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Sample records for catheter related bloodstream

  1. Tsukamurella catheter-related bloodstream infection in a pediatric patient with pulmonary hypertension

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    Kristen A. Wendorf

    2010-03-01

    Full Text Available Catheter-related bloodstream infections (CR-BSI are important complications in patients with long-term indwelling central venous catheters. In this report, we present the case of a 14-year-old male with pulmonary hypertension treated with continuous treprostinil infusion, who presented with a CR-BSI caused by a Tsukamurella species. This case highlights the potential for this unusual organism to cause infection in immunocompetent patients.

  2. Taurolidine lock is superior to heparin lock in the prevention of catheter related bloodstream infections and occlusions.

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    Evelyn D Olthof

    Full Text Available BACKGROUND AND AIMS: Patients on home parenteral nutrition (HPN are at risk for catheter-related complications; mainly infections and occlusions. We have previously shown in HPN patients presenting with catheter sepsis that catheter locking with taurolidine dramatically reduced re-infections when compared with heparin. Our HPN population therefore switched from heparin to taurolidine in 2008. The aim of the present study was to compare long-term effects of this catheter lock strategy on the occurrence of catheter-related bloodstream infections and occlusions in HPN patients. METHODS: Data of catheter-related complications were retrospectively collected from 212 patients who received HPN between January 2000 and November 2011, comprising 545 and 200 catheters during catheter lock therapy with heparin and taurolidine, respectively. We evaluated catheter-related bloodstream infection and occlusion incidence rates using Poisson-normal regression analysis. Incidence rate ratios were calculated by dividing incidence rates of heparin by those of taurolidine, adjusting for underlying disease, use of anticoagulants or immune suppressives, frequency of HPN/fluid administration, composition of infusion fluids, and duration of HPN/fluid use before catheter creation. RESULTS: Bloodstream infection incidence rates were 1.1/year for heparin and 0.2/year for taurolidine locked catheters. Occlusion incidence rates were 0.2/year for heparin and 0.1/year for taurolidine locked catheters. Adjusted incidence ratios of heparin compared to taurolidine were 5.9 (95% confidence interval, 3.9-8.7 for bloodstream infections and 1.9 (95% confidence interval, 1.1-3.1 for occlusions. CONCLUSIONS: Given that no other procedural changes than the catheter lock strategy were implemented during the observation period, these data strongly suggest that taurolidine decreases catheter-related bloodstream infections and occlusions in HPN patients compared with heparin.

  3. Central venous catheter-related bloodstream infections in the intensive care unit

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    Harsha V Patil

    2011-01-01

    Full Text Available Context: Central venous catheter-related bloodstream infection (CRBSI is associated with high rates of morbidity and mortality in critically ill patients. Aims: This study was conducted to determine the incidence of central venous catheter-related infections (CRIs and to identify the factors influencing it. So far, there are very few studies that have been conducted on CRBSI in the intensive care unit in India. Settings and Design: This was a prospective, observational study carried out in the medical intensive care unit (MICU over a period of 1 year from January to December 2004. Materials and Methods: A total of 54 patients with indwelling central venous catheters of age group between 20 and 75 years were included. The catheters were cultured using the standard semiquantitative culture (SQC method. Statistical analysis used SPSS-10 version statistical software. Results: A total of 54 CVC catheters with 319 catheter days were included in this study. Of 54 patients with CVCs studied for bacteriology, 39 (72.22% catheters showed negative SQCs and also negative blood cultures. A total of 15 (27.77% catheters were positive on SQC, of which 10 (18.52% were with catheter-associated infection and four (7.41% were with catheter-associated bacteremia; the remaining one was a probable catheter-associated bacteremia. CRIs were high among catheters that were kept in situ for more than 3 days and emergency procedures where two or more attempts were required for catheterization (P 3 days, inexperienced venupucturist, more number of attempts and emergency CVC were associated with more incidence of CVCBSIs, with P <0.02. The duration of catheter in situ was negatively correlated (-0.53 and number of attempts required to put CVC was positively correlated (+0.39 with incidence of CVCBSIs. Sixty-five percent of the isolates belonged to the CONS group (13/20. Staphylococcus epidermidis showed maximum susceptibility to amikacin, doxycycline and amoxycillin with

  4. Bacillus Cereus catheter related bloodstream infection in a patient in a patient with acute lymphblastic leukemia

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    Lütfiye Öksüz

    2012-01-01

    Full Text Available Bacillus cereus infection is rarely associated with actual infection and for this reason single positive blood culture is usually regarded as contamination . However it may cause a number of infections, such catheter-related blood stream infections. Significant catheter-related bloodstream infections (CRBSI caused by Bacillus spp. are mainly due to B.cereus and have been predominantly reported in immunocompromised hosts1 . Catheter removal is generally advised for management of infection. In this report, catheter-related bacteremia caused by B.cereus in a patient with acute lymphoblastıc leukemia (ALL in Istanbul Medical Faculty was presented.A 44-year old man presented with fatigue, weight loss, epistaxis and high fever. A double-lumen Hickman–catheter (Bard 12.0 Fr, Round Dual Lumen was inserted by surgical cut-down to access the right subclavian vein which would be necessary for allogeneic stem cell transplantation. Three weeks later the patient presented with high fever and headache. Bacillus spp. was isolated from the cathether while blood culture obtained from the peripheral vein remained negative. The bacterial identification was confirmed as B.cereus using VITEK identification system It has been reported Bacillus cereus septicemia may be fatal in immunocompromised hosts despite broad-spectrum appropriate treatment10. Catheter removal is essential for prevention of recurrent bacteremia. Long-term cathater salvage should be reserved for appropriate patient group.

  5. Central venous catheter-related bloodstream infection caused by Staphylococcus aureus: microbiology and risk factors

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    Geraldo Sadoyma

    2006-04-01

    Full Text Available Although central vascular catheters (CVC are indispensable in modern medicine, they are an important risk factor for primary bacteremias. We examined the incidence and risk factors associated with catheter-related bloodstream infection (CR-BSI caused by Staphylococcus aureus in surgical patients. A prospective study was carried out in the Hospital das Clínicas da Universidade Federal de Uberlândia (HC-UFU from September 2000 to December 2002. The skin insertion site, catheter tip, and blood were microbiologically analyzed. Demographics and risk factors were recorded for each patient, and cultures were identified phenotypically. Staphylococcus aureus was the most frequent pathogen, with an incidence rate of 4.9 episodes of CR-BSIs per 1,000 catheter/days. Based on logistic regression, the independent risk factors were: colonization on the insertion site =200 colony forming units (CFU/20 cm² (p=0.03; odds ratio (OR =6.89 and catheter tip (p=0.01; OR=7.95. The CR-BSI rate was high; it was mainly associated with S. aureus, and skin colonization at the insertion site and on the catheter tip were important risk factors for CR-BSI.

  6. Catheter related bloodstream infection%导管相关血流感染

    Institute of Scientific and Technical Information of China (English)

    陶建平

    2012-01-01

    儿科患者发生的医院获得性菌血症,绝大多数与血管内装置相关,本文根据国内外指南和新的研究,对导管相关血流感染的流行病学、发病机制、诊断及预防和管理作一综述.%Most nosocomial bloodstream infections among pediatric patients are related to the usage of an intravascular device.This article reviewed catheter related bloodstream infections from aspects of epidemiology,pathogenesis,diagnosis,prevention and care based on guidelines and new research both in abroad and at home.

  7. Clinical-epidemiological characteristics and outcome of patients with catheter-related bloodstream infections in Europe (ESGNI-006 Study)

    DEFF Research Database (Denmark)

    Muñoz, P; Bouza, E; San Juan, R;

    2004-01-01

    (1.55 vs. 0.33/1,000 admissions). Most (67%) catheters were non-tunneled central venous catheters, were in the jugular vein (44%), had been implanted for > 7 days (70%), were made of polyurethane (61%) and were multi-lumen (67%). In 36% of cases, catheters were implanted by physicians other than......This study analysed 89 episodes of catheter-related bloodstream infection (CR-BSI) occurring during one week in 107 hospitals from 21 European countries (1.02 episodes/1,000 admissions). Patients from European Union (EU) countries had a higher incidence of CR-BSI than patients from non-EU countries...

  8. Microbiologic characterization of isolates from a dalbavancin clinical trial for catheter-related bloodstream infections.

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    Goldstein, Beth P; Jones, Ronald N; Fritsche, Thomas R; Biedenbach, Douglas J

    2006-02-01

    Dalbavancin, a new-generation semisynthetic lipoglycopeptide in phase 3 clinical development, has been documented to be more active than vancomycin or teicoplanin against Gram-positive bacteria, including multidrug-resistant strains, by in vitro testing and in animal models. The human pharmacokinetics of dalbavancin predicts efficacy at weekly dosing intervals. In a phase 2 open-label clinical trial, dalbavancin exhibited superiority when compared with vancomycin against catheter-related bloodstream infection (CR-BSI). The majority of pathogens identified in this study as in clinical practice were coagulase-negative staphylococci (CoNS), necessitating rigorous characterization of duplicate isolates to rule out contaminants and to validate cases for study evaluations. At follow-up for the intent-to-treat population, overall pathogen eradication was 92.3% for dalbavancin and 75.9% for vancomycin. We describe the details of organisms isolated, their epidemiologic/genetic characterization, susceptibility patterns against glycopeptides, and the eradication rates by organism group. In conclusion, dalbavancin was active against all isolated pathogens associated with CR-BSI (CoNS, Staphylococcus aureus and Enterococcus faecalis; all MIC results, < or = 0.25 microg/mL) and achieved significant (P < 0.05) clinical success when compared with vancomycin. PMID:16458124

  9. Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital.

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    Martínez-Morel, H R; Sanchez-Payá, J; García-Shimizu, P; Mendoza-García, J L; Tenza-Iglesias, I; Rodríguez-Díaz, J C; Merino-DE-Lucas, E; Nolasco, A

    2016-07-01

    The objective of this study was to assess the effectiveness of a catheter-related bloodstream infection (CR BSI) reduction programme and healthcare workers' compliance with recommendations. A 3-year surveillance programme of CR BSIs in all hospital settings was implemented. As part of the programme, there was a direct observation of insertion and maintenance of central venous catheters (CVCs) to determine performance. A total of 38 education courses were held over the study period and feedback reports with the results of surveillance and recommendations were delivered to healthcare workers every 6 months. A total of 6722 short-term CVCs were inserted in 4982 patients for 58 763 catheter-days. Improvements of compliance with hand hygiene was verified at the insertion (87·1-100%, P education programme clearly improved compliance with recommendations for CVC handling, and was effective in reducing the burden of CR BSIs. PMID:26758404

  10. Absence of microbial adaptation to taurolidine in patients on home parenteral nutrition who develop catheter related bloodstream infections and use taurolidine locks

    NARCIS (Netherlands)

    Olthof, E.D.; Rentenaar, R.J.; Rijs, A.J.M.M.; Wanten, G.J.A.

