clinical setting. J Parenter Enteral Nutr 1988;12:356–359.Google Scholar
311. Snydman, DR, Murray, SA, Kornfeld, SJ, Majka, JA, Ellis, CA. Total parenteral nutrition-related infections. Am J Med 1982;73:695–699.Google Scholar
312. Ryan, JA Jr, Abel, RM, Abbott, WA, et al. Catheter complication in parenteral nutrition. A prospective study of 200 consecutive patients. N Engl J Med 1974;290:757–761.Google Scholar
313. Vanhuynegem, L, Parmentier, P, Potvliege, C. In situ bacteriologic diagnosis of total parenteral catheter infection. Surgery 1988;103:174–177.Google Scholar
314. Keohane, PP, Jones, B, Attrill, H, et al. Effect of catheter tunneling and a nutrition nurse on catheter sepsis during parenteral nutrition. A controlled trial. Lancet 1983;2:1388–1390.Google Scholar
315. Powell, CR, Traetow, MJ, Fabri, PJ, Kudsk, KA, Ruberg, RL. Op- Site dressing study: a prospective randomized study evaluating povidone iodine ointment and extension set changes with 7-day Op-Site dressings applied to total parenteral nutrition subclavian sites. J Parenter Enteral Nutr 1985;9:443–446.Google Scholar
316. Herruzo-Cabrera, R, Garcia-Cabellero, J, Vera-Cortes, L, et al. Growth of microorganism in parenteral nutrient solutions. Am J Hosp Pharm 1984;41:1178–1180.Google Scholar
317. Federal Standard No. 209E. Airborne particulates cleanliness classes in clean rooms and clean zones. Washington, DC: General Services Administration; 1992.Google Scholar
318. American Society of Hospital Pharmacists. ASHP technical assistance bulletin on quality assurance for pharmacy-prepared sterile products. Am J Hosp Pharm 1993;50:2386–2398.Google Scholar
319. Rannem, T, Ladefoged, K, Hegnhoj, F, Hylander Moller, E, Bruun, B, Farnum, S. Catheter-related sepsis in long-term parenteral nutrition with Broviac catheters. An evaluation of different disinfectants. Clinical Nutrition 1990;9:131–136.Google Scholar
320. Maki, DG, McCormack, KN. Defatting catheter insertion sites in total parenteral nutrition is no value as an infection control measure. Controlled clinical trial. Am J Med 1987;83:833–840.Google Scholar
321. Palidar, PJ, Simonowitz, DA, Oreskovich, MR, et al. Use of Op- Site as an occlusive dressing for total parenteral nutrition catheters. J Parenter Enteral Nutr 1982;6:150–151.Google Scholar
322. Uldall, PR, Dyck, RF, Woods, F, et al. A subclavian catheter for temporary vascular access for hemodialysis and plasmaphere- sis. Dialysis Transplant 1979;296:1305–1309.Google Scholar
323. Tokars, JI, Alter, MS, Favero, MS, Moyer, LA, Bland, LA. National surveillance of hemodialysis associated disease in the United States, 1990. ASAIO J 1993;39:71–80.Google Scholar
324. Keane, WF, Shapiro, FL, Raij, L. Incidence and type of infection occurring in 445 chronic hemodialysis patients. Trans Am Soc Artif Intern Organs 1977;23:41–47.Google Scholar
325. Pezzarossi, HE, Ponce de Leon, S, Calva, JJ, Lazo de la Vega, SA, Ruiz-Palacios, GM. High incidence of subclavian dialysis catheter-related bacteremias. Infect Control 1986;7:596–599.Google Scholar
326. Kong, NC, Morad, Z, Suleiman, AB. Subclavian catheters as temporary vascular access. Singapore Med J 1989:261–262.Google Scholar
327. Shaffer, D, Madras, PN, Williams, ME, D’Elia, JA, Kaldany, A, Monaco, AP. Use of Dacron cuffed silicone catheters as long-term hemodialysis access. ASAIO J 1992:55–58.Google Scholar
328. Shusterman, NH, Kloss, K, Mullen, JL. Successful use of double-lumen, silicone rubber catheters for permanent hemodialysis access. Kidney Int 1989;35:887–890.Google Scholar
329. Bour, ES, Weaver, AS, Yang, HC, Gifford, RR. Experience with the double-lumen silastic catheter for hemoaccess. Gynecol Obstet 1990;171:33–39.Google Scholar
