#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Catheter-related Bloodstream Infections: Do We Know All of It?


Authors: Antoňáková Nemčíková A. 1–3;  E. Bednárovská 3
Authors‘ workplace: Abteilung für Anästhesiologie und Intensivmedizin KH Kittsee, Rakousko 1;  LF SZU v Bratislave, Slovenská republika 2;  Oddelenie anestéziológie a intenzívnej medicíny, Národný onkologický ústav, Bratislava, Slovenská republika 3
Published in: Klin Onkol 2017; 30(6): 405-411
Category: Review
doi: https://doi.org/10.14735/amko2017405

Overview

Background:
Catheter-related bloodstream infections (CRBSI) represent a life-threatening complication. They are associated with high morbidity, mortality and healthcare costs. Cancer patients are at particular risk due to the nature of the disease and the therapy-associated immunodeficiency. Although the incidence of catheter-related infections decreased in the past decade, the mortality rate remains high at 12–25%. The incidence of CRBSI differs among patients. While the incidence in ICU patients across the Europe was reported to be 0.5–4.1 episodes per 1.000 catheter-days, the incidence in cancer patients was 1.1–7.5 episodes per 1.000 catheter-days. One of the factors negatively influencing the incidence is the lack of uniformity in CRBSI definitions, etiology and risk factors for surveillance purposes.

Purpose:
This preview not only presents the definitions of catheter-related infections and etiology and risk factors for developing CRBSI, it also it also summarizes epidemiologic data, diagnostic techniques, and the prevention and treatment strategies for CRBSI according to knowledge acquired over the last 10 years. Following the implementation of the prevention strategies guidelines for CRBSI published in 2011 by Center for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee, the incidence of CRBSI has decreased by more than 50%. As central venous catheters are a common part of cancer treatment, every oncologist should be aware of the risk of catheter-related infections. The prevention and treatment guidelines with surveillance of CRBSI should be the gold standard in the care of cancer patients as well.

Conclusion:
Adherence to evidence-based guidelines for prevention of catheter-related infections and surveillance of CRBSI are the basic steps required to reduce the rate of CRBSI. Implementation of these strategies in hospital healthcare policy, particularly in written form, and control of adherence and reporting of the incidence rate to higher authorities are strongly recommended. When these interventions were successfully implemented, they reduced the incidence rate under 1 episode of CRBSI per 1.000 catheter-days in Western countries. Each healthcare facility using central venous catheters should be advised to implement these strategies, particular when treating cancer patients.

Key words:
central venous catheter – catheter-related infections – cancer – epidemiology – etiology – guidelines – prevention and control – therapy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
8. 4. 2017

Accepted:
4. 6. 2017


Sources

1. Tomlison D, Mermel LA, Ethier MC et al. Defining Bloodstream Infections Related to Central Venous Catheters in Patients With Cancer: a Systemic Review. Clin Inf Dis 2011; 53 (7): 697–710. doi: 10.1093/cid/cir523.

2. Mollee P, Jones M, van Kuilenburg R et al. Catheter-associated bloodstream infection incidence and risk factors in adults with cancer: a prospective cohort study. J Hosp Infect 2011; 78 (1): 26–30. doi: 10.1016/j.jhin.2011.01.018.

3. Abad CL, Safdar N. Catheter-related Bloodstream Infections. Infectious disease Special Edition 2011, McMahon Publishing p: 84-98. Available from: http://www.idse.net/download/BSI_IDSE11_WM.pdf.

4. O´Grady NP, Alexander M, Burns LA et al. Guidelines for the Prevention of Intravascular Catheter-Related Infections. Clin Infect Dis 2011; 52 (9): 162–193. doi: 10.1093/cid/cir257.

5. CDC. Central Line-Associated Blood Stream Infections-United States, 2001, 2008 and 2009. [online]. Available from: http://www.cdc.gov/MMWR/preview/mmwrhtml/mm6008a4.htm.