    2013-01-01

    BACKGROUND & AIMS: Some home parenteral nutrition (HPN) patients develop catheter related bloodstream infections (CRBSI) despite using an anti-microbial catheter lock solution taurolidine. The aim of this study was to assess whether long-term use of taurolidine leads to selective growth of microorga

  11. Risk factors for catheter-related bloodstream infection: a prospective multicenter study in Brazilian intensive care units

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    Daniela Bicudo

    2011-08-01

    Full Text Available INTRODUCTION: Central venous catheters (CVC are devices of great importance in health care. The advantages gained from the use of catheters outweigh the complications that might result from their use, among which bloodstream infections (BSI. In spite of its importance, few national studies have addressed this issue. OBJECTIVE: The aim this study was to determine the incidence of BSI in patients with CVC, hospitalized in ICU, as well as the variables associated with this complication. METHODS: Multicentric cohort study carried out at ICUs of three hospitals at Universidade Federal de São Paulo complex. RESULTS: A total of 118 cases of BSI in 11.546 catheters day were observed: 10.22 BSI per 1,000 catheters day. On average, BSI was associated to seven additional days of hospital stay in our study (p < 0.001, with a significant difference between types of catheters. Concerning the place of insertion, there was no statistical difference in BSI rates. CONCLUSION: We concluded that a patient who uses a catheter for longer than 13 days presents a progressive risk for infection of approximately three times higher in relation to a patient who uses the catheter for less than 13 days (p < 0.001. The median duration of catheter use was 14 days among patients with BSI and 9 days in patients without infection (p < 0.001. There was higher prevalence of Gram-negative infections. The risk factors for BSI were utilization of multiple-lumen catheters, duration of catheterization and ICU length of stay.

  12. Etiology and epidemiology of catheter related bloodstream infections in patients receiving home parenteral nutrition in a gastromedical center at a tertiary hospital in denmark

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    Nielsen, Xiaohui Chen; Chen, Ming; Hellesøe, Anne-Marie Blok;

    2012-01-01

    We conducted a retrospective epidemiologic study of catheter related bloodstream infections (CRBSI) in patients receiving long-term home parenteral nutrition (HPN) from January 2002 to December 2005. Our results showed that coagulase negative staphylococci (CoNS) were the most prevalent pathogens...

  13. Catheter related bloodstream infection (CR-BSI in ICU patients: making the decision to remove or not to remove the central venous catheter.

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    Rodrigo Octávio Deliberato

    Full Text Available BACKGROUND: Approximately 150 million central venous catheters (CVC are used each year in the United States. Catheter-related bloodstream infections (CR-BSI are one of the most important complications of the central venous catheters (CVCs. Our objective was to compare the in-hospital mortality when the catheter is removed or not removed in patients with CR-BSI. METHODS: We reviewed all episodes of CR-BSI that occurred in our intensive care unit (ICU from January 2000 to December 2008. The standard method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and a positive semi quantitative (>15 CFU culture of a catheter segment from where the same organism was isolated. The conservative method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and one of the following: (1 differential time period of CVC culture versus peripheral culture positivity of more than 2 hours, or (2 simultaneous quantitative blood culture with ≥ 5:1 ratio (CVC versus peripheral. RESULTS: 53 CR-BSI (37 diagnosed by the standard method and 16 by the conservative method were diagnosed during the study period. There was a no statistically significant difference in the in-hospital mortality for the standard versus the conservative method (57% vs. 75%, p = 0.208 in ICU patients. CONCLUSION: In our study there was a no statistically significant difference between the standard and conservative methods in-hospital mortality.

  14. Five-Lumen Antibiotic-Impregnated Femoral Central Venous Catheters in Severely Burned Patients: An Investigation of Device Utility and Catheter-Related Bloodstream Infection Rates.

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    Friedman, Bruce C; Mian, Mohammad A H; Mullins, Robert F; Hassan, Zaheed; Shaver, Joseph R; Johnston, Krystal K

    2015-01-01

    The objective of this study is to determine the catheter-related bloodstream infection (CRBSI) rate in a severely burned patient population, many of whom required prolonged use of central venous catheters (CVCs). Between January 2008 and June 2012, 151 patients underwent placement of 455 five-lumen minocycline/rifampin-impregnated CVCs. CRBSI was defined as at least one blood culture (>100,000 colonies) and one simultaneous roll-plate CVC tip culture (>15 colony forming units) positive for the same organism. Most patients had accidental burns (81.5%) with a mean TBSA of 50%. A mean of three catheters were inserted per patient (range, 1-25). CVCs were inserted in the femoral vein (91.2%), subclavian vein (5.3%), and internal jugular vein (3.3%). Mean overall catheter indwell time was 8 days (range, 0-39 days). The overall rate of CRBSI per 1000 catheter days was 11.2; patients with a TBSA >60% experienced significantly higher rates of CRBSI than patients with a TBSA ≤60% (16.2 vs 7.3, P = .01). CVCs placed through burned skin were four times more likely to be associated with CRBSI than CVCs placed through intact skin. The most common infectious organism was Acinetobacter baumannii. Deep venous thrombosis developed in eleven patients (7%). The overall rate of CRBSI was 11.2, consistent with published rates of CRBSI in burn patients. Thus, femoral placement of 5-lumen CVCs did not result in increased CRBSI rates. These data support the safety of femoral CVC placement in burn patients, contrary to the Centers for Disease Control recommendation to avoid femoral CVC insertion.

  15. Use of the Tego needlefree connector is associated with reduced incidence of catheter-related bloodstream infections in hemodialysis patients

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    Brunelli SM

    2014-04-01

    Full Text Available Steven M Brunelli,1 Levi Njord,2 Abigail E Hunt,1 Scott P Sibbel1 1DaVita Clinical Research®, Minneapolis, MN, USA; 2DaVita HealthCare Partners, Inc, Denver, CO, USA Background and objectives: Catheter-related bloodstream infections (CRBSIs are common in hemodialysis patients using central venous catheters, and catheter occlusion also occurs frequently. The Tego needlefree connector was developed to reduce the incidence of these complications; however, existing studies of its effectiveness and safety are limited. Materials and methods: This retrospective analysis compared outcomes among patients of a large dialysis organization receiving in-center hemodialysis using a central venous catheter with either the Tego connector or standard catheter caps between October 1 and June 30, 2013. Incidence rates for intravenous (IV antibiotic starts, receipt of an IV antibiotic course, positive blood cultures, mortality, and missed dialysis treatments were calculated, and incidence-rate ratios (IRRs were estimated using Poisson regression models. Utilization of erythropoiesis-stimulating agents (ESAs and thrombolytics was described for each patient-month and compared using mixed linear models. Models were run without adjustment, adjusted for covariates that were imbalanced between cohorts, or fully adjusted for all potential confounders. Results: The analysis comprised 10,652 Tego patients and 6,493 controls. Tego use was independently associated with decreased risk of CRBSI, defined by initiation of IV antibiotics (adjusted IRR 0.92, 95% confidence interval [CI] 0.87–0.97 or initiation of IV antibiotic course (adjusted IRR 0.89, 95% CI 0.84–0.95. Tego use was independently associated with decreased rate of missed dialysis treatments (adjusted IRR 0.98, 95% CI 0.97–1.00; no significant difference between Tego and control cohorts was observed with respect to mortality. Tego use was associated with decreased likelihood of thrombolytic use (adjusted per

  16. Bloodstream Infection in Neutropenic Cancer Patients Related to Short-Term Nontunnelled Catheters Determined by Quantitative Blood Cultures, Differential Time to Positivity, and Molecular Epidemiological Typing with Pulsed-Field Gel Electrophoresis

    OpenAIRE

    Seifert, Harald; Cornely, Oliver; Seggewiss, Kerstin; Decker, Mathias; Stefanik, Danuta; Wisplinghoff, Hilmar; Fätkenheuer, Gerd

    2003-01-01

    To determine the rate of catheter-related bloodstream infection (CRBSI) among cases of primary bloodstream infection (BSI) in febrile neutropenic cancer patients with short-term nontunnelled catheters, quantitative paired blood cultures (Isolator) from the central venous catheter (CVC) and peripheral vein were obtained between November 1999 and January 2001. Bactec blood culture bottles were obtained to determine the differential time to positivity (DTP). CRBSI was defined as a quantitative b...

  17. 抗感染中心静脉导管预防导管相关性血流感染的效果%Effect in prevention of catheter-related bloodstream infection using antiseptic impregnated central venous catheter

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    罗蕾; 秦英; 向亚娟

    2011-01-01

    Objective To evaluate the clinical effect in prevention of catheter-related bloodstream infection(CRBSI) using antiseptic impregnated central venous catheter. Methods The incidence of catheterrelated bloodstream infection was compared between 420 cases performed with antiseptic impregnated central venous catheter ( experimental group ) and 430 cases performed with general central venous catheter (control).Besides, the categories and characteristics of pathogenic bacteria which resulted in catheter-related bloodstream infection were analyzed. Results There were 66 cases of CRBSI in 850 cases, 25 cases were inserted antiseptic impregnated central venous catheter and 41 cases inserted general central venous catheter. No significant difference in the incidence between the two groups was found during 7 days(χ2 = 0. 06 ,P > 0. 05), however, the incidence of CRBSI was lower in the experimental group than of the control group after 7 days( χ2 = 3.91,4.30 ;P 0.05),7 d后实验组CRBSI感染率较对照组低,差异有统计学意义(χ2分别为3.91,4.30,P<0.05).实验组减少导管相关性血流感染的病原体主要为革兰阳性菌.结论 抗感染中心静脉导管可明显减少导管相关性血流感染的发生,有很大的临床价值.

