Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Critical Care
Erschienen in: Critical Care 3/2004

01.06.2003 | Review

Clinical review: New technologies for prevention of intravascular catheter-related infections

verfasst von: Stefania Cicalini, Fabrizio Palmieri, Nicola Petrosillo

Erschienen in: Critical Care | Ausgabe 3/2004

Einloggen, um Zugang zu erhalten

Abstract

Intravascular catheters have become essential devices for the management of critically and chronically ill patients. However, their use is often associated with serious infectious complications, mostly catheter-related bloodstream infection (CRBSI), resulting in significant morbidity, increased duration of hospitalization, and additional medical costs. The majority of CRBSIs are associated with central venous catheters (CVCs), and the relative risk for CRBSI is significantly greater with CVCs than with peripheral venous catheters. However, most CVC-related infections are preventable, and different measures have been implemented to reduce the risk for CRBSI, including maximal barrier precautions during catheter insertion, catheter site maintenance, and hub handling. The focus of the present review is on new technologies for preventing infections that are directed at CVCs. New preventive strategies that have been shown to be effective in reducing risk for CRBSI, including the use of catheters and dressings impregnated with antiseptics or antibiotics, the use of new hub models, and the use of antibiotic lock solutions, are briefly described.
Literatur
1.
Centers for Disease Control and Prevention: Guidelines for the prevention of intravascular catheter-related infections. MMWR Recomm Rep 2002,51(RR-10):1-29.
2.
3.
Richet H, Hubert B, Nitemberg G, Andremont A, Buu-Hoi A, Ourbak P, Galicier C, Veron M, Boisivon A, Bouvier AM: 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.PubMedCentralPubMed
4.
Collignon PJ: Intravascular catheter associated sepsis: a common problem. The Australian Study on Intravascular Catheter Associated Sepsis. Med J Aust 1994, 161: 374-378.PubMed
5.
Garland JS, Alex CP, Mueller CD, Otten D, Shivpuri C, Harris MC, Naples M, Pellegrini J, Buck RK, McAuliffe TL, Goldmann DA, Maki DG: A randomised trial comparing povidone-iodine to a chlorhexidine gluconate impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001, 107: 1431-1437.CrossRefPubMed
6.
Bonawitz SC, Hammell EJ, Kirkpatrick JR: Prevention of central venous catheter sepsis: a prospective randomized trial. Am Surg 1991, 57: 618-623.PubMed
7.
Maki DG, Cobb L, Garman JK, Chapiro 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.CrossRefPubMed
8.
Flowers RHD, Schenzer KJ, Kopel RF, Fish 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. 10.1001/jama.261.6.878CrossRefPubMed
9.
Smith HO, DeVictoria CL, Garfinkel D, Anderson P, Goldberg GL, Soeiro R, Elia G, Runowicz CD: A prospective randomized comparison of an attached silver-impregnated cuff to prevent central venous catheter-associated infection. Gynecol Oncol 1995, 58: 92-100. 10.1006/gyno.1995.1189CrossRefPubMed
10.
Dahlberg PJ, Agger WA, Singer JR, Yutuc WR, Newcomer KL, Schaper A, Rooney BL: Subclavian haemodialysis catheter infections: a prospective randomized trial of an attachable silver impregnated cuff for prevention of catheter-related infections. Infect Control Hosp Epidemiol 1995, 16: 506-511.CrossRefPubMed
11.
Groeger JS, Lucas AB, Coit D, LaQuaglia M, Brown AE, Turnbull A, Exelby P: A prospective, randomized evaluation of the effect of silver impregnated subcutaneous cuffs for preventing tunnelled chronic venous access catheter infections in cancer patients. Ann Surg 1993, 218: 206-210.PubMedCentralCrossRefPubMed
12.
Greenfild JI, Sampath L, Popiskis SJ, Brunnert SR, Stylianos S, Modak S: Decreased bacterial adherence and biofilm formation on chlorexidine and silver sulfadiazine impregnated central venous catheters implanted in swine. Crit Care Med 1995, 23: 894-900. 10.1097/00003246-199505000-00018CrossRef
13.
Kamal GD, Pfaller MA, Rempe LE, Jebson PJ: Reduced intravascular catheter infection by antibiotic bolding. JAMA 1991, 265: 2364-2368. 10.1001/jama.265.18.2364CrossRefPubMed
14.
Maki DG, Stolz SM, Wheeler S, Mermel LA: Prevention of central venous catheter-related infection by use of an antiseptic impregnated catheter. A randomized, controlled trial. Ann Intern Med 1997, 127: 257-266.CrossRefPubMed
15.
Raad I, Darouiche R, Dupuis J, Abi-Said D, Gabrielli A, Hachem R, Wall M, Harris R, Jones J, Buzaid A, Robertson C, Shenaq S, Curling P, Burke T, Ericsson C: Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infection: a randomized, double-bind trial. The Texas Medical Center Catheter Study Group. Ann Intern Med 1997, 127: 267-274.CrossRefPubMed
16.
Bach A, Bohrer H, Motsh J, Martin E, Geiss HK, Sonntag HG: Prevention of bacterial colonization of intravenous catheters by antiseptic impregnation of polyurethane polymers. J Antimicrobial Chemother 1994, 33: 969-978.CrossRef
17.
Veenstra DL, Saint S, Saha S, Lumeley T, Sullivan SD: Efficacy of antiseptic-impregnated central venous catheters in preventing catheter related bloodstream infection: a meta-analysis. JAMA 1999, 281: 261-267. 10.1001/jama.281.3.261CrossRefPubMed
18.
Bach A, Schmidt H, Bottiger B, Schreiber B, Bohrer H, Motsch J, Martin E, Sonntag HG: Retention of antibacterial activity and bacterial colonization of antiseptic-bonded central venous catheters. J Antimicrob Chemoter 1996, 37: 315-322.CrossRef
19.
Logghe C, Van Ossel C, D'Hoore W, Ezzedine H, Wauters G, Haxhe JJ: Evaluation of chlorexidine and silver sulfadiazine impregnated central venous catheters for the prevention of bloodstream infection in leukaemia patients: a randomized controlled trial. J Hosp Infect 1997, 37: 145-156. 10.1016/S0195-6701(97)90184-5CrossRefPubMed
20.
Raad I, Darouiche R, Hachem R, Mansouri M, Bodey GP: The broad-spectrum activity and efficacy of catheter coated with minocycline and rifampin. J Infect Dis 1996, 173: 418-424.CrossRefPubMed
21.
Bassetti S, Hu J, D'Agostino RB Jr, Sherertz RJ: Prolonged antimicrobial activity of a catheter containing chlorhexidine-silver sulfadiazine extends protection against catheter infections in vivo. Antimicrob Agents Chemoter 2001, 45: 1535-1538. 10.1128/AAC.45.5.1535-1538.2001CrossRef
22.
Oda T, Hamasaki J, Kanda N, Mikami K: Anaphylactic shock induced by an antiseptic-coated central venous catheter. Anesthesiology 1997, 87: 1242-1244. 10.1097/00000542-199711000-00031CrossRefPubMed
23.
Stephens R, Mythen M, Kallis P, Davies DW, Egner W, Rickards A: Two episodes of life-threatening anaphylaxis in the same patient to a chlorhexidine-sulphadiazine-coated central venous catheter. Br J Anaesth 2001, 87: 306-308. 10.1093/bja/87.2.306CrossRefPubMed
24.
Crnich CJ, Maki DG: The promise of novel technology for the prevention of intravascular device-related bloodstream infection. I. Pathogenesis and short-term devices. Clin Infect Dis 2002, 34: 1232-1242. 10.1086/339863CrossRefPubMed
25.
Darouiche RO, Raad II, Heard SO, Thornby JI, Wenker OC, Gabrielli A, Berg J, Khardori N, Hanna H, Hachem R, Harris RL, Mayhall G: A comparison of two antimicrobial impregnated central venous catheters. N Engl J Med 1999, 340: 1-8. 10.1056/NEJM199901073400101CrossRefPubMed
26.
Raad II, Darouiche RO, Hachem R, Abi-Said D, Safar H, Darnule T, Mansouri M, Morck D: Antimicrobial durability and rare ultrastructural colonization of indwelling central catheters coated with minocycline and rifampin. Crit Care Med 1998, 26: 219-224. 10.1097/00003246-199802000-00015CrossRefPubMed
27.
Marciante KD, Veenstra DL, Lipsky BA, Saint S: Which antimicrobial impregnated catheter should we use? Modelling the costs and outcomes of antimicrobial catheter use. Am J Infect Control 2003, 31: 1-8. 10.1067/mic.2003.35CrossRefPubMed
28.
Tambe SM, Sampath L, Modak SM: In vitro evaluation of the risk of developing bacterial resistance to antiseptics and antibiotics used in medical devices. J Antimicrob Chemother 2001, 47: 589-598. 10.1093/jac/47.5.589CrossRefPubMed
29.
Ranucci M, Isgro G, Giomarelli PP, Pavesi M, Luzzani A, Cattabriga I, Carli M, Giomi P, Compostella A, Digito A, Mangani V, Silvestri V, Mondelli E, Catheter Related Infection Trial (CRIT) Group: Impact of oligon central venous catheters on catheter colonization and catheter-related bloodstream infection. Crit Care Med 2003, 3: 52-59. 10.1097/00003246-200301000-00008CrossRef
30.
Liu WK, Tebbs SE, Byrne PO, Elliott TS: The effects of electric current on bacteria colonizing intravenous catheters. J Infect 1993, 27: 261-269.CrossRefPubMed
31.
Raad I, Hachem R, Zermeno A, Dumo M, Bodey GP: In vitro antimicrobial efficacy of silver iontophoretic catheters. Biomaterials 1996, 17: 1055-1059. 10.1016/0142-9612(96)85905-9CrossRefPubMed
32.
Segura M, Alvarez-Lerma F, Tellado JM, Jimenez-Ferreres J, Oms L, Rello J, Baro T, Sanchez R, Morera A, Mariscal D, Marrugat J, Sitges-Serra A: A clinical trial on the prevention of catheter-related sepsis using a new hub model. Ann Surg 1996, 223: 363-369. 10.1097/00000658-199604000-00004PubMedCentralCrossRefPubMed
33.
Luna J, Masdeu G, Perez M, Claramonte R, Forcadell I, Barrachina F, Panisello M: Clinical trial evaluating a new hub device designate to prevent catheter-related sepsis. Eur J Clin Microbiol Infect Dis 2000, 19: 655-662. 10.1007/s100960000346CrossRefPubMed
34.
Halpin DP, O'Byrne P, Mc Entee G, Hennessy TP, Stephens RB: Effects of a Betadine connection shield on central venous catheters sepsis. Nutrition 1991, 7: 33-34.PubMed
35.
Mendelson MH, Short LJ, Schechter CB, Meyers BR, Rodriguez M, Cohen S, Lozada J, DeCambre M, Hirschman SZ: Study of needleless intermittent intravenous access system for peripheral infusions: analysis of staff patient, and institutional outcomes. Infect Control Hosp Epidemiol 1998, 19: 401-406.CrossRefPubMed
36.
Danzig LE, Short LJ, Collins K, Mahoney M, Sepe S, Bland L, Jarvis WR: Bloodstream infections associated with a needleless intravenous infusion system in patients receiving home infusion therapy. JAMA 1995, 273: 1862-1864. 10.1001/jama.273.23.1862CrossRefPubMed
37.
Cookson ST, Ihrig M, O'Mara EM, Denny M, Volk H, Banerjee SN, Hartstein AI, Jarvis WR: Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol 1998, 19: 28-31.CrossRefPubMed
38.
Kellerman S, Shay DK, Howard J, Goes C, Feusner J, Rosenberg J, Vugia DJ, Jarvis WR: Bloodstream infections in home infusion patients: the influence of race and needleless intravescular devices. J Pediatr 1996, 129: 711-717.CrossRefPubMed
39.
Do AN, Ray BJ, Banerjee SN, Illian AF, Barnett BJ, Pham MH, Hendricks KA, Jarvis WR: Bloodstream infection associated with needleless devices use and the importance of infection control practices in the home health care setting. J Infect Dis 1999, 179: 442-448. 10.1086/314592CrossRefPubMed
40.
Seymour VM, Dhallu TS, Moss HA, Tebbs SE, Elliot TS: A prospective clinical study to investigate the microbial contamination of a needleless connector. J Hosp Infect 2000, 45: 165-168. 10.1053/jhin.2000.0726CrossRefPubMed
41.
Rackoff WR, Weiman M, Jakobowski D, Hirschl R, Stallings V, Bilodeau J, Danz P, Bell L, Lange B: A randomized, controlled trial of the efficacy of a heparin and vancomycin solution in preventing central venous catheter infection in children. J Pediatr 1995, 127: 147-151.CrossRefPubMed
42.
Shwartz C, Henrickson KJ, Roghmann K, Powell K: Prevention of bacteremia attributed to luminal colonization of tunnelled central venous catheter with vancomycin susceptible organisms. J Clin Oncol 1990, 8: 591-597.
43.
Raad II, Hanna HA: Intravascular catheter-related infections. New horizons and recent advances. Arch Intern Med 2002, 162: 871-878. 10.1001/archinte.162.8.871CrossRefPubMed
44.
Henrickson KJ, Axtell RA, Hoover SM, Kuhn SM, Pritchett J, Kehl SC, Klein JP: Prevention of central venous catheter-related infections and thrombotic events in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solutions: a randomized, multicenter, double-blind trial. J Clin Oncol 2000, 18: 1269-1278.PubMed
45.
Centers for Disease Control and Prevention: Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 1995,44(RR-12):1-13.
46.
Raad I, Buzaid A, Rhyne J, Hachem R, Darouiche R, Safar H, Albitar M, Sherertz RJ: Minocycline and etylenediaminetetraacetate for the prevention of recurrent vascular catheter infections. Clin Infect Dis 1997, 25: 149-151.CrossRefPubMed
47.
Chatzinikolaou I, Zipf TF, Hanna H, Umphrey J, Roberts WM, Sherertz R, Hachem R, Raad I: Minocycline-ethylenediamine tetracetate lock solution for the prevention of implantable port infections in children with cancer. Clin Infect Dis 2003, 36: 116-119. 10.1086/344952CrossRefPubMed
48.
Raad II, Luna M, Khalil SA, Costerton JW, Lam C, Bodey GP: The relationship between the thrombotic and infectious complications of central venous catheters. JAMA 1994, 271: 1014-1016. 10.1001/jama.271.13.1014CrossRefPubMed
49.
Timsit JF, Farkas JC, Boyer JM, Martin JB, Misset B, Renaud B, Carlet J: Central vein catheter-related thrombosis in intensive care patients: incidence, risk factors, and relationship with catheter-related sepsis. Chest 1998, 113: 165-171.CrossRef
50.
Pierce CM, Wade A, Mok Q: Heparin-bonded central venous lines reduce thrombotic and infective complications in critically ill children. Intensive Care Med 2000, 26: 967-972. 10.1007/s001340051289CrossRefPubMed
51.
Randolph AG, Cook DJ, Gonzales CA, Andrew M: Benefit of heparin in central venous and pulmonary artery catheters: a meta-analysis of randomised controlled trials. Chest 1998, 113: 165-171.CrossRefPubMed
52.
Donelli G, Francolini I, Piozzi A, Di Rosa R, Marconi W: New polymer-antibiotic systems to inhibit bacterial biofilm formation: a suitable approach to prevent central venous catheter-associated infections. J Chemother 2002, 14: 501-507.CrossRefPubMed
53.
Schmidt S, Haase G, Csomor E, Lutticken R, Peltroche-Llacsahuanga H: Inhibitor of complement, Compstatin, prevents polymer-mediated Mac-1 up-regulation of human neutrophils independent of biomaterial type tested. J Biomed Mater Res 2003, 66A: 491-499. 10.1002/jbm.a.10031CrossRef
54.
Parsek MR, Val DL, Hanzelka BL, Cronan JE Jr, Greenberg EP: Acyl homoserine-lactone quorum-sensing signal generation. Proc Natl Acad Sci USA 1999, 96: 4360-4365. 10.1073/pnas.96.8.4360PubMedCentralCrossRefPubMed
55.
Davies DG, Parsek MR, Pearson JP, Iglewski BH, Costerton JW, Greenberg EP: The involvement of cell-to-cell signals in the development of a bacterial biofilm. Science 1998, 280: 295-298. 10.1126/science.280.5361.295CrossRefPubMed
Metadaten
Titel
Clinical review: New technologies for prevention of intravascular catheter-related infections
verfasst von
Stefania Cicalini
Fabrizio Palmieri
Nicola Petrosillo
Publikationsdatum
01.06.2003
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 3/2004
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc2380

Weitere Artikel der Ausgabe 3/2004

Critical Care 3/2004 Zur Ausgabe

Research

Preload-independent mechanisms contribute to increased stroke volume following large volume saline infusion in normal volunteers: a prospective interventional study

Review

Statistics review 10: Further nonparametric methods

Research

Clinically important deep vein thrombosis in the intensive care unit: a survey of intensivists

Review

Clinical review: Influence of vasoactive and other therapies on intestinal and hepatic circulations in patients with septic shock

Review

Bench-to-bedside review: Understanding genetic predisposition to sepsis

Research

Case report: Purple urine bag syndrome

Neu im Fachgebiet AINS

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren
Bildnachweise