Nosocomial blood-borne infection secondary to intravascular devices

• Published in: The American journal of surgery Vol. 167; no. 2; pp. 268 - 272
• Main Authors: Fry, Donald E., Fry, Rosemary V., Borzotta, Anthony P.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.1994; Elsevier; Elsevier Limited
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Arteries; Bacteremia; Bacteremia - etiology; Bacteremia - microbiology; Bacteremia - mortality; Biological and medical sciences; Blood; Blood culture; Catheterization, Central Venous - adverse effects; Catheterization, Peripheral - adverse effects; Catheterization, Swan-Ganz - adverse effects; Catheters; Catheters, Indwelling - adverse effects; Cross Infection - etiology; Cross Infection - microbiology; Cross Infection - mortality; Dialysis; Emergency and intensive care: techniques, logistics; Hospitals; Humans; Infections; Intensive care medicine; Male; Medical instruments; Medical sciences; Middle Aged; Nosocomial infection; Perfusions. Catheterizations. Hyperbaric oxygenotherapy; Prospective Studies; Infection; Human; Nosocomial infection; Catheterization; Bacteriosis; Catheter; Complication; Resuscitation
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/0002-9610(94)90090-6

A total of 143 patients with 159 episodes of intravascular device, blood-borne infection were studied. All infections were confirmed by the same organism being recovered from blood culture and by semiquantitative culture of the catheter tip. Sites of infection included the peripheral venous Une (n = 72), central catheter (n = 49), arterial Une (n = 18), subclavian dialysis catheter (n = 12), Swan-Ganz catheter (n = 4), Broviac catheter (n = 3), and transvenous pacemaker wires (n = 1). Staphylococcus aureus (n = 78) and Staphylococcus epidermidis (n = 33) predominated as pathogens. Excessive length of catheterization was implicated as directly responsible for this complication in patients with peripheral intravenous and arterial lines. Nosocomial staphylococcal bacteremia must be considered secondary to an indwelling intravascular device until proven otherwise. Appropriate therapy requires removal of the catheters, excision of the vein if suppuration or persistent bacteremia is identified, and specific antibiotic therapy.