6. Fletcher S, MB BS FRCA MRCP (UK) FJFICM. Catheter-related bloodstream infection. Continuing Education in Anaesthesia Critical Care & Pain 2005; 5 (2): 49–51. doi: 10.1093/bjaceaccp/mki011.

7. CDC/NHSN Surveillance for Bloodstream Infections: Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and non-central line-associated Bloodstream Infection). [online]. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf.

8. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definitions of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2009; 36 (5): 309–332. doi: 10.1016/j.ajic.2008.03.002.

9. Mermel LA, Allon M, Bouza E et al. Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter.related Infection: 2009 Update by the Infectious Disease Society of America. Clin Infect Dis 2009; 49 (1): 1–45. doi: 10.1086/599376.

10. APIC (Association for Professionals in Infection Control and Epidemiology). Guide to the Elimination of Catheter-Related Bloodstream Infections. [online]. Available from: http://www.apic.org/Resource_/EliminationGuideForm/259c0594-17b0-459d-b395-fb143321414a/File/APIC-CRBSI-Elimination-Guide.pdf.

11. Shah H, Bosch W, Thompson KM et al. Intravascular Catheter-Related Bloodstream Infection. Neurohospitalist 2013; 3 (3): 144–151. doi: 10.1177/1941874413476 043.

12. Hentrich M, Schalk E, Schmidt-Hiebet M et al. Central venous cathter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol 2014; 25 (5): 936–947. doi: 10.1093/annonc/mdt545.

13. Raad I, Hanna H, Maki D. Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis 2007; 7 (10): 645–657. doi: 10.1016/S1473-3099 (07) 70235-9.

14. Wolf HH, Leithäuser M, Maschmeyer G et al. Central venous catheter-related infections in hematology and oncology. Ann Hematol 2009; 87 (11): 863–876. doi: 10.1007/s00277-008-0509-5.

15. Zingg W, Cartier-Fässler V, Walder B. Central venous catheter-associated infections. Best Pract Clin Anaesthesiol 2008; 22 (3): 407–421.

16. European Centre for Disease Prevention and Control. Annual Epidemiological Report 2013. Reporting on 2011 surveillance data and 2012 epidemic intelligence data. Stockholm: ECDC 2013.

17. ECDC SURVEILLANCE REPORT. Annual epidemiological report Antimicrobial resistance and healthcare-associated infections. [online]. Available from: http://ecdc.europa.eu/en/publications/Publications/antimicrobial-resistance-annual-epidemiological-report.pdf.

18. CDC. Healthcare-associated Infections. [online]. Available from: http://www.cdc.gov/hai/surveillance/.

19. Frasca D, Dahyot-Fizelier C, Mimoz O. Prevention of central venous catheter-related infection in the intensive care unit. Ctrit Care 2010; 14 (2): 212. doi: 10.1186/cc8853.

20. Bordi C, de Bentzmann S. Hacking into bacterial biofilms: a new therapeutic challange. Ann Intetensive Care 2011; 1 (1): 19. doi: 10.1186/2110-5820-1-19.

21. Ryder MA. CatheterRelated Infections: It’s All About Biofilm. Topics in Advanced Practice Nursing eJournal. [online]. Available from: https://www.medscape.com/viewarticle/508109.

22. Leonidou L, Gogos C.A. Catheter-related bloodstream infections: catheter management according to pathogen. Int J Antimicrob Agents. 2010; 36 (Suppl 2): 26–32.

23. Hidron AI, Edwards JR, Patel J et al. NHSN annual update: antimicrobial resistant patogens associated with healthcare-acquired infections (HAIs) reported to the National Healthcare Safety Network az the Centers for Disease Control and Prevention, 2006-7. Infect Control Hosp Epidemiol 2008; 29 (11): 996–1011. doi: 10.1086/591861.

Labels
Paediatric clinical oncology Surgery Clinical oncology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#