Guidelines for the Management of Intravascular Catheter‐Related Infections

• Published in: Infection control and hospital epidemiology 2001-04, Vol.22 (4), p.222-242
• Main Authors: Mermel, Leonard A., Farr, Barry M., Sherertz, Robert J., Raad, Issam I., O’Grady, Naomi, Harris, JoAnn S., Craven, Donald E.
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Infective Agents - therapeutic use; Antibiotics; Bacteremia; Bacteremia - diagnosis; Bacteremia - drug therapy; Bacteremia - etiology; Biological and medical sciences; Blood; Candida albicans; Catheterization; Catheterization, Central Venous - adverse effects; Catheterization, Peripheral - adverse effects; Catheters; Catheters, Indwelling - adverse effects; Central venous catheterization; Cross Infection - blood; Cross Infection - drug therapy; Cross Infection - etiology; Emergency and intensive care: techniques, logistics; Equipment Contamination; Evidence-Based Medicine; Fungemia - diagnosis; Fungemia - drug therapy; Fungemia - etiology; Humans; Infections; Intensive care medicine; Medical instruments; Medical sciences; Nursing; Perfusions. Catheterizations. Hyperbaric oxygenotherapy; Peripheral catheterization; Pulmonary artery catheterization; Special Report; Staphylococcus; Staphylococcus aureus
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/501893

These guidelines from the Infectious Diseases Society of America (IDSA), the American College of Critical Care Medicine (for the Society of Critical Care Medicine), and the Society for Healthcare Epidemiology of America contain recommendations for the management of adults and children with, and diagnosis of infections related to, peripheral and nontunneled central venous catheters (CVCs), pulmonary artery catheters, tunneled central catheters, and implantable devices. The guidelines, written for clinicians, contain IDSA evidence-based recommendations for assessment of the quality and strength of the data. Recommendations are presented according to the type of catheter, the infecting organism, and the associated complications. Intravascular catheter-related infections are a major cause of morbidity and mortality in the United States. Coagulase-negative staphylococci, Staphylococcus aureus , aerobic gram-negative bacilli, and Candida albicans most commonly cause catheter-related bloodstream infection. Management of catheter-related infection varies according to the type of catheter involved. After appropriate cultures of blood and catheter samples are done, empirical iv antimicrobial therapy should be initiated on the basis of clinical clues, the severity of the patient's acute illness, underlying disease, and the potential pathogen (s) involved. In most cases of nontunneled CVC-related bacteremia and fungemia, the CVC should be removed.