330. Almirall, J, Gonzalez, J, Rello, J, et al. Infection of hemodialysis catheters: incidence and mechanisms. Am J Nephrol 1989;1989:454–459.Google Scholar
331. Cheesbrough, JS, Finch, RG, Burden, RP. A prospective study of the mechanisms of infection associated with hemodialysis catheters. J Infect Dis 1986;154:579–589.Google Scholar
332. Sherertz, RJ, Falk, RJ, Huffman, KA, Thomann, CA, Mattern, WD. Infections associated with subclavian Uldall catheters. Arch Intern Med 1983;143:52–56.Google Scholar
333. Blake, PG, Huraib, S, Uldall, PR. The use of dual lumen jugular venous catheters as definitive long term access for haemodial- ysis. Int J Artif Organs 1990;13:26–31.Google Scholar
334. Dobkin, JF, Miller, MH, Steigbigel, NH. Septicemia in patients on chronic hemodialysis. Ann Intern Med 1978;88:28–33.Google Scholar
335. Vanherweghem, JL, Dhaene, M, Goldman, M, et al. Infections associated with subclavian dialysis catheters: the key role of nurse training. Nephron 1986;42:116–119.Google Scholar
336. Moss, AH, Vasilakis, C, Holley, JL, Foulks, CJ, Pillai, K, McDowell, DE. Use of a silicone dual-lumen catheter with a Dacron cuff as a long-term vascular access for hemodialysis patients. Am J Kidney 1990;16:211–215.Google Scholar
337. Watson, AR, Bahoric, A, Wesson, D. A central venous (W-B-W) catheter for multipurpose vascular access in children. Artif Organs 1986;10:59–61.Google Scholar
338. Canaud, B, Beraud, JJ, Joyeux, H, Mion, C. Internal jugular vein cannulation using two silastic catheters. A new simple, safe long-term vascular access for extracorporeal treatment. Nephron 1986;43:133–138.Google Scholar
339. Donnelly, PK, Hoenich, NA, Lennard, TW, Proud, G, Taylor, RM. Surgical management of long-term central venous access in uraemic patients. Nephrol Dial Transplant 1988;3:57–65.Google Scholar
340. Tapson, JS, Uldall, PR. Avoiding deaths from subclavian cannu- lation for haemodialysis. Int J Artif Organs 1983;6:227–230.Google Scholar
341. Barton, BR, Hermann, G, Weil, R III. Cardiothoracic emergencies associated with subclavian hemodialysis catheters. JAMA 1983;250:2600–2662.Google Scholar
342. Tapson, JS, Uldall, R. Fatal hemothorax caused by a subclavian hemodialysis catheter. Thoughts on prevention. Arch Intern Med 1984;144:1685–1687.Google Scholar
343. Brady, HR, Fitzcharles, B, Goldberg, H, et al. Diagnosis and management of subclavian vein thrombosis occurring with subclavian cannulation for hemodialysis. Blood Purif 1989;7:210–217.Google Scholar
344. Schwab, SJ, Buller, GL, McCann, RL, Bollinger, RR, Stickel, DL. Prospective evaluation of a Dacron-cuffed hemodialysis catheter for prolonged use. Am J Kidney Dis 1988;11:166–169.Google Scholar
345. Pourchez, T, Moriniere, P, Fournier, A, Pietri, J. Use of a Perm-cath (Quinton) catheter in uraemic patients in whom the creation of conventional vascular access for haemodialysis is difficult. Nephron 1989;53:297–302.Google Scholar
346. Foissac-Gegoux, P, Dumont, A. Septicemias au cours du traitement par hemodialyse periodique. Nouv Presse Med 1974;3:151.Google Scholar
347. Meyrier, A, Chevet, D, Marsac, J, Leroux-Robert, C, Sraer, JD, Scetbon, V. Staphylococcemias chez las malades hemodialyses. Nouv Presse Med 1973;2:2379–2383.Google Scholar
348. Kaplowitz, LG, Comstock, JA, Landwehr, DM, Dalton, HD, Mayhall, CG. A prospective study of infections in hemodialysis patients: patient hygiene and other risk factors for infection. Infect Control Hosp Epidemiol 1988;9:534–541.Google Scholar
349. Cappello, M, De Pauw, L, Bastin, G, et al. Central venous access for hemodialysis using the Hickman catheter. Nephrol Dial Transplant 1989;4:988–992.Google Scholar
350. Vanherweghem, JL, Cabolet, P, Dhaene, M, et al. Complications related to subclavian catheters for hemodialysis. Int J Artif Organs 1986;5:297–309.Google Scholar
