Abstract
The most important targets of hospital-acquired infection control are to reduce the incidence of surgical-site, catheter-related, and ventilator-associated infections. In this report, we address previously presented infection-control strategies for central venous (CV) line catheterization, using a CV catheter-related infection surveillance system. Data concerning CV catheter insertion were collected from all facilities in our 650-bed hospital, excluding the operating and hemodialysis wards. Collected data included the insertion method, purpose, length of catheter inserted, duration of catheterization, infection rate, and complication rate. Catheter-related infection was diagnosed based on bacteriological examinations from blood cultures. The total number of catheterizations was 806 a year, and average duration of catheterization was 9.8 days. The purpose of catheterization was nutritional support in 210 cases, hemodialysis in 96 cases, cardiac support in 174 cases, and other treatments in 260 cases. In 66 cases, the purpose of CV catheter was not specified. The rate of positive cultures was 7.1%, and complications other than infection occurred in 0.5%. The main causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) in 38.6%, coagulase-negative Staphylococcus epidermidis (CNS) in 33.3%, and S. aureus in 12.3% of infections. Infection rates were 3.8 per 1000 catheter-days in subclavian, 6.1 in jugular, and 15.7 in femoral vein catheterization. In high-risk departments (intensive care unit [ICU] and emergency departments) the infection rate was 5.4 for subclavian and 10.2 for jugular catheterization, whereas it was 3.6 for subclavian and 4.6 for jugular catheterization in noncritical-care departments. Considering complications such as pneumothorax, CV catheterization of the jugular vein is recommended in certain situations.
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NP O'Grady M Alexander EP Dellinger JL Gerberding SO Heard DG Maki et al. (2002) ArticleTitleGuideline for the prevention of intravascular catheter-related infections Morb Mortal Wkly Rep 51 1–26
AJ Mangram TC Horan ML Pearson LC Sliver WR Jarvis (1999) ArticleTitleGuideline for prevention of surgical site infection Infect Control Hosp Epidemiol 20 250–78 Occurrence Handle10219875 Occurrence Handle10.1086/501620 Occurrence Handle1:STN:280:DyaK1M3jsFarsw%3D%3D
OC Tablan LJ Anderson R Besserr C Bridges R Hajjeh (2004) ArticleTitleGuidelines for preventing health-care-associated pneumonia Morb Mortal Wkly Rep 53 1–36
ES Wong (1983) ArticleTitleGuideline for prevention of catheter-associated urinary tract infections Am J Infect Control 11 28–36 Occurrence Handle6551151 Occurrence Handle10.1016/S0196-6553(83)80012-1 Occurrence Handle1:STN:280:BiyC2snksFY%3D
RT Gil JA Kruse MC Thill-Baharozian RW Carlson (1989) ArticleTitleTriple- vs single-lumen central venous catheters. A prospective study in a critically ill population Arch Intern Med 149 1139–43 Occurrence Handle2497712 Occurrence Handle10.1001/archinte.149.5.1139 Occurrence Handle1:STN:280:BiaB2crptFw%3D
H Richet B Hubert G Nitemberg A Andremont A Buu-Hoi P Ourbak et al. (1990) ArticleTitleProspective multicenter study of vascular-catheter-related complications and risk factors for positive central-catheter cultures in intensive care unit patients J Clin Microbiol 28 2520–5 Occurrence Handle2254429 Occurrence Handle1:STN:280:By6D2s3mtFQ%3D
PF Mansfield DC Hohn BD Fornage MA Gregurich DM Ota (1994) ArticleTitleComplications and failures of subclavian-vein catheterization New Engl J Med 331 1735–8 Occurrence Handle7984193 Occurrence Handle10.1056/NEJM199412293312602 Occurrence Handle1:STN:280:ByqD2srktVE%3D
A Yilmaziar H Bilgin G Korfali A Eren U Özkan (1997) ArticleTitleComplications of 1303 central venous cannulations J R Soc Med 90 319–21
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Nagashima, G., Kikuchi, T., Tsuyuzaki, H. et al. To reduce catheter-related bloodstream infections: Is the subclavian route better than the jugular route for central venous catheterization?. J Infect Chemother 12, 363–365 (2006). https://doi.org/10.1007/s10156-006-0471-x
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DOI: https://doi.org/10.1007/s10156-006-0471-x