Prospective study of infections in indwelling central venous catheters using quantitative blood cultures Journal Article
| Authors: | Benezra, D.; Kiehn, T. E.; Gold, J. W. M.; Brown, A. E.; Turnbull, A. D. M.; Armstrong, D. |
| Article Title: | Prospective study of infections in indwelling central venous catheters using quantitative blood cultures |
| Abstract: | Purpose: Surgically implanted central venous catheters are widely used in cancer patients in whom there is a need for prolonged venous access for chemotherapy, parenteral nutrition, antibiotics, and blood sampling. This study evaluated catheter infectious complications, including catheter-relat- ed sepsis, exit site infection, and tunnel infection. Specifically, an evaluation of the incidence, type, and response to treatment of indwelling catheter infections was performed, and conditions under which the catheter should be removed were delin- eated. Patients and methods: During the year of this study, 488 central venous catheters were implant- ed. Records were maintained on demographic vari- ables, date of catheter implantation, surgeon, white blood cell count, absolute neutrophil count, and un- derlying diagnosis. Blood for both aerobic and an- aerobic culture was collected from each patient. For patients in whom infection developed, clinical features, white blood cell count, absolute neutro- phil count, and microbiologic data were noted, as were the clinical course and response to treatment. Results: A total of 142 episodes of infectious complications were documented. There were 88 episodes of catheter-related sepsis, and 33 of 54 evaluable episodes (61 percent) were successfully treated with antibiotics. There were 34 episodes of exit site infection, and 20 of the 29 evaluable epi- sodes (69 percent) were successfully treated with antibiotics and local care. Of the 20 tunnel infec- tions, only five (25 percent) were successfully treated with antibiotics, and the other 15 required catheter removal for cure. Twelve of the 15 cases requiring catheter removal were caused by Pseu- domonas species. Conclusion: On the basis of these results, com- pulsory removal of the catheter is not required in cases of catheter-related sepsis. Similarly, exit site infections can often be cured by means of antibiot- ics and local care. However, catheter removal is re- quired to achieve cure in most tunnel infections, particularly if Pseudomonas species are cultured from the exit sites of patients with tunnel infection. © 1988 Reed Publishing USA. |
| Keywords: | adult; major clinical study; prospective study; prospective studies; neoplasms; infection; surgery; sepsis; yeast; staphylococcus aureus; catheter infection; fungus; catheters, indwelling; antibiotics; pseudomonas aeruginosa; catheterization, central venous; intravascular catheter; human; male; female; priority journal |
| Journal Title: | The American Journal of Medicine |
| Volume: | 85 |
| Issue: | 4 |
| ISSN: | 0002-9343 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1988-10-01 |
| Start Page: | 495 |
| End Page: | 498 |
| Language: | English |
| DOI: | 10.1016/s0002-9343(88)80084-6 |
| PUBMED: | 3177396 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 6 August 2020 -- Source: Scopus |
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