Management and Prevention of Central Venous Catheter-Related Infections in the ICU

Semin Respir Crit Care Med 2019; 40: 508-523 DOI: 10.1055/s-0039-1693705Central venous catheter-related bloodstream infections (CR-BSI) are a frequent event in the intensive care unit (ICU) setting. In contrast to other nosocomial infections, most risk factors for CR-BSI are linked to the device and can be prevented efficiently. Rates of CR-BSI higher than 1 per 1,000 catheter days are no longer acceptable. A continuous quality improvement program is effective to reduce them. Key elements of prevention of CR-BSI are hand hygiene, avoidance of insertion of unnecessary catheters, full sterile barrier precautions at insertion, preferential use of subclavian venous insertion site, cutaneous antisepsis with 2% chlorhexidine alcoholic preparation, use of chlorhexidine-impregnated dressings, immediate replacement of moistened or detached catheter dressings, and removal of catheters as soon as possible. Audit and feedback of the process of care, infection rates, and periodic re-education of health care providers are other instrumental tools in the prevention of CR-BSI. Catheter removal is the main therapeutic intervention, especially recommended in the case of sepsis or shock. While awaiting culture results, an empiric antimicrobial treatment of CR-BSI should target gram-positive microorganism (i.e., Staphylococcus aureus) and gram-negative coverage should be based on clinical variables, patients' risk factors, and previous colonization status. While a short course of antimicrobials ...
Source: Seminars in Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Review Article Source Type: research

Related Links:

CONCLUSIONS: Considering the low number of university students disclosing sexual assaults to health professionals or support services, the results of this survey suggest more work is needed to facilitate greater disclosures to health professionals enabling victims to access the services they need regardless of alcohol use. PMID: 33032303 [PubMed - in process]
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
Abstract The main aim of this study was to evaluate the performance of an air membrane bioreactor (aMBR) for the treatment of gas-phase methanol. A laboratory-scale hollow fiber aMBR was operated for 150 days, at inlet methanol concentrations varying between 2 and 30 g m-3 and at empty bed residence times (EBRT) of 30, 10 and 5 s. Under steady-state conditions, a maximum methanol removal efficiency (RE) of 98% was obtained at an EBRT of 30 s and a decrease in RE of methanol was observed at lower EBRTs. On increasing the inlet loading rate, some portion of gas-phase MeOH was stripped into the li...
Source: Chemosphere - Category: Chemistry Authors: Tags: Chemosphere Source Type: research
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): E.K. Grantham, A.S. Warden, G.S. McCarthy, A. DaCosta, S. Mason, Y. Blednov, R.D. Mayfield, R.A. Harris
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Authors: Mantero V, Rigamonti A, Basilico P, Sangalli D, Scaccabarozzi C, Salmaggi A PMID: 33029982 [PubMed]
Source: Journal of Clinical Neurology - Category: Neurology Tags: J Clin Neurol Source Type: research
CONCLUSION: When gastroenterologists encounter NAFLD/NASH patients, serum CK should be verified. If hyperCKemia, frontal baldness, a hatched face, history of cataract surgery, and grip myotonia are noted, the possibility of MD may be considered. PMID: 33033573 [PubMed]
Source: World Journal of Hepatology - Category: Gastroenterology Tags: World J Hepatol Source Type: research
Authors: Arab JP, Dirchwolf M, Álvares-da-Silva MR, Barrera F, Benítez C, Castellanos-Fernandez M, Castro-Narro G, Chavez-Tapia N, Chiodi D, Cotrim H, Cusi K, de Oliveira CPMS, Díaz J, Fassio E, Gerona S, Girala M, Hernandez N, Marciano S, Masson W, Mendez-Sanchez N, Leite N, Lozano A, Padilla M, Panduro A, Paraná R, Parise E, Perez M, Poniachik J, Restrepo JC, Ruf A, Silva M, Tagle M, Tapias M, Torres K, Vilar-Gomez E, Costa Gil JE, Gadano A, Arrese M Abstract Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chr...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
CONCLUSION: The ultrasonography measure of right liver lobe diameter by itself can reliably identify patients with NAFLD with a good sensitivity and specificity, however, this can be improved by adding the LAP mathematical index in our population. PMID: 33031969 [PubMed - as supplied by publisher]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
This study investigated antibacterial-producing Streptomyces isolated from the gut of estuarine fish Chanos chanos, emphasizing screening for the producer of peptide-containing antibacterial compounds. Eighteen isolates were found during preliminary screening, in which four isolates showed the best antibacterial activities. Based on the morphological, physiological, and biochemical characterization, as well as 16S rRNA partial sequencing, all of the four isolates belonged to Streptomyces. Three isolates were suspected as novel isolate candidates based on homology presentations and phylogenetic tree analysis. Disk-diffusion...
Source: International Journal of Microbiology - Category: Microbiology Tags: Int J Microbiol Source Type: research
Publication date: Available online 9 October 2020Source: Colloids and Surfaces B: BiointerfacesAuthor(s): Cezhi Du, Chengyong Wang, Jianbo Sui, Lijuan Zheng
Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
CONCLUSION: There is a high prevalence of MRSA causing abscesses in the Hispanic population evaluated in an ED in Puerto Rico. Systemic antibiotic use for the treatment of skin abscesses after incision and drainage remains high despite published guidelines arguing against their widespread use. Clindamycin resistance in our patient population appears to be more frequent than previously reported. PMID: 33031694 [PubMed - as supplied by publisher]
Source: Puerto Rico Health Sciences Journal - Category: International Medicine & Public Health Tags: P R Health Sci J Source Type: research
More News: Alcoholism | Antibiotic Therapy | Candida | Central Venous Catheterization | Chlorhexidine | Education | Endocarditis | Health Management | Intensive Care | Respiratory Medicine | Staphylococcus Aureus | Universities & Medical Training