  18. FACTORS ASSOCIATED WITH MORTALITY AMONG PATIENTS WITH CENTRAL VENOUS CATHETER-RELATED BLOODSTREAM INFECTION IN AN INTENSIVE CARE UNIT

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    Priscilla Roberta Silva Rocha

    2012-01-01

    Full Text Available Central venous catheterization is a common practice in the management of critically ill patients and is associated with various complications, such as Bloodstream Infections (BSI, which are major determinants of increased morbidity, mortality and healthcare expenses. Few studies have addressed factors that predict mortality in patients with this complication. The aim of this study was to investigate factors associated with mortality in patients with Central Venous Catheter (CVC-related BSI in an intensive care unit of a tertiary care hospital in the Federal District, Brazil. This was a retrospective and observational study, in which all CVC-related BSI that occurred between January 2008 and December 2010 were reviewed. We obtained demographic, clinical, biochemical and microbiological data from medical records and investigated its association with mortality during ICU stay. There were 4,504 ICU admissions during the study period and 68 were complicated by CVC-related BSI (4.09 per 1000 catheter-days, most due to gram-negative organisms (45.6%. Overall mortality was 59.7%. Death risk was significantly associated with mechanical ventilation (OR 27.8, 95% CI 3.28-250, p-1 in survivors vs. 73.9 mg dL-1 in non-survivors, p = 0.001. Mortality was not associated with other clinical or biochemical features, neither with microbiological variables, although lethality was high among patients with gram-positive infections (77% Vs 58.33% for fungi and 54.83% for gram-negative. CVC-related BSI was associated with high absolute mortality, which was predicted by mechanical ventilation and a higher number of invasive devices other than the CVC. Knowledge of local factors predictive of mortality is critical for planning strategies to reduce death risk associated with this complication.

  19. High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus

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    Viedma, Esther; Chaves, Fernando; Lalueza, Antonio; Fortún, Jesús; Loza, Elena; Pujol, Miquel; Ardanuy, Carmen; Morales, Isabel; de Cueto, Marina; Resino-Foz, Elena; Morales-Cartagena, Alejandra; Rico, Alicia; Romero, María P.; Orellana, María Ángeles; López-Medrano, Francisco; Fernández-Ruiz, Mario; Aguado, José María

    2016-01-01

    We investigated the prognostic role of high MICs for antistaphylococcal agents in patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection (MSSA CRBSI). We prospectively reviewed 83 episodes from 5 centers in Spain during April 2011–June 2014 that had optimized clinical management and analyzed the relationship between E-test MICs for vancomycin, daptomycin, oxacillin, and linezolid and development of complicated bacteremia by using multivariate analysis. Complicated MSSA CRBSI occurred in 26 (31.3%) patients; MICs for vancomycin and daptomycin were higher in these patients (optimal cutoff values for predictive accuracy = 1.5 μg/mL and 0.5 μg/mL). High MICs for vancomycin (hazard ratio 2.4, 95% CI 1.2–5.5) and daptomycin (hazard ratio 2.4, 95% CI 1.1–5.9) were independent risk factors for development of complicated MSSA CRBSI. Our data suggest that patients with MSSA CRBSI caused by strains that have high MICs for vancomycin or daptomycin are at increased risk for complications. PMID:27192097

  20. The first reported catheter-related Brevibacterium casei bloodstream infection in a child with acute leukemia and review of the literature.

    Science.gov (United States)

    Bal, Zumrut Sahbudak; Sen, Semra; Karapinar, Deniz Yilmaz; Aydemir, Sohret; Vardar, Fadil

    2015-01-01

    Brevibacterium spp. are catalase-positive, non-spore-forming, non motile, aerobic Gram-positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. casei catheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature. PMID:25636191

  1. Taurolidine lock is superior to heparin lock in the prevention of catheter related bloodstream infections and occlusions

    NARCIS (Netherlands)

    Olthof, E.D.; Versleijen, M.W.J.; Huisman-de Waal, G.J.; Feuth, T.; Kievit, W.; Wanten, G.J.A.

    2014-01-01

    BACKGROUND AND AIMS: Patients on home parenteral nutrition (HPN) are at risk for catheter-related complications; mainly infections and occlusions. We have previously shown in HPN patients presenting with catheter sepsis that catheter locking with taurolidine dramatically reduced re-infections when c

  2. The current understanding of arterial-catheter related bloodstream infection%当前对动脉导管相关性血流感染的认识

    Institute of Scientific and Technical Information of China (English)

    王斌; 安友仲

    2016-01-01

    导管相关性血流感染(CRBSI)是重症加强治疗病房(ICU)中常见的严重感染之一,可增加患者的病死率,延长住院时间,增加住院费用.在CRBSI中,动脉导管相关性血流感染(AC-BSI)常被忽视或低估,目前的报道显示,AC-BSI的发生率接近甚至不低于中心静脉导管相关性血流感染(CVC-BSI).一旦怀疑AC-BSI,应在留取相关培养物培养后立即拔出动脉导管,并根据患者的情况实施抗感染治疗;预防是减少AC-BSI的关键.本文作者从AC-BSI的流行病学、病原学及发病机制、危险因素、诊断、治疗和预防等方面的进展进行综述,以期为临床处理提供帮助.%Catheter-related bloodstream infection (CRBSI) is one of the common severe infections in intensive care unit (ICU),which tends to increase the mortality of patients,the length of hospital stay and the cost of hospitalization.Arterial catheter-related bloodstream infection (AC-BSI) is often overlooked or underestimated.Some studies pointed out that the incidence of AC-BSI is close to or even higher than central venous catheter related bloodstream infection (CVC-BSI),which plays an important role in catheter-related infections.Once AC-BSI is suspected,arterial catheter should be removed immediately after bacterial culture and antibiotics should be prescribed according to severities of patients.Prevention is the key to reduce AC-BSI.The research progress of epidemiology,etiology,pathogenesis,risk factors,diagnosis,treatment and prevention of AC-BSI was reviewed to facilitate the clinical decision.

  3. Prevention of Catheter-related Bloodstream Infection in ICU%ICU患者中心静脉导管相关性血流感染的预防

    Institute of Scientific and Technical Information of China (English)

    徐文

    2011-01-01

    Central venous catheter( CVC )is one of the most common technique for monitoring and treatment in ICU. But There is a risk of catheter-related bloodstream infection causing prolonged hospital stay and increased mortality. Positioning the CVC through the subclavian vein and using a antibiotic catheter can help to reduce the incidence of CRBSI. A bundle stratige is of a crucial role in CRBSI provention.It should include strict hand hygiene, sterilizing with mixture of 70% ethano and 2% chlorhexidine, maximal sterile barrier and regular dressing change. The efficiency of regular CVC replacement and of antibiotic based catheter lock solution are not clear, and are not recommended as a routine.%留置中心静脉导管是ICU中最常用的监测和治疗措施,但其同时存在发生导管相关性血流感染(CRBSI)的风险,从而导致患者住院时间延长和病死率升高.选择锁骨下穿刺径路、使用抗生素导管可减少CRBSI的发生.应用集束化预防措施进行置管及日常护理是预防CRBSI发生的重要措施,包括严格的手卫生、应用2%氯己定和70%乙醇混合液消毒皮肤、最大消毒屏障以及定期更换辅料.定期更换导管及使用抗生素封管对预防CRBSI效果不明确,不作为常规推荐.

  4. Catheter Removal versus Retention in the Management of Catheter-Associated Enterococcal Bloodstream Infections

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    Jonas Marschall

    2013-01-01

    Full Text Available BACKGROUND: Enterococci are an important cause of central venous catheter (CVC-associated bloodstream infections (CA-BSI. It is unclear whether CVC removal is necessary to successfully manage enterococcal CA-BSI.

  5. Laboratory-based surveillance of hospital-acquired catheter-related bloodstream infections in Catalonia. Results of the VINCat Program (2007-2010).

    Science.gov (United States)

    Almirante, Benito; Limón, Enric; Freixas, Núria; Gudiol, F

    2012-06-01

    The VINCat Program is an institutional surveillance program for hospital-acquired infections developed in the healthcare institutions of Catalonia, Spain. The program includes the monitoring of various components of hospital-acquired infection, among which is catheter-related bloodstream infection (CRBSI). The aim of this study was to describe the frequency of CRBSI in hospitals participating in the VINCat Program over a period of 4 years (2007-2010). The monitoring of the CRBSI component is carried out continuously in all inpatient units by performing a daily assessment of all blood culture results issued by the Microbiology Laboratories. Precise definitions are used for CRBSI, and adjusted rates are expressed per 1,000 days of hospitalization, hospital size and type of catheter. The rates of CRBSI in catheters used for parenteral nutrition are adjusted and expressed per 1,000 days of device use. The aggregate data of the total period are shown in percentiles (10%, 25%, 50% or median, 75%, and 90%). From 2007 to 2010, a total of 2977 episodes of CRBSI were reported in 40 hospitals participating in the VINCat Program. The cumulative incidence of CRBSI has been 0.26 episodes per 1,000 days of hospitalization (CI95% 0.2 to 0.3). The overall incidence varied depending on hospital size: 0.36 ‰ for hospitals in Group I (>500 beds), 0.17 ‰ for Group II (200-500 beds), and 0.09 ‰ for Group III (catheters (CVC), 19% of the episodes with peripheral venous catheters (PVC), and the remaining 5% with peripherally inserted CVCs (PICC). The most common organisms causing CRBSI were staphylococci, the group Klebsiella, Serratia and Enterobacter, Candida spp., and Pseudomonas aeruginosa. There are important differences in the etiology of CRBSI in relation to these variables. During the reporting period, a significant reduction (38.1%, CI95%, 29.0-46.0%) of CRBSI rates have been observed in Group I hospitals. CRBSI surveillance is an important element of the VINCat Program

  6. Tigecycline Lock Therapy for Catheter-Related Bloodstream Infection Caused by KPC-Producing Klebsiella pneumoniae in Two Pediatric Hematological Patients.

    Science.gov (United States)

    Foresti, Sergio; Di Bella, Stefano; Rovelli, Attilio; Sala, Alessandra; Verna, Marta; Bisi, Luca; Nisii, Carla; Gori, Andrea

    2015-12-01

    Catheter-related bacteremias carry high mortality rates in hematological patients. When a multidrug-resistant microorganism is involved, the catheter should ideally be removed; however, this approach is not always possible. Tigecycline lock therapy was used in two pediatric oncohematological patients with intravascular catheter-related infection due to KPC-producing Klebsiella pneumoniae. The catheter was salvaged in both cases, and the patients were later discharged. Our experience suggests the usefulness of this approach in treating this type of infection.

