Premium
Infection associated with central venous catheters: a prospective survey
Author(s) -
Gosbell Iain B,
Duggan Dorelle,
Breust Megan,
Mulholland Katherine,
Gottlieb Tom,
Bradbury Ross
Publication year - 1995
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1995.tb126027.x
Subject(s) - medicine , catheter , central venous catheter , prospective cohort study , staphylococcus aureus , local infection , population , surgery , antibiotics , biology , environmental health , bacteria , microbiology and biotechnology , genetics
Objective To assess the incidence of local and systemic infection caused by central venous catheters in a general hospital population. Setting Concord Repatriation General Hospital, Sydney, April to August 1991 inclusive. Design A prospective survey of all patients with in situ central venous catheters. Systemic catheter‐related infection was detected by blood and routine catheter tip culture, and local infection by clinical observation of the catheter exit site. Outcome measures Local and systemic infection and complications. Results 479 central venous catheters were surveyed in 311 patients. Local infection developed in association with 54 catheters (11%) and systemic infection with 32 (6.7%). Local infection was predictive of systemic infection, but its absence did not exclude systemic infection. Haemodialysis catheters were responsible for a higher systemic infection rate than other catheter types, the most common organism responsible being methi‐cillin‐resistant Staphylococcus aureus. Twenty per cent of all bac‐teraemias (33/160) detected in the hospital occurred in patients with a central venous catheter and 24 of these (73%) were definitely or probably due to the catheter. Staphylococci were the predominant isolates and 40% of the methicillin‐resistant S. aureus bacteraemias detected were due to catheter‐related infection. Infection complications were few: three patients developed local abscesses; one endocarditis; and two died. Conclusions Central venous catheter‐related infection is com‐mon in general hospital populations. Staphylococcal bacteraemia and local infection in a patient with a central venous catheter are strongly suggestive of catheter‐related systemic infection. Empirical antibiotic treatment should include at least antistaphylococcal cover.