Journal ArticleDOI
A Randomized Trial on the Effect of Tubing Changes on Hub Contamination and Catheter Sepsis during Parenteral Nutrition
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TLDR
Delaying tubing changes does not increase catheter sepsis or hub contamination rates and, together with adequate hub protection, has proved to be a valuable factor in controlling an outbreak of catheter Sepsis due to the coagulase negative staphylococci.Abstract:
In previous studies the contamination of the catheter hub was found to be a common portal of entry for bacteria causing catheter-related sepsis. Since hub manipulations during tubing changes may increase the risk of contamination, a prospective trial was conducted to find out the effects of the frequency of tubing replacements on hub colonization and catheter sepsis rates. The results were compared with those obtained during an outbreak of coagulase negative staphylococci septicemia. Fifty-two patients were randomly allocated into two groups. Group A (n = 20) had the line changes every 2 days while group B (n = 32) had it replaced every 4 days. When the catheter was removed, the catheter tip and the hub were cultured by a quantitative method. Sterile, colonized, or infected hubs were equally distributed in both groups (A: 80, 15, and 5% vs B: 84, 6, and 10%). There were three episodes of catheter sepsis, one in group A and one in group B due to hub infection, and one in group B due to hematogenous seeding of the catheter tip. There were significant (p less than 0.001) differences between the trial and the historic series in respect to rates of hub colonization infection (19 vs 50%) and catheter sepsis (5.7 vs 40%). Delaying tubing changes does not increase catheter sepsis or hub contamination rates and, together with adequate hub protection, has proved to be a valuable factor in controlling an outbreak of catheter sepsis due to the coagulase negative staphylococci.read more
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Journal ArticleDOI
Guidelines for the Prevention of Intravascular Catheter-related Infections
Naomi P. O'Grady,Mary Alexander,Lillian A. Burns,E. Patchen Dellinger,Jeffrey Garland,Stephen O. Heard,Pamela A. Lipsett,Henry Masur,Leonard A. Mermel,Michele L. Pearson,Issam I Raad,Adrienne G. Randolph,Mark E. Rupp,Sanjay Saint +13 more
TL;DR: In this paper, the authors developed guidelines for healthcare personnel who insert intravascular catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home healthcare settings.
Guidelines for the prevention of intravascular catheter-related infections, 2011
TL;DR: O'Grady et al. as mentioned in this paper presented a list of the members of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Infectious Disease Task Force (IDTF).
Journal ArticleDOI
epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England
Heather Loveday,Jennie Wilson,Robert Pratt,Mana Golsorkhi,Alison Tingle,Aggie Bak,Jessica Browne,Jacqui Prieto,Mark H. Wilcox +8 more
TL;DR: These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence, and the synopses of evidence underpinning the guideline recommendations have been updated.
Journal ArticleDOI
Guidelines for the prevention of intravascular catheter-related infections.
Naomi P. O'Grady,Mary Alexander,E. Patchen Dellinger,Julie L. Gerberding,Stephen O. Heard,Dennis G. Maki,Henry Masur,Rita D. McCormick,Leonard A. Mermel,Michele L. Pearson,Issam I Raad,Adrienne G. Randolph,Robert A. Weinstein,Jane D. Siegel,Raymond Chinn,Alfred DeMaria,Elaine Larson,James T. Lee,Ramon E. Moncada,William A. Rutala,William E. Scheckler,Beth H. Stover,Marjorie A. Underwood +22 more
TL;DR: The recommended preventive strategies with the strongest supportive evidence are education and training of healthcare providers who insert and maintain catheters, and maximal sterile barrier precautions during central venous catheter insertion, which can reduce the risk for serious catheter-related infection.
Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention.
Naomi P. O'Grady,Mary Alexander,E. Patchen Dellinger,Julie Louise Gerberding,Stephen O. Heard,Dennis G. Maki,Henry Masur,Rita D. McCormick,Leonard A. Mermel,Michele L. Pearson,Issam I Raad,Adrienne G. Randolph,Robert A. Weinstein +12 more
TL;DR: Examples of evidence-based interventions that can reduce the risk for serious catheter-related infection are education and training, maximal sterile barrier precautions, and 2% chlorhexidine preparation for skin antisepsis.
References
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TL;DR: Recommendations of the National Committee for Clinical Laboratory Standards continue to be based on this publication; the “Kirby-Bauer” method is, among the many disk methods used in other countries, still the one that has been researched most thoroughly and updated continuously.
Journal ArticleDOI
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Journal ArticleDOI
Quantitative Culture of Intravenous Catheters and Other Intravascular Inserts
TL;DR: The inserts in one bacteremic patient were infected from a distant bloodstream focus; however, in the majority of patients, quantitative intradermal cultures suggested that the insertion site was the portal of entry.
Journal Article
Association between microorganism growth at the catheter insertion site and colonization of the catheter in patients receiving total parenteral nutrition
TL;DR: It is demonstrated that colonization of catheters by organisms present on the skin at the site of catheter insertion occurred twice as frequently as colonization by the hematogenous route, and suggested that colonies of organisms present at the insertion site occurred only after a threshold number of organisms was reached.