  7. Procalcitonin and procalcitonin kinetics for diagnosis and prognosis of intravascular catheter-related bloodstream infections in selected critically ill patients: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Theodorou Vasiliki P

    2012-10-01

    Full Text Available Abstract Background Procalcitonin (PCT has emerged as a valuable marker of sepsis. The potential role of PCT in diagnosis and therapy monitoring of intravascular catheter-related bloodstream infections (CRBSI in intensive care unit (ICU is still unclear and was evaluated. Methods Forty-six patients were included in the study, provided they were free of infection upon admission and presented the first episode of suspected CRBSI during their ICU stay. Patients who had developed any other infection were excluded. PCT was measured daily during the ICU hospitalization. Primary endpoint was proven CRBSI. Therapy monitoring as according to infection control was also evaluated. Results Among the 46 patients, 26 were diagnosed with CRBSI. Median PCT on the day of infection suspicion (D0 was 7.70 and 0.10 ng/ml for patients with and without proven CRBSI, respectively (p 0.20 ng/ml of PCT between the D0 and any of the 4 preceding days was associated with a positive predictive value exceeding 96%. PCT concentrations from the D2 to D6 after suspected infection tended to decrease in controlled patients, whereas remained stable in non-controlled subjects. A PCT concentration exceeding 1.5 ng/ml during D3 was associated with lack of responsiveness to therapy (p = 0.028. Conclusions We suggest that PCT could be a helpful diagnostic and prognostic marker of CRBSI in critically ill patients. Both absolute values and variations should be considered.

  8. Successful Salvage of Central Venous Catheters in Patients with Catheter-Related or Central Line-Associated Bloodstream Infections by Using a Catheter Lock Solution Consisting of Minocycline, EDTA, and 25% Ethanol.

    Science.gov (United States)

    Raad, Issam; Chaftari, Anne-Marie; Zakhour, Ramia; Jordan, Mary; Al Hamal, Zanaib; Jiang, Ying; Yousif, Ammar; Garoge, Kumait; Mulanovich, Victor; Viola, George M; Kanj, Soha; Pravinkumar, Egbert; Rosenblatt, Joel; Hachem, Ray

    2016-06-01

    In cancer patients with long-term central venous catheters (CVC), removal and reinsertion of a new CVC at a different site might be difficult because of the unavailability of accessible vascular sites. In vitro and animal studies showed that a minocycline-EDTA-ethanol (M-EDTA-EtOH) lock solution may eradicate microbial organisms in biofilms, hence enabling the treatment of central line-associated bloodstream infections (CLABSI) while retaining the catheter in situ Between April 2013 and July 2014, we enrolled 30 patients with CLABSI in a prospective study and compared them to a historical group of 60 patients with CLABSI who had their CVC removed and a new CVC inserted. Each catheter lumen was locked with an M-EDTA-EtOH solution for 2 h administered once daily, for a total of 7 doses. Patients who received locks had clinical characteristics that were comparable to those of the control group. The times to fever resolution and microbiological eradication were similar in the two groups. Patients with the lock intervention received a shorter duration of systemic antibiotic therapy than that of the control patients (median, 11 days versus 16 days, respectively; P < 0.0001), and they were able to retain their CVCs for a median of 74 days after the onset of bacteremia. The M-EDTA-EtOH lock was associated with a significantly decreased rate of mechanical and infectious complications compared to that of the CVC removal/reinsertion group, who received a longer duration of systemic antimicrobial therapy. (This study has been registered at ClinicalTrials.gov under registration no. NCT01539343.). PMID:27001822

  9. High Rate of qacA- and qacB-Positive Methicillin-Resistant Staphylococcus aureus Isolates from Chlorhexidine-Impregnated Catheter-Related Bloodstream Infections

    OpenAIRE

    Ho, Cheng-Mao; Li, Chi-Yuan; Ho, Mao-Wang; Lin, Chien-Yu; Liu, Shu-Hui; Lu, Jang-Jih

    2012-01-01

    Chlorhexidine has been widely used for infection control. Although the use of chlorhexidine-impregnated catheters has reduced catheter-related infections, chlorhexidine-resistant Staphylococcus aureus has emerged. The correlation between the existence of the chlorhexidine-resistant genes qacA and qacB (qacA/B) in methicillin-resistant Staphylococcus aureus (MRSA) isolates and the effectiveness of chlorhexidine-impregnated catheters in the prevention of MRSA infections is unknown. Sixty methic...

  10. 导管相关性血流感染的病原菌分析%Pathogens of catheter-related bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    孙敏霞; 董梅; 雷红; 杨昌梅; 朱蕾; 匡铁吉

    2011-01-01

    Objective To provide the reference for the diagnosis and treatment of catheter-related bloodstream infection(CRBSI) by analyzing the distribution of pathogens in CRBSI. Methods One hundred and eighty patients with positive central vein culture of CRBSI admitted to our hospital from September 2008 to December 2010 were retrospectively analyzed. Results Of the 180 patients, 56(31.1%) were diagnosed as CRBSI, including 29 in Intensive Care Unit, 8 in Tuberculosis Department, 6 in Department of Kidney Medicine, 4 in Department of Respiratory Medicine, 8 in other departments. Of the 56 pathogens, 24(42.8%) were Gram-negative bacilli(mainly Acinetobacter baumannii and Klebsiella pneumoniae), 22(393%) were Gram-positive cocci(mainly coagulase-negative staphylococci and S.aureus), and 10(17.9%) were Candida. Conclusion Great importance should be attached to the multi-drug resistant Acinetobacter baumannii and fungi which are present in CRBSI.%目的 分析导管相关性血流感染(CRBSI)的病原菌分布,为临床诊治提供参考.方法 对本院2008年9月-2010年12月中心静脉导管培养阳性的180例病例进行回顾性分析.结果 180例中56例(31.1%)为CRBSI确诊病例.来源于重症监护病房29例,结核病区8例,肾内科6例,呼吸科4例,其他科室9例;56株病原菌中革兰阴性杆菌24株(42.8%),主要为鲍曼不动杆菌和肺炎克雷伯菌;革兰阳性球菌22株(39.3%),以凝固酶阴性葡萄球菌和金黄色葡萄球菌为主;假丝酵母菌属10株(17.9%).结论多耐药鲍曼不动杆菌和真菌在CRBSI中出现,应引起临床高度重视.

  11. The first reported catheter-related Brevibacterium casei bloodstream infection in a child with acute leukemia and review of the literature

    Directory of Open Access Journals (Sweden)

    Zumrut Sahbudak Bal

    2015-04-01

    Full Text Available Brevibacteriumspp. are catalase-positive, non-spore-forming, non motile, aerobic Gram- positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. caseicatheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature.

  12. 氯己定醇皮肤消毒液在预防导管相关血流感染中的效果研究%Effect of chlorhexidine skin disinfectant on prevention of catheter-related bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    吴晓琴; 李兰云; 郭晶; 何金; 李琳; 徐莉; 杜永川

    2014-01-01

    目的:探讨2%葡萄糖酸氯己定(CHG)醇皮肤消毒液对预防经外周静脉导入中心静脉置管(PICC)导管相关血流感染(CRBSI)的消毒效果。方法对2013年1-12月行PICC置管的肿瘤患者进行前瞻性随机对照研究,将64例PICC置管的患者进行随机分组,观察组34例使用2% CHG醇进行皮肤消毒,对照组30例使用5%聚维酮碘进行皮肤消毒,分别于各组患者进行PICC置管前及置管后48 h对置管周围部位的皮肤采样,进行细菌监测并比较两组间的差异。结果观察组在 PICC置管前和置管后较对照组48h皮肤菌落数低、干燥时间短(P<0.05),观察组总置管日2356 d ,无CRBSI发生;对照组总置管日1970 d ,CRBSI 4例,2% CHG醇消毒液能降低CRBSI的发生率(P<0.05)。结论2% CHG醇皮肤消毒液可降低PICC导管相关血流感染的发生率,并可减少皮肤表面的暂居菌,抑制其生长从而降低CRBSI风险。%OBJECTIVE To explore the effect of 2% chlorhexidine gluconate (CHG) on prevention of peripherally inserted central venous catheter-related bloodstream infections .METHODS The prospective randomized control study was conducted for the tumor patients who underwent PICC from Jan 2013 to Dec 2013;the 64 PICC patients were randomly divided into the observation group with 34 cases and the control group with 30 cases , the observation group was treated with 2% CHG for skin disinfection ,while the control group was given 5% povidone iodine for skin disinfection .The skins around the catheter insertion sites were respectively sampled before the PICC catheterization and at 48 hours after the PICC catheterization ;the bacterial species were monitored and compared between the two groups .RESULTS The bacterial colony counts in the skin were less in the observation group than in the control group before and after the PICC catheterization ,and the drying time of the observation group was shorter

  13. Elimination of Bloodstream Infections Associated with Candida albicans Biofilm in Intravascular Catheters

    Directory of Open Access Journals (Sweden)

    Freshta Akbari

    2015-06-01

    Full Text Available Intravascular catheters are among the most commonly inserted medical devices and they are known to cause a large number of catheter related bloodstream infections (BSIs. Biofilms are associated with many chronic infections due to the aggregation of microorganisms. One of these organisms is the fungus Candida albicans. It has shown to be one of the leading causes of catheter-related BSIs. The presence of biofilm on intravascular catheters provide increased tolerance against antimicrobial treatments, thus alternative treatment strategies are sought. Traditionally, many strategies, such as application of combined antimicrobials, addition of antifungals, and removal of catheters, have been practiced, but they were not successful in eradicating BSIs. Since these fungal infections can result in significant morbidity, mortality, and increased healthcare cost, other promising preventive strategies, including antimicrobial lock therapy, chelating agents, alcohol, and biofilm disruptors, have been applied. In this review, current success and failure of these new approaches, and a comparison with the previous strategies are discussed in order to understand which preventative treatment is the most effective in controlling the catheter-related BSIs.

  14. Impact of Cluster of Intervention Strategies on CRRT Central Venous Catheter-related Bloodstream Infections%集束化干预策略对CRRT中心静脉导管相关性血行感染的影响

    Institute of Scientific and Technical Information of China (English)

    陈刚; 黄晓铭; 陈鑫鑫

    2014-01-01

    Objective To explore the cluster intervention strategies for CRRT central venous catheter related bloodstream infections (hereinafter referred to as CRBIS). Methods Retrospective analysis of our department in August 2012-February 2013 lines of central venous catheter and conventional CRRT infection intervention measures of patients 150 cases (control group) and March 2013-September 2013 lines of central venous catheter and CRRT in 196 patients with cluster intervention strategies (observation group), compared two groups of patients the incidence of CRBIS, ICU hospitalization days and hospitalization expenses, etc. Results Cluster intervention strategies significantly reduce the rate of catheter-related bloodstream infection, which reduces the patients in ICU time, reduced the cost of patients. Conclusion Cluster intervention strategy can decrease the CRRT CRBIS rate of femoral vein, but need to improve the clinical compliance.%目的:探讨集束化干预策略对CRRT中心静脉导管相关性血流感染(以下简称 CRBIS)的影响。方法回顾性对比分析我科2012年8月~2013年2月行CRRT中心静脉导管并按常规实施感染干预措施的患者150例(对照组)与2013年3月~9月行CRRT中心静脉导管并按集束化干预策略患者196例(观察组),比较两组患者的CRBIS发生率、ICU 住院天数、住院费用等。结果集束化干预策略明显降低导管相关性血行感染,从而降低了患者入住 ICU时间,减少了患者费用。结论集束化干预策略可降低CRRT股静脉的CRBIS率,但需提高临床的依从性。

  15. Prevenção da infecção da corrente sanguínea relacionada ao cateter venoso central: Uma revisão integrativa | Prevention of bloodstream infection related to central venous catheter: An integrative review

    Directory of Open Access Journals (Sweden)

    Alanna Gomes da Silva

    2016-05-01

    Full Text Available Objetivo: Analisar as produções científicas nacionais e internacionais sobre a adoção aos bundles para prevenção de infecção da corrente sanguínea relacionada ao cateter venoso central em unidade de terapia intensiva adulto. Métodos: Foi realizada uma revisão integrativa da literatura nas bases de dados Pubmed, Cinahl e Science Direct, publicados de 2011 a 2014. Resultados: Foram encontrados 11 artigos e em 100% deles as principais medidas adotadas foram antes da inserção do cateter, sendo: antissepsia da pele, uso de barreira máxima de precaução, preferência pela veia subclávia, higienização prévia das mãos e educação e treinamento dos profissionais de saúde. Conclusões: Os bundles estão sendo utilizados na prática clínica como estratégias para redução das infecções, contudo, as infecções da corrente sanguínea relacionadas a cateter continuam a ocorrer de forma alarmante e com grande impacto no cuidado a saúde. Desse modo, estratégias que apontem subsídios para melhoria da prática clínica e segurança do paciente devem ser incentivadas, sobretudo aquelas voltadas para o período crítico da inserção e manutenção do cateter. -----------------------------------------------------------------------------------------------Objective: To analyze the national and international scientific production on the adoption of bundles to prevent bloodstream infection related to central venous catheters in adult intensive care unit. Methods: An integrative literature review of studies published from 2011 to 2014 was conducted in the databases Pubmed, CINAHL and Science Direct. Results: 11 articles were found. In all of them the principal measures adopted before catheter insertion were: skin antisepsis, use of maximum barrier precaution, preference by the subclavian vein, previous hand hygiene, and education and training of health professionals. Conclusions: The bundles are being used in clinical practice as

  16. 血管内导管相关性血流感染的病原菌分布及耐药分析%Distribution and drug resistance of pathogens causing intravascular catheter-related bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    王晓峰; 蔡福景; 孙庆丰; 吴杨荷; 李克诚; 丁继光

    2012-01-01

    OBJECTIVE To analyze the distribution and drug resistance of the pathogens causing intravascular catheter-related bloodstream infections, so as to direct the treatment of intravascular catheter-related infections. METHODS A total of 35 patients diagnosed as intravascular catheter-related infections were retrospectively analyzed, the distribution and drug resistance of the pathogens were statistically significant. RESULTS A total of 41 strains of pathogens were isolated from 35 patients, gram-positive bacteria accounted for 56. 10% , 43. 90% of which were Staphylococcus, gram-negative bacteria accounted for 39. 02%, 12. 20% of which were Acinetobacter and Klebsiella, fungi accounted for 4. 88% ; the drug resistance rates of gram-positive bacteria to teicoplanin and vancornycin were 0, the resistance rates to rifampicin and tetracycline were 18. 18% and 13. 64%; the drug resistance rates of gram-negative bacteria to amikacin, cefoperazone/sulbactam, meropenem and imipenem were 25.00%; no strains of fungi resistant to fluconazole, itraconazole, amphotericin B and 5-fluorocytosine. CONCLUSION It's very important for the treatment of intravascular catheter-related bloodstream infections to learn about the distribution and drug resistance of the pathogens causing intravascular catheter-related bloodstream infections.%目的 分析血管内导管相关性血流感染的病原菌分布及耐药性,指导血管内导管相关性血流感染的治疗.方法 对医院确诊为血管内导管相关性血流感染的35例患者进行回顾性分析病原菌分布及其耐药性.结果 35例患者共检出41株病原菌,其中革兰阳性菌占56.10%,以葡萄球菌属为主,占43.90%,革兰阴性菌占39.02%,以不动杆菌属、克雷伯菌属为主,均占12.20%,真菌占4.88%;革兰阳性菌对替考拉宁、万古霉素耐药率均为0,对利福平、四环素耐药率为18.18%、13.64%;革兰阴性菌对阿米卡星、头孢哌酮/舒巴坦、亚

  17. Central venous catheters and catheter locks in children with cancer

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Møller, Jens Kjølseth; Schrøder, Henrik

    2013-01-01

    To determine if the catheter lock taurolidine can reduce the number of catheter-related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC).......To determine if the catheter lock taurolidine can reduce the number of catheter-related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC)....

  18. Central venous catheter-related bloodstream infections in blood purification department%血液净化中心静脉导管相关性血流感染调查分析

    Institute of Scientific and Technical Information of China (English)

    张祥文; 贾中尉; 滕廷波; 李丽华

    2012-01-01

    目的 了解血液净化患者中心静脉导管相关性血流感染(CRBSI)的病原菌分布特点及药敏,分析CRBSI的相关因素.方法 对三峡大学第一临床医学院肾病科血液净化室,2008年1月-2010年12月所有新增留置中心静脉导管的患者进行回顾性分析.结果 医院32例半永久留置、105例临时留置CRBSI患者发生率分别为1.09次/1000导管日、5.19次/1000导管日,两者比较差异有统计学意义(P<0.01);临时导管留置时间>45、<45 d患者的CRBSI发生率分别为6.73次/1000导管日、2.28次/1000导管日;颈内静脉、股静脉置管患者的CRBSI发生率分别为2.43次/1000导管日、6.95次/1000导管日,两者比较差异均有统计学意义(P<0.05);表面葡萄球菌、金黄色葡萄球菌、溶血性葡萄球菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌是常见病原菌.结论 置管方式、部位、留置时间是CRBSI的危险因素,留置导管的CRBSI应根据本中心的经验及药敏选择抗菌药物.%OBJECTIVE To investigate the isolated pathogens and their drug susceptibility of the pathogens causing central venous catheter-related blood stream infections (CRBSI) in patients in blood purification department, and analyze the risk factors for CRBSI. METHODS A retrospective analysis of central venous catheter-related bloodstream infection (CRBSI) in all the patients who were newly placed with CVCs in our hospital s hemodialysis room from Jan 2008 to Dec 2010 was performed. RESULTS The incidence of CRBSI were 1. 09 episodes per 1,000 catheter-days in 32 permanent CVC cases and 5. 19 episodes per 1,000 catheter-days in 105 temporary CVC cases, and there was statistically difference between them (P<0. 05). The incidence of CRBSI were 6. 73 episodes per 1, 000 catheter-days in cases with temporary catheter time more than 45 days, and 2. 28 in cases with temporary catheter time less than 45 days. There was statistical difference between them (P

  19. Equipe interdisciplinar reduz infecção sanguínea relacionada ao cateter venoso central em Unidade de Terapia Intensiva Pediátrica Interdisciplinary task-force reduces catheter-related bloodstream infection in a Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Ricardo Vilela

    2010-12-01

    Full Text Available OBJETIVO: Avaliar o impacto de intervenções interdisciplinares nos indicadores de infecção de corrente sanguínea relacionada ao cateter venoso central e microrganismos isolados, em uma Unidade de Terapia Intensiva Pediátrica. MÉTODOS: Estudo de intervenção do tipo antes e depois. Foi criado um programa educativo e constituída uma equipe interdisciplinar de intervenção composta por médicos e enfermeiros da unidade e do Serviço de Controle de Infecção Hospitalar. As intervenções foram compostas por medidas diretas e indiretas educativas e processuais. O período pré-intervenção (Fase 1, de junho de 2003 a maio de 2004, foi comparado ao período pós-intervenção nas Fases 2 (junho de 2004 a maio de 2005 e 3 (junho de 2005 a maio de 2006. As taxas de infecção foram comparadas por ANOVA, sendo significante pOBJECTIVE: To determine the impact of interdisciplinary interventions on central venous catheter-related bloodstream infections rates in a Pediatric Intensive Care Unit (PICU and on the bloodstream infection organisms. METHODS: Interventional study type before-and-after. An educational program was performed and an interdisciplinary team of interventions was created. This team was formed by nurses and doctors of the PICU and of the Infection Control Committee. The interventions were composed by direct and indirect educational and procedural measures. Task-force interventions were developed from Jun/2003 to May/2004. This pre-intervention period (Phase 1 was compared with two post-intervention periods: Phases 2 (Jun/2004 to May/2005 and 3 (Jun/2005 to May/2006. Central venous catheter-related bloodstream infection rates during the three periods were compared by ANOVA, being significant p<0.05. RESULTS: 1,234 patients were studied from June 1st 2003 to May 31, 2006. The number of central venous catheter-related bloodstream infections was 22.72 per 1,000 catheter-days in Phase 1, and 6.81 and 5.87 in Phases 2 and 3

  20. 综合ICU导管相关性血流感染的危险因素分析%Research on risk factors for central venous catheter-related bloodstream infections in general ICU

    Institute of Scientific and Technical Information of China (English)

    许燕卿; 周立新; 罗盛鸿; 李杏崧; 李轶男; 莫韶妹; 吕春梅; 邵劲松

    2012-01-01

    目的 探讨ICU导管相关性血流感染(CRBSI)的感染率及危险因素.方法 采用前瞻性监测,对2009年7月-2010年11月入住ICU> 24 h、年龄>1月龄的置管患者进行监测,并对发生CRBSI的病例进行危险因素分析.结果 监测患者共1145例,其中接受血管内置管的患者890例,血管内导管使用率为77.7%,置管日为9189 d,发生CRBSI 26例,CRBSI感染率为2.9%,平均日感染率为2.8/千日;CRBSI感染率与置管时间、置管次数均呈正相关(x2=40.71,P=0.000;x2=28.6,P=0.000);留置天数(OR=2.415)与置管次数(OR=1.531)是综合ICU的CRBSI独立危险因素.结论 严格执行手卫生、无菌技术置管和维护、尽早拔除导管是预防CRBSI发生的关键.%OBJECTIVE To determine the incidence rate and risk factors for catheter-related bloodstream infections (CRBSI ) in general ICU. METHODS Prospective monitoring was carried out on patients aged over one month whose ICU length of stay was over 24 hours from Jul 2009 to Nov 2010. The risk factors for CRBSI were analyzed. RESULTS Among the 1145 cases surveyed,890 cases were under intravenous catheterization. The rate of intravenous catheterization was 77. 7% while the overall duration was 9189 days. A total of 26 cases of CRBSI were observed with the incidence rate of 2. 9% and the mean daily incidence rate of 2. 8 per 1,000 catheter-day; the incidence rate of CRBSI was positively correlated with the duration of catheterization (x2 =40. 71,P = 0. 000) and frequency of catheterization (x2 =28. 6, P=0. 000), respectively. The duration (OR=2. 415) and frequency (OR=l. 531) of the catheterization were the independent risk factors for CRBSI in general ICU patients with central intravenous catheter. CONCLUSION The incidence rate of CRBSI can be reduced by performing strict hand hygiene procedures, aseptic technique for insertion, care for intravascular catheters and the removal of catheters in a timely manner.

  1. 探讨ICU患者中心静脉导管相关性血流感染的集束化预防策略%Increase the bundle prevention strategies of central venous catheter-related bloodstream infection in patients of ICU

    Institute of Scientific and Technical Information of China (English)

    王艳菊; 陈奕文; 姜爱丽

    2014-01-01

    ICU收治急危重症患者,大多数患者需要使用中心静脉导管测压、输液等,但其同时存在发生导管相关性血流感染(CRBSI)的风险,从而导致患者住院时间延长和病死率升高等。选择最优的穿刺途径、严格的手卫生、消毒皮肤、最大消毒屏障以及定期更换辅料等,应用集束化预防措施进行置管及日常护理是预防导管相关性血流感染发生的重要措施。%In ICU,there are critically ill patients,and most patients require the use of central venous catheter manometer,infusion and so on.But at the same time,the occurrence of catheter-related bloodstream infection(CRBSI) risk,result in patients with prolonged hospitalization and mortality rate higher.The application of bundle preventive measures of catheter and daily care, including the selection of optimal puncture,strict hand hygiene,disinfection, the biggest disinfection and barrier regular replacement of accessories and so on,is an important measure to prevent occurrence of catheter-related bloodstream infection,.

  2. 批量重度烧伤患者中心静脉置管相关血流感染病例分析%Central venous catheter-related bloodstream infection in mass severe burn patients

    Institute of Scientific and Technical Information of China (English)

    黄慧敏; 徐晓莉; 尹湘毅; 方红梅; 聂牛燕; 沈小玥

    2015-01-01

    目的:了解批量重度烧伤患者中心静脉置管相关血流感染情况、危险因素及感染防控措施效果。方法某院2014年8月抢救了9例重度烧伤患者,对其行中心静脉置管术,置管全程对患者进行感染防控干预。结果9例患者共进行中心静脉置管30例次,置管总日数227 d,其中2例患者股静脉三腔置管细菌培养阳性,导管相关血流感染(CRBSI)发病率为8.81‰;其中1例患者培养出屎肠球菌,另1例患者培养出鲍曼不动杆菌和嗜麦芽窄食单胞菌。2例 CRBSI 患者均为股静脉置管,置管部位均为创面,置管时间均≥7 d,均为三腔置管,且患者Ⅲ°烧伤面积≥60%。经及时拔除导管和使用抗菌药物,2例感染患者均治愈。结论中心静脉置管有利于危重烧伤患者长期、安全、有效地补液,但其可导致 CRBSI;对中心静脉导管置管患者进行全程感染防控干预,选用少腔导管,有助于降低 CRBSI 的发生。%Objective To investigate the occurrence of central venous catheter-related bloodstream infection(CRB-SI)in mass severe burn patients,evaluate related risk factors for infection,and effectiveness of prevention and con-trol measures.Methods In August 2014,9 cases of severe burn patients were rescued in a hospital,all patients re-ceived CVC,infection prevention and control intervention measures were performed during the whole process of catheterization.Results All patients received 30 episodes of CVC,total CVC-days were 227 days,bacterial culture for three-cavity catheters of femoral veins in 2 patients were positive,incidence of CRBSI was 8.81 ‰;1 patient was isolated Enterococcus faecium ,1 isolated both Acinetobacter baumannii and Stenotrophomonas maltophilia .2 CRB-SI patients received femoral vein catheterization,catheterization site was trauma surface,duration of catheterization were both ≥7 days,both used three-cavity catheters,and third degree burns

  3. 中心静脉导管留置时间与血行性感染的相关性分析%The Correlation Analysis of Central Venous Catheter Retention Time and Catheter Related Bloodstream Infection

    Institute of Scientific and Technical Information of China (English)

    徐艳; 常勇杰; 徐红炜; 张振; 胡波

    2015-01-01

    目的:探讨中心静脉导管(CVC)留置时间与导管相关性血行感染(CRBSI)的相关性。方法:收集2010年2月-2014年2月本院1086例使用过CVC的患者资料,分析CVC留置1~7 d、7~14 d、14~21 d、21~28 d和≥28 d几个不同时间段CRBSI的发病率,并对CRBSI患者不同年龄段、性别、CVC留置时间和CVC置管处皮肤细菌数做统计学分析。结果:1086例使用过CVC的患者中共发生了352例CRBSI,CVC留置1~7 d、7~14 d、14~21 d、21~28 d和≥28 d CRBSI的发病数分别为65例(5.98%)、69例(8.84%)、143例(13.17%)、198例(18.23%)和352例(32.41%)。CVC留置≤3 d比3~7 d CRBSI发病率有显著性升高,差异有统计学意义(P<0.01),≥28 d比3~28 d CRBSI发病率也有显著性升高,差异有统计学意义(P=0.04)。另外患者年龄≥60岁、CVC经皮穿刺置管和CVC置管处皮肤细菌数≥100 CFU/10 cm2也是导致CRBSI的重要因素。结论:CVC留置的前3天和后28天是CRBSI发生的高峰时间,CRBSI的发生与患者年龄大和置管处皮肤细菌数多有关。%Objective: To investigate the correlation of central venous catheter (CVC) retention time and catheter related b1oodstream infection (CRBSI).Method: A total of 1086 patients who were treated with CVC in our hospital were selected from February 2010 to February 2014,the CRBSI incidence of 1086 patients in different time periods of indwelling CVC 1-7 d, 7-14 d, 14-21 d, 21-28 d and ≥28 d were analysed,the CRBSI of different ages,gender, CVC retention time and the number of skin bacteria of indwelling CVC were statistical analysed.Result: There were 352 cases of CRBSI in 1086 patients who used CVC, CRBSI incidence were respectively 65 cases (5.98%), 69 cases (8.84%), 143 cases (13.17%), 198 cases (18.23%) and 352 cases (32.41%) in indwelling CVC 1-7 d, 7-14 d, 14-21 d, 21-28 d and≥28 d.The CRBSI incidence of indwelling CVC ≤3 days has increased significantly than 3 to

  4. 儿科导管相关性血流感染的病原菌分布与耐药性分析%Distribution and drug resistance of pathogens causing catheter-related bloodstream infections in department of pediatrics

    Institute of Scientific and Technical Information of China (English)

    刘素品; 刘智; 丁朝鹏; 段玉龙; 刘瑞云; 岳慧芳

    2016-01-01

    OBJECTIVE To observe the distribution and drug resistance of pathogens causing catheter‐related blood‐stream infections in department of pediatrics so as to provide guidance for clinical prevention and control . METHODS A total of 211 children who were treated with central venous catheter indwelling in hospitals from Dec 2013 to Jan 2015 were recruited as the study objects .The incidence of catheter‐related bloodstream infections and distribution and drug resistance of the pathogens were observed .RESULTS Of the 211 children ,73 had the cathe‐ter‐related bloodstream infections ,with the infection rate 34 .60% .Totally 73 strains of pathogens were isolated , of which 28 (38 .36% ) were gram‐positive bacteria ,32 (43 .83% ) were gram‐negative bacteria ,and 13 (17 .81% ) were fungi .The drug resistance rates of the Staphylococcus epidermidis , Staphylococcus haemolyticus ,and Staphylococcus aureus to nitrofurantoin ,vancomycin ,and linezolid were 0 ;the drug resistance rate of the Acine‐tobacter baumannii to cefoperazone was the lowest (13 .33% );the drug resistance rate of the Klebsiella spp to imipenem was the lowest (0);the drug resistance rate of other species of gram‐negative bacteria to cefoperazone was the lowest (22 .22% );the drug resistance rates of the Candida albicans ,Candida tropicalis ,and Candida parapsilosis to amphotericin B and flucytosine were the highest (100 .00% ) .CONCLUSION The incidence of the catheter‐related bloodstream infections is relatively high in the children of the department of pediatrics .It is neces‐sary for the hospital to conduct targeted treatment based on the distribution and drug resistance of the pathogens .%目的:分析医院儿科患儿发生导管相关性血流感染病原菌分布及耐药性,为其临床预防控制提供参考依据。方法选取2013年12月-2015年1月医院儿科收治211例留置中心静脉导管患儿为研究对象,对其发生导管相关性血流感染率、病

  5. Erratum to: Seasonal trend and clinical presentation of Bacillus cereus bloodstream infection: association with summer and indwelling catheter.

    Science.gov (United States)

    Kato, K; Matsumura, Y; Yamamoto, M; Nagao, M; Ito, Y; Takakura, S; Ichiyama, S

    2016-05-01

    Bacillus cereus, an opportunistic pathogen, can cause fatal infection. However, B. cereus bloodstream infections (BSIs) have not been well characterised. From 2008 to 2013, B. cereus isolates from all of the specimens and patients with B. cereus BSIs were identified. Environmental samples were collected to detect B. cereus contamination. We also characterised the clinical presentation of B. cereus BSI through analyses of risk factors for BSI and mortality. A total of 143 clinical B. cereus isolates was detected. Fifty-one patients with nosocomial infections were diagnosed as B. cereus BSI, and 37 had contaminated blood cultures. The number of B. cereus isolates and BSI patients was significantly greater from June to September than from January to April (3.4 vs. 1.0 per month and 1.4 vs. 0.2, respectively). All BSIs were nosocomial and related to central or peripheral vascular catheter. Urinary catheter [odds ratio (OR) 6.93, 95 % confidence interval (CI) 2.40-20.0] was the independent risk factor associated with BSI patients when compared to patients regarded as contaminated. In-hospital mortality among BSI patients was 20 % and was associated with urinary catheter (OR 12.3, 95 % CI 0.67-225, p=0.045) and higher Charlson index (OR 1.99, 95 % CI 1.26-3.12). The number of B. cereus isolates and BSI increased during summer. Inpatients with indwelling vascular or urinary catheters should be carefully monitored for potential B. cereus BSIs. PMID:27010814

  6. Risk factors for catheter-related bloodstream infection in an intensive care unit%ICU 导管相关血流感染危险因素分析

    Institute of Scientific and Technical Information of China (English)

    刘银梅; 余红; 杨惠英

    2014-01-01

    目的:了解重症监护室(ICU)导管相关血流感染(CRBSI)的危险因素,为其预防控制提供科学依据。方法选取2008年1月-2012年12月某院 ICU 行中心静脉置管(CVC)且时间>48 h 的住院患者1677例,分为CRBSI 组和非 CRBSI 组,对其进行危险因素分析。结果 CVC 使用率为92.88%(21041 d);发生 CRBSI 86例, CRBSI 发生率为5.13%,千导管日 CRBSI 发生率为4.02/1000,CRBSI 组患者病死率为58.14%(50/86),显著高于非CRBSI 组的36.83%(586/1591),差异有统计学意义(χ2=15.74,P <0.01)。多因素 logistic 回归分析结果显示,入住ICU 时间>5 d、CVC 时间>5 d、CVC 次数>1次是 CRBSI 的危险因素(均 P <0.01)。结论了解 ICU 住院患者CRBSI 状况及其危险因素,可为进一步开展目标性监测,实现 CRBSI“零宽容”的奋斗目标提供参考。%Objective To study the risk factors for catheter-related bloodstream infection (CRBSI)in an intensive care unit (ICU),and provide scientific evidence for CRBSI prevention and control.Methods 1 677 ICU patients with central venous catheterization (CVC)for>48 hours between January 2008 and December 2012 were divided in-to CRBSI group and non-CRBSI group,risk factors for CRBSI were analyzed.Results The utilization rate of CVC was 92.88% (21 041 d);86 (5.13%)patients developed CRBSI,the incidence of CRBSI per 1 000 catheterization-day was 4.02,the mortality of CRBSI group was significantly higher than non-CRBSI group (58.14% [50/86]vs 36.83%[586/1 591])(χ2 =15.74,P 5 days,CVC>5 days,the episode of CVC>1 (P <0.01).Conclusion Realizing the occur-rence status and risk factors of CRBSI in ICU patients can provide reference for further targeted monitor and implementation of zero tolerance goal of the CRBSI.

  7. Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    M Kaur

    2015-01-01

    Full Text Available Purpose : Central venous catheters (CVCs though indispensable in current medical and intensive care treatment, also puts patients at risk of catheter related infection (CRI resulting in increased morbidity and mortality. We analysed the incidence, risk factors, bacteriological profile and antimicrobial susceptibility pattern of the isolates in central venous catheter associated bloodstream infection (CVC-BSI in the intensive care unit (ICU patients and studied the formation of biofilm in CVCs. Materials and Methods: The following case control study included 115 patients with CVC in situ. Quantitative blood cultures (QBC and catheter tip cultures were performed for the diagnoses. Direct catheter staining was done for an early diagnosis by acridine orange (AO and Gram staining methods. Biofilm production in catheters was detected by ′tissue culture plate′ (TCP method. The results were analysed using the computer-based program statistical package for the social sciences (SPSS. Results : In 25/115 patients, definite diagnosis of CVC-BSI was made. The mean age was 48.44 ± 17.34 years (cases vs 40.10 ± 18.24 years (controls and the mean duration of catheterisation was 25.72 ± 8.73 days (cases vs 11.89 ± 6.38 days (controls. Local signs of infection (erythema, tenderness and oozing were found more significantly in CVC-BSI cases. The AO staining was more sensitive and Gram staining of catheters showed higher specificity. Staphylococcus aureus followed by Pseudomonas aeruginosa and non-albicans Candida were common CVC-BSI pathogens. Multidrug-resistant (MDR strains were isolated in bacterial agents of CVC-BSI. Non-albicans Candida and Enterococcus faecalis showed strong biofilm production. Conclusion : The incidence of CVC-BSI was 21.73% and the rate was 14.59 per 1000 catheter days. Prolonged ICU stay and longer catheterisation were major risk factors. S. aureus was isolated most commonly in CVC-BSI cases. The menace of multidrug resistance and

  8. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection.

    Science.gov (United States)

    Zingg, Walter; Cartier, Vanessa; Inan, Cigdem; Touveneau, Sylvie; Theriault, Michel; Gayet-Ageron, Angèle; Clergue, François; Pittet, Didier; Walder, Bernhard

    2014-01-01

    Central line-associated bloodstream infection (CLABSI) is the major complication of central venous catheters (CVC). The aim of the study was to test the effectiveness of a hospital-wide strategy on CLABSI reduction. Between 2008 and 2011, all CVCs were observed individually and hospital-wide at a large university-affiliated, tertiary care hospital. CVC insertion training started from the 3rd quarter and a total of 146 physicians employed or newly entering the hospital were trained in simulator workshops. CVC care started from quarter 7 and a total of 1274 nurses were trained by their supervisors using a web-based, modular, e-learning programme. The study included 3952 patients with 6353 CVCs accumulating 61,366 catheter-days. Hospital-wide, 106 patients had 114 CLABSIs with a cumulative incidence of 1.79 infections per 100 catheters. We observed a significant quarterly reduction of the incidence density (incidence rate ratios [95% confidence interval]: 0.92 [0.88-0.96]; P<0.001) after adjusting for multiple confounders. The incidence densities (n/1000 catheter-days) in the first and last study year were 2.3/1000 and 0.7/1000 hospital-wide, 1.7/1000 and 0.4/1000 in the intensive care units, and 2.7/1000 and 0.9/1000 in non-intensive care settings, respectively. Median time-to-infection was 15 days (Interquartile range, 8-22). Our findings suggest that clinically relevant reduction of hospital-wide CLABSI was reached with a comprehensive, multidisciplinary and multimodal quality improvement programme including aspects of behavioural change and key principles of good implementation practice. This is one of the first multimodal, multidisciplinary, hospital-wide training strategies successfully reducing CLABSI. PMID:24714418

  9. 中心静脉导管相关性血流感染21例临床分析%Clinical analysis of intravascular catheter-related bloodstream infection in neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    赵方; 曾宾; 刘筱萍; 周于新; 张双船

    2010-01-01

    Objective To find out the clinical characteristics and morbility factors of intravascular catheterrelated bloodstream infection(CRBSI). Methods Totally 21 patients who had CRBSI in neonatal intensive care unit were investigated retrospectively. Results The distribution of CRBSI was higher in very low birthweight preterm infants, gestational age among 28 ~34week, whose intravascular catheter remaining time were obove three weeks. Principal clinical presentation of CRBSI were poor feeding, unaocountable tachycardia, temperature instability, stressed hyperglycemia,refractoriness metabolic acidosis. The most common pathogens were coagulase-negative staphylococci (35.7%), Klebsiella pneumonia, bacilli ( 11.9% ) Staphylococcus aureus (9.5 % ), Pseudomonas aeruginosa( 7. 1% )and Enterobacter cloacae(7.1% ). Conclusions The clinical manifestations of CRBSI were concealment,and reducing the time of inserted central catherization and total parenteral nutrition, strengthening the nutrition of body would provide effective prevention of CRBSI.%目的 探讨中心静脉导管相关性血流感染(CRBSI)的临床特征和发病因素.方法 对新生儿重症监护病房发生的21例CRBSI患儿的临床资料进行回顾性分析.结果 胎龄28~34周、出生体质量<1 500 g、导管留置时间在3周以上的早产儿是CRBSI的高发人群,以喂养不耐受、不明原因的心率加快、体温不稳、应激性血糖升高及顽固性代谢性酸中毒为主要临床表现.感染的病原以凝固酶阴性的葡萄球菌为主(35.7%),其次分别为肺炎克雷伯杆菌(11.9%)、金黄色葡萄球菌(9.5%)、铜绿假单胞菌(7.1%)及阴沟肠杆菌(7.1%).结论 CRBSI患儿临床表现隐匿,缩短导管留置时间及胃肠外营养时间、加强全身的营养支持是预防CRBSI的有效措施.

  10. Investigation and analysis of postoperative cardiac venous catheter-related bloodstream infections in children with congenital heart disease%先天性心脏病患儿术后中心静脉导管相关性血流感染的调查分析

    Institute of Scientific and Technical Information of China (English)

    贾鹏; 黄睿; 李刚; 刘斌

    2015-01-01

    OBJECTIVE To investigate postoperative central venous catheter‐related bloodstream infections in children with congenital heart disease as well as the distribution of pathogenic bacteria ,so as to provide the basis for reducing infection rates .METHODS A total of 617 children with congenital heart disease who underwent surgical treatment in the cardiology center during May 2011 to Mar .2013 were enrolled .The targeted monitoring of central venous catheter‐related bloodstream infections was performed , and the infection incidence and the pathogen distribution were investigated .RESULTS Among the 617 children who underwent cardiac surgery and had indwelling central venous catheters ,12 cases of related bloodstream infections occurred ,the incidence was 1 .94% .Three cases (25 .00% ) had related bloodstream infections occurring in 7 days ,7 cases (58 .33% ) in 8 - 15 days and 2 cases (16 .67% ) after 15 days .Totally 21 pathogens were detected ,including 12 gram‐negative bacteria accounting for 57 .14% and 9 gram‐positive bacteria accounting for 42 .86% ,among which Acinetobacter baumannii ,Pseudomonas aeruginosa ,Staphylococcus aureus accounted for the top three .CONCLUSION The rate of postoperative central venous catheter‐related bloodstream infections in children with congenital heart disease is relatively high .In the course of treatment ,health care workers should be strictly in accordance with the instruc‐tion manual ,implement proactive measures to prevent infection in children ,reduce central venous catheter‐related bloodstream infections ,shorten hospital stay in children and reduce mortality .%目的:探讨先天性心脏病患儿术后中心静脉导管(CVC)相关性血流感染以及病原菌分布,为临床降低其感染率提供依据。方法选取2011年5月-2013年3月心脏病治疗中心收治的617例实施手术治疗的先天性心脏病患儿,进行中心静脉导管相关血流感染目标性监测,调查研究感

  11. 降钙素原在血液透析患者导管相关性血行感染中的应用价值%The value of procalcitonin for the evaluation of catheter-related bloodstream infection in hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    王芳; 潘淼; 李大勇; 刘小华; 陈晶; 谢鸣部; 黄智敏; 郑佩兰; 韦永光

    2013-01-01

    目的 研究降钙素原(Procalcitonin,PCT)在血液透析患者导管相关性血行感染(catheter related bloodstream infection,CRBSI)中的应用价值.方法 62例行中心静脉临时置管后临床怀疑导管相关性血行感染的血液透析患者,采集血常规、C反应蛋白(CRP)、降钙素原血样后拔除导管,同时留取血培养及导管标本.62例患者根据诊断标准分为CRBSI组27例和非CRBSI组35例,比较2组患者的年龄、性别、导管类型、导管留置时间、血白细胞计数(WBC)值、CRP值及降钙素原值(PCT值),并对比CRBSI组治疗前后的PCT值. 结果 CRBSI组患者年龄、导管留置时间明显大于非CRBSI组,CRBSI组及非CRBSI组拔管时的血清PCT水平分别为7.16±5.84μ g/L和0.97±1.44 μ g/L(F =11.759,t=5.387,P<0.001),具有统计学意义,其WBC (109/L)分别为9.52±3.10及8.65±2.19 (F =0.860 t=1.291 P=0.202),CRP值分别为10.57±3.74mg/L及10.66±4.94mg/L(F=1.641,t=0.081 P=0.935),2组均无统计学意义.CRBSI组拔管前后的降钙素原值(PCT值)分别为7.16±5.84 μ g/L及0.63±0.43 μ g/L (t=5.904,P<0.001),具有统计学意义. 结论 PCT在早期诊断CRBSI方面具有较高的指导价值.%Objective To study the value of procalcitonin for the evaluation of catheter-related bloodstream infection (CRBSI) in hemodialysis patients. Methods Blood samples from 62 hemodialysis patients suspected to have catheter-related bloodstream infection were obtained for the assays of blood routine examinations, procalcitonin and C-reactive protein (CRP). Blood and the catheter taken from the patients were cultured for bacteria. Patients were assigned into CRBSI group (n=27 cases) or non-CRBSI group (n=35 cases) based on the diagnostic criteria. Age, gender, catheter type, catheter retention period, WBC, CRP and procalcitonin were compared between the two groups. Procalcitonin levels were also compared before and after treatment. Results Age and catheter retention period were

  12. 基于循证医学的综合护理预防外科住院患者导管相关性血行感染的效果%Effect of integrated nursing based on evidence-based medicine to prevent catheter-related bloodstream infection in surgical inpatients

    Institute of Scientific and Technical Information of China (English)

    刘庆; 彭秋玲; 戴薇

    2010-01-01

    目的 评价实施基于循证医学的临床护理方案对降低外科住院患者导管相关性血行感染(CRBSI)的作用.方法 将本院普外科病房留置中心静脉导管进行治疗的患者随机分为常规护理组和加强护理组.每组患者根据导管留置时间分为短期置管组(导管留置时间≤28 d)和长期置管组(导管留置时间>28 d)两个亚组.对于加强护理组患者,根据中华医学会和欧洲肠外肠内营养学会指南的推荐意见,修订了以"加强无菌隔离和消毒技术"为中心的中心静脉导管临床护理方案.对于常规护理组患者根据现行护理常规进行护理.分别比较两组患者导管留置及CRBSI发生情况.结果 在常规护理组中,长期置管患者CRBSI发生率较短期置管患者轻度增高(6.37 vs.5.77/千导管留置日),其增高幅度为10.40%;在加强护理组中,长期置管患者CRBSI发生率较短期置管患者显著增高(5.18 vs.2.48/千导管留置日),其增高幅度为108.87%.与常规护理组的短期置管患者相比,加强护理组的短期置管患者CRBSI发生率明显降低(5.77 vs.2.48/千导管留置日),其下降幅度约为57.02%,差异有统计学意义(P<0.05);而与常规护理组的长期置管患者相比,加强护理组的长期置管患者CRBSI发生率轻度降低(6.37 vs.5.18/千导管留置日),其下降幅度约为18.68%,差异无统计学意义(P>0.05).结论 基于循证医学的以"加强无菌隔离和消毒技术"为中心的中心静脉导管综合护理方案可以降低短期留置深静脉导管患者CRBSI的发生率,但并不能降低导管留置时间超过28 d患者的CRBSI的发生率.%Objective To evaluate the role of evidence-based clinical care programs in reducing the catheter related bloodstream infection (CRBSI) rate. Methods Patients implanted with central venous catheter (CVC) were divided into two groups: the general care group (group GC) and the intensive care group (groupIC). Based on the

  13. Incidencia de bacteriemia asociada a catéter en niños hospitalizados que reciben nutrición parenteral Blood-stream catheter related infection in inpatient children receiving parenteral nutrition

    Directory of Open Access Journals (Sweden)

    E. Vaquero Sosa

    2011-02-01

    Full Text Available Las infecciones relacionadas con el catéter son la complicación más grave en los pacientes portadores de un catéter venoso central. Se considera que la nutrición parenteral (NP constituye un factor de riesgo de desarrollar una infección relacionada con el catéter (IRCat. Material y métodos: para conocer la tasa de infección y poder establecer estrategias de prevención de la infección nosocomial, se revisaron todas las historias de los 120 pacientes que recibieron NP a lo largo de 2008. Todas las historias de los pacientes con un episodio fiebre y hemocultivo positivo fueron consideradas. La tasa de infección se definió como número de episodios por cada 1000 días de NP. Resultados: Se obtuvieron 48 hemocultivos positivos. La tasa global de bacteriemia asociada a catéter fue de 37,8/1000 días de NP. La incidencia fue significativamente mayor en lactantes menores de 2 años de edad. Los gérmenes que se encontraron con mayor frecuencia fueron Estafilococo coagulasa negativo (56,8%, seguidos de bacilos Gram (20,8%, Staph aureus (12,5% y los hongos (12,5%. No encontramos diferencias en la tasa de infección cuando ajustamos por la enfermedad de base o la duración de la NP. Conclusiones: La tasa de infección en niños con NP en el hospital es considerablemente elevada. La NP parece constituir un factor de riesgo de desarrollar IRCat. Es necesario establecer políticas adecuadas y continuadas para conseguir disminuir la tasa de infección nosocomial.Blood-stream catheter related infection is the most severe complication in patients carrying a central venous catheter. Parenteral nutrition (PN use seems to be a risk factor for developing a catheter-related infection (CRI. Material & methods: In order to know the incidence of CRI in children to further implement policies to reduce nosocomial infection, we review all charts of children (1 month to 17 years who received parenteral nutrition while in hospital. All episodes of fever

  14. An analysis of catheter-related bloodstream infections in old hemodialysis patients with tunneled central venous catheterization%老年透析患者隧道式中心静脉置管相关血流感染临床分析

    Institute of Scientific and Technical Information of China (English)

    郑洁; 黄雯; 姜立萍

    2012-01-01

    Objective To study catheter-related bloodstream infections (CRBSI) in old hemodialysis patients with tunneled central venous catheterization. Methods Twenty-six old hemodialysis patients with tunneled central venous catheterization were observed and analyzed. Results The incidence of CRBSI in old hemodialysis patients with tunneled central venous catheterization was 1.36 times/1000 catheterization days. Nine strains bacteria were isolated. The bacteria included Staphylococcus epidermidis(33.3%), Staphylococcus aureus (22.2%), Staphylococcus hominis(ll.l%), extended spectrum beta -lactamases type Escherichia coli (11.1%), pseudomonas aeruginosa (11.1%), Klebsiella pneumoniae procalcitonin of patients with CRBSI were remarkablely increased. Catheter indwelling time was an independent risk factor for CRBSI (OR = 11.09, P < 0.05). Low albumin level was associated with CRBSI. The level of procalcitonin of patients with CRBSI was increased obviously. Conclusion Prolonged catheter indwelling time is an independent risk factor of CRBSI in old hemodialysis patients with tunneled central venous catheterization.%目的 探讨老年血液透析患者隧道式中心静脉置管所致导管相关血流感染(catheter-related bloodstream infections,CRBSI)的病原菌及相关因素.方法 选择北京同仁医院使用隧道式中心静脉置管的老年维持性血液透析患者26例,根据血培养结果分为感染组和非感染组,分析CRBSI患者血培养分离出的病原菌及相关因素.结果 老年血液透析患者隧道式中心静脉置管CRBSI的发生率为1.36次/1000导管日.CRBSI患者血培养阳性8例,分离出病原菌9株,包括表皮葡萄球菌3株(33.3%)、金黄色葡萄球菌2株(22.2%)、人葡萄球菌1株(11.1%)、超广谱β内酰胺酶阳性大肠埃希菌1株(11.1%)、绿脓杆菌1株(11.1%)、肺炎克雷伯杆菌1株(11.1%).导管留置时间是CRBSI的独立危险因素(OR值为11.09,P< 0.05).低白蛋白水平与CRBSI的

  15. 系统评价抗生素在预防新生儿深静脉置管相关感染中的价值%Systematic review of prophylactic antibiotics in the prevention of catheter-related bloodstream infection in newborn infants

    Institute of Scientific and Technical Information of China (English)

    余章斌; 韩树萍; 沙莉; 陈玉林; 邱玉芳

    2013-01-01

    Objective To assess the effect of prophylactic antibiotics in the prevention of catheter-related bloodstream infection ( CRBSI ) in newborn infants. Methods We searched the randomizedcontroller( RCT ) studies on prophylactic antibiotics to prevent catheter-related bloodstream infection ( CRