Catheter-Re¬lated and Infusion- Related Sepsis

Abstract

About half of nosocomial bloodstream infections (BSIs) occur in intensive care units, and the majority are associated with the presence of an intravascular device. Catheter-related bloodstream infections (CR-BSI) are an important cause of morbidity and mortality worldwide, including resource-limited settings. All types of intravascular catheters pose significant but varying risk of infection. Duration of catheterization, catheter material, insertion conditions, and site care also impact the risk of catheter-associated infections. Bloodstream infection associated with central venous catheters can be attributed to four major sources: colonization from the skin, intraluminal or hub contamination, secondary seeding from a bloodstream infection, and contamination of the infusate In general, the diagnostic approach to catheter-related blood stream infection (CRBSI) consists of clinical evaluation and microbiologic confirmation with peripheral blood and catheter cultures. Catheter-related bloodstream infection (CRBSI) should be suspected when bloodstream infection occurs in the setting of a central venous catheter with no other apparent source. Fever is the most sensitive clinical manifestation. Other clinical manifestations include hemodynamic instability, altered