351. Yu, VL, Goetz, A, Wagener, M, et al. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. N Engl J Med 1986;315:91–96.Google Scholar
352. Kirmani, S, Tuazon, CU, Murray, HW, Parrish, AE, Sheagran, JN. Staphylococcal aureus carriage rate of patients receiving long- term hemodialysis. Arch Intern Med 1978;138:1657–1679.Google Scholar
353. Levin, A, Mason, AJ, Jindal, KK, Fong, IW, Goldstein, MB. Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Kidney Int 1991;40:934–938.Google Scholar
354. Ralston, AJ, Harlow, GR, Jones, DM, Davis, P. Infections of Scribner and Brescia arteriovenous shunts. Br Med J 1971;3:408–409.Google Scholar
355. Goldblum, SE, Ulrich, JA, Goldman, RS, Reed, WP. Nasal and cutaneous flora among hemodialysis patients and personnel: quantitative and qualitative characterization and patterns of staphylococcal carriage. Am J Kidney Dis 1982;2:281–286.Google Scholar
356. Uldall, PR. Subclavian cannulation for hemodialysis. Int J Artif Organs 1981;4:213–214.Google Scholar
357. Carlisle, EJ, Blake, P, McCarthy, F, Vas, S, Uldall, R. Septicemia in long-term jugular hemodialysis catheters: eradicating infection by changing the catheter over a guidewire. Int J Artif Organs 1991;14:150–153.Google Scholar
358. Graeve, AH, Carpenter, CM, Schiller, WR. Management of central venous catheters using a wire introducer. Am J Surg 1981;142:752–755.Google Scholar
359. Farber, BF. The multi-lumen catheter: proposed guidelines for its use. Infect Control Hosp Epidemiol 1988;9:206–208.Google Scholar
360. Domoto, DT, Kennedy, DJ. Antibiotic treatment of chronic central venous hemodialysis catheter infection without catheter removal. Int J Artif Organs 1985:239–240.Google Scholar
361. Garland, JS, Dunne, WM, Havens, P, et al. Peripheral intravenous catheter complications in critically ill children: a prospective study. Pediatrics 1992;89:1145–1150.Google Scholar
362. Freeman, J, Platt, R, Sidebottom, DG, Leclair, JM, Epstein, MF, Goldmann, DA. Coagulase-negative staphylococcal bacteremia in the changing neonatal intensive care unit population. Is there an epidemic? JAAMA 1987;258:2548–2552.Google Scholar
363. Garland, JS, Nelson, DB, Cheah, T, Hennes, HH, Johnson, TM. Infectious complications during peripheral intravenous therapy with Teflon catheters: a prospective study. Pediatr Infect Dis J 1987;6:918–921.Google Scholar
364. Batton, DG, Maisels, MJ, Appelbaum, P. Use of peripheral intravenous cannulas in premature infants: a controlled study. Pediatrics 1982;70:487–490.Google Scholar
365. Furfaro, S, Gauthier, M, Lacroix, J, Nadeau, D, Lefleur, L, Mathews, S. Arterial catheter-related infections in children: a 1- year cohort analysis. Am J Dis Child 1991;145:1037–1043.Google Scholar
366. Adam, RD, Edwards, LD, Becker, CC, Schrom, HM. Semiquantitative cultures and routine tip cultures on umbilical catheters. J Pediatr 1982;100:123–126.Google Scholar
367. Danker, WM, Spector, SA, Fierer, J, Davis, CE. Malassezia fungemia in neonates and adults: complication of hyperalimen-tation. Rev Infect Dis 1987;9:743–753.Google Scholar
368. Garcia, CR, Johnston, BL, Corvi, G, Walker, LJ, George, WL. Intravenous catheter-associated Malassezia furfur fungemia. Am J Med 1987;83:790–792.Google Scholar
369. Long, JG, Keyserling, HL. Catheter-related infection in infants due to an unusual lipophilic yeast—Malassezia furfur . Pediatrics 1985;76:896–900.CrossRefGoogle Scholar
370. Alpert, G, Bell, LM, Campos, JM. Malassezia furfur fungemia in infancy. Clin Pediatr 1987;26:528–531.Google Scholar
371. Bertone, SA, Fisher, MC, Mortensen, JE. Quantitative skin cultures at potential catheter sites in neonates. Infect Control Hosp Epidemiol 1994;15:315–318.Google Scholar
372. Gaynes, RP, Martone, WJ, Culver, DH, et al. Comparison of rates of nosocomial infections in neonatal intensive care units in the United States. National Nosocomial Infections Surveillance System. Am J Med 1991;91(suppl 3B):192S–196S.Google Scholar
373. Cronin, WA, Germanson, TP, Donowitz, LG. Intravascular catheter colonization and related bloodstream infection in critically ill neonates. Infect Control Hosp Epidemiol 1990;11:301–308.Google Scholar
374. Nelson, DB, Garland, JS. The natural history of Teflon catheter associated phlebitis in children. Am J Dis Child 1987;141:1090–1092.Google Scholar
375. Garland, JS, Buck, RK, Maloney et al. Comparison of 10% povi-don^iodine and 0.5% chlorhexidine gluconate for the prevention of peripheral intravenous catheter colonization in neonates: a prospective trial. Pediatr Infect Dis J 1995;14:510–516.Google Scholar
376. Landers, S, Moise, AA, Fraley, JK, Smith, EO, Baker, CJ. Factors associated with umbilical catheter-related sepsis in neonates. Am J Dis Child 1991;145:675–680.Google Scholar
377. Krauss, AN, Albert, RF, Kannan, MM. Contamination of umbilical catheters in the newborn infant. J Pediatr 1970;77:965–969.Google Scholar
378. Balagtas, RC, Bell, CE, Edwards, LD, Levin, S. Risk of local and systemic infections associated with umbilical vein catheterization: a prospective study in 86 newborn patients. Pediatrics 1971;48:359–367.Google Scholar
379. Bard, H, Albert, G, Teasdale, F, Doray, B, Martineau, B. Prophylactic antibiotics in chronic umbilical artery catheterization in respiratory distress syndrome. Arch Dis Child 1973;48:630–635.Google Scholar
380. Mayhall, CG. Diagnosis and management of infections of implantable devices used for prolonged venous access. In: Remington, JS, Swartz, MN, eds. Current Clinical Topics in Infectious Diseases, XII. Boston, MA: Blackwell Scientific Publications; 1992:83–110.Google Scholar
381. LaQuaglia, MP, Lucas, A, Thaler, HT, Friedlander-Klar, H, Exelby, PR, Groeger, JS. A prospective analysis of vascular access device-related infections in children. J Pediatr Surg 1992;27:840–842.Google Scholar
382. Wiener, ES, McGuire, P, Stolar, CJ, et al. The CCSG prospective study of venous access devices: an analysis of insertions and causes for removal. J Pediatr Surg 1992;27:155–164.Google Scholar
383. Sola, JE, Stone, MM, Wise, B, Columbani, PM. Atypical throm- botic and septic complications of totally implantable venous access devices in patients with cystic fibrosis. Pediatr Pulmonol 1992;14:239–242.Google Scholar
384. Johnson, PR, Decker, MD, Edwards, KM, et al. Frequency of Broviac catheter infections in pediatric oncology patients. J Infect Dis 1984;154:570–578.Google Scholar
385. Mulloy, RH, Jadavji, T, Russell, ML. Tunneled central venous catheter sepsis: risk factors in a pediatric hospital. J Parenter Enteral Nutr 1991;15:460–463.Google Scholar
386. Gorelick, MH, Owen, WC, Seibel, NL, Reaman, GH. Lack of association between neutropenia and the incidence of bacteremia associated with indwelling central venous catheters in febrile pediatric cancer patients. Pediatr Infect Dis J 1991;10:506–510.Google Scholar
387. Mirro, JJ, Rao, BN, Stokes, DC, et al. A prospective study of Hickman/Broviac catheters and implantable ports in pediatric oncology patients. J Clin Oncol 1989;7:214–222.Google Scholar
388. Stenzel, JP, Green, TP, Fuhrman, BP, Carlson, PE, Marchessault, RP. Percutaneous central venous catheterization in a pediatric intensive care unit: a survival analysis of complications. Crit Care Med 1989;17:984–988.Google Scholar
389. East, SA. Planning, implementation, and evaluation of a successful hospital-based peripherally inserted central catheter program. J Intraven Nurs 1994;17:189–192.Google Scholar
390. Food and Drug Administration, Center for Devices and Radiological Health, Office of Technical Assistance, Central Venous Catheter Working Group. Central venous catheter complications (a three part series); Winter 1994.Google Scholar
391. Kyle, KS, Myers, JS. Peripherally inserted central catheters. Development of a hospital-based program. J Intraven Nurs 1990;13:287–290.Google Scholar
392. BeVier, PA, Rice, CE. Initiating a pediatric peripherally inserted central catheter and midline catheter program. J Intraven Nurs 1994;17:201–205.Google Scholar
393. Conly, JM, Hill, S, Ross, J, Lertzman, J, Louie, TJ. Handwashing practices in an intensive care unit: the effects of an educational program and its relationship to infection rates. Am J Clin Pathol 1989;17:330–339.Google Scholar
394. Seto, WH, Ching, TY, Yuen, KY, Chu, YB, Seto, WL. The enhancement of infection control in-service education by ward opinion leaders. Am J Clin Pathol 1991;19:86–91.Google Scholar
395. Freeman, J, McGowan, JE Jr. Methodologic issues in hospital epidemiology, I: rates, case finding, and interpretation. Rev Infect Dis 1981;3:658–667.Google Scholar
396. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182–205.Google Scholar
397. Josephson, A, Karanfil, L, Alonso, H, Watson, A, Bilght, J. Risk- specific nosocomial infection rates. Am J Med 1991;91(suppl 3B):131S–137S.Google Scholar
398. Evans, ME, Schaffner, W, Federspiel, CF, Cotoon, RB, McKee, KT, Stratton, CW. Sensitivity, specificity, and predictive value of body surface cultures in a neonatal intensive care unit. JAMA 1988;259:248–252.Google Scholar
399. Raad, I, Baba, M, Bodey, GP. Diagnosis of catheter-related infections: role of the surveillance and targeted quantitative skin cultures. Clin Infect Dis 1995;20:593–597.Google Scholar
400. Adams, BG, Marrie, TJ. Hand carriage of gram-negative rods may not be transient. J Hyg 1982;89:33–46.Google Scholar
401. Adams, BG, Marrie, TJ. Hand carriage of gram-negative rods by health care personnel. J Hyg 1982;89:23–31.Google Scholar
402. Steere, AC, Mallison, GF. Handwashing practices for the prevention of nosocomial infections. Ann Intern Med 1975;1975:83.Google Scholar
403. Casewell, M, Phillips, I. Hands as a route of transmission of Klebsiella species. Br Med J 1977;2:1315–1317.Google Scholar
404. Sprunt, K, Redman, W, Leidy, G. Antimicrobial effectiveness of routine handwashing. Pediatrics 1973;52:264–271.Google Scholar
405. Daschner, FD. The transmission of infections in hospitals by staff carriers, methods of prevention and control. Infect Control 1985;6:97–98.Google Scholar
406. Simmons, B, Bryant, J, Neiman, K, et al. The role of handwashing in prevention of endemic intensive care unit infections. Infect Control Hosp Epidemiol 1990;11:589–594.Google Scholar
407. Reybrouck, G. Role of the hands in the spread of nosocomial infections. J Hosp Infect 1983;41:103–110.Google Scholar
408. Knittle, MA, Eitzman, DV, Baer, H. Role of hand contamination of personnel in the epidemiology of gram-negative nosocomial infections. J Pediatr 1975;86:433–437.Google Scholar
409. Centers for Disease Control and Prevention. Update: universal precautions for prevention of transmission of HIV, Hepatitis B, and other bloodborne pathogens in healthcare settings. MMWR 1988;24:377–382, 387-388.Google Scholar
410. McKee, KT Jr, Melly, MA, Greene, HL, Schaffner, W. Gram-negative bacillary sepsis associated with use of lipid emulsion in parenteral nutrition. Am J Dis Child 1979;133:649–650.Google Scholar
411. Allen, JR. Guidelines for changing administration sets for intravenous therapy. National Intravenous Therapy Association. 1980;3:175–179.Google Scholar
412. Ansel, HC, Gigandet, MP. Change in pH of infusion solutions upon mixing with blood. JAMA 1971;218:1052.Google Scholar
413. Leroy, O, Billau, V, Beuscart, C, et al. Nosocomial infections associated with long-term radial artery cannulation. Intensive Care Med 1989;15:241–256.Google Scholar
414. Ruschman, KL, Fulton, JS. Effectiveness of disinfectant techniques on intravenous tubing latex injection ports. J Intraven Nurs 1993;16:304–308.Google Scholar
415. Cortopassi, RF, Kikugawa, CA. Evaluation of antiseptics in the preparation of intravenous admixtures. Am J Hosp Pharm 1977;34:1193–1196.Google Scholar
416. Plott, RT, Wagner, RF, Tyring, SK. Iatrogenic contamination of multidose vials in simulated use. A reassessment of current patient injection technique. Arch Dermatol 1990;126:1441–1444.Google Scholar
417. Shulan, DJ, Weiler, JM, Koontz, F, Richerson, HB. Contamination of intradermal skin test syringes. J Allergy Clin Immunol 1985;76:226–227.Google Scholar
418. Lutz, CT, Bell, CE Jr, Wedner, HJ, Krogstad, DJ. Allergy testing of multiple patients should no longer be performed with a common syringe. N Engl J Med 1984;310:1335–1337.Google Scholar
419. Scalley, RD, Van, CS, Cochran, RS. The impact of an IV team on the occurrence of intravenous-related phlebitis. A 30-month study. J Intraven Nurs 1992;15:100–109.Google Scholar
420. Thomson, S. IV therapy: a financial feasibility study. Nurs Manage 1993;24:68A–68G.Google Scholar
421. Smith, I, Hathaway, M, Goldman, C, et al. A randomized study to determine complications associated with duration of insertion of heparin locks. Res Nurs Health 1990;13:367–373.Google Scholar
422. American Society of Hospital Pharmacists. ASHP therapeutic position statement on the institutional use of 0.9% sodium chloride injection to maintain patency of peripheral indwelling intermittent infusion devices. Am J Hosp Pharm 1994;51:1572–1574.Google Scholar
423. Goode, CJ, Titler, M, Rakel, B, et al. A meta-analysis of effects of heparin flush and saline flush: quality and cost implications. Nurs Res 1991;40:324–330.Google Scholar
424. Gyves, J, Ensminger, W, Niederhuber, J, et al. Totally-implanted system for intravenous chemotherapy in patients with cancer. Am J Med 1982;73:841–845.Google Scholar
425. Nahata, MC, King, DR, Powell, DA, Marx, SM, Ginn-Pease, ME. Management of catheter-related infections in pediatric patients. J Parenter Enteral Nutr 1988;12:58–59.Google Scholar
426. Powell, C, Kudsk, KA, Kulich, PA, Mandelbaum, JA, Fabri, PJ. Effect of frequent guidewire changes on triple-lumen catheter sepsis. J Parenter Enteral Nutr 1988;12:462–464.Google Scholar
427. Salzman, MB, Isenberg, HD, Rubin, LG. Use of disinfectant to reduce microbial contamination of hubs of vascular catheters. J Clin Microbiol 1993;31:475–479.Google Scholar
428. Wormser, GP, Onorato, IM, Preminger, TJ, Culver, D, Martone, WJ. Sensitivity and specificity of blood cultures obtained through intravascular catheters. Crit Care Med 1990;18:152–156.Google Scholar
429. Bryant, JK, Strand, CL. Reliability of blood cultures collected from intravascular catheter versus venipuncture. Am J Clin Pathol 1987;88:113–116.Google Scholar
430. Felices, FJ, Hernandez, JL, Ruiz, J, Meseguer, J, Gomez, JA, Molina, E. Use of the central venous pressure catheter to obtain blood cultures. Crit Care Med 1979;7:78–79.Google Scholar
431. Tafuro, P, Colbourn, D, Gurevich, I, et al. Comparison of blood cultures obtained simultaneously by venopuncture and from vascular lines. J Hosp Infect 1986;7:283–288.Google Scholar
432. Mayo, DJ, Helsabeck, CB, Horne, DK III. Intraluminal clots in Groshong catheters. JVAD 1995;1:20–22.Google Scholar
433. Nehme, AE, Trigger, JA. Catheter dressings in central parenteral nutrition: a prospective randomized comparative study. Nutritional Support Services 1984;4:42.Google Scholar
434. White, WJ, Hurst, WJ, Achey, BE, Lang, CM. Effectiveness of skin absorption of tincture of I in blocking radioiodine from the human thyroid gland. Health Phys 1989;56:911–914.Google Scholar