Selection of the vascular catheter: can it minimise the risk of infection?

Abstract Data regarding the prevention of catheter-related bloodstream infection (CRBSI) by making the correct decisions about when to place a central line, the appropriate selection of catheter composition and the size and number of lumens, a suitable choice of insertion site and the technique used...

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Bibliographic Details
Published in:International journal of antimicrobial agents 2010-12, Vol.36, p.S22-S25
Main Authors: Bouza, E, Guembe, M, Muñoz, P
Format: Article
Language:English
Subjects:
Bacteraemia
Catheter-related bloodstream infections
Catheter-Related Infections - epidemiology
Catheter-Related Infections - prevention & control
Catheterization - adverse effects
Colonised lumens
Disinfectants - therapeutic use
Humans
Infectious Disease
Risk Factors
Selection of catheters
Sepsis - epidemiology
Sepsis - prevention & control
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Summary:Abstract Data regarding the prevention of catheter-related bloodstream infection (CRBSI) by making the correct decisions about when to place a central line, the appropriate selection of catheter composition and the size and number of lumens, a suitable choice of insertion site and the technique used are not well reported in recent medical literature. There is no clear evidence that the composition of the catheters presently on the market makes a significant difference to the risk of infection. Several prospective studies suggest that femoral vein location represents the highest risk of infection, followed by jugular vein and subclavian vein positioning, however, most articles do not correct for basic confounding variables. Several papers have reported that arterial catheters have a similar risk of infection as central venous catheters (CVCs). The slight increase in infection risk when using multi-lumen catheters is probably offset by their improved convenience. Current evidence does not support routine tunnelling of short-term catheters until its efficacy is evaluated at different placement sites, using specific catheters and situations and in relation to other preventive interventions. Cuffing is usually applied only to long-term tunnelled catheters. The available evidence suggests that chlorhexidine–silver sulfadiazine, minocycline–rifampicin CVCs and antifungal-coated catheters are useful in decreasing the incidence of CRBSI when other measures are not effective.
ISSN:0924-8579
1872-7913
DOI:10.1016/j.ijantimicag.2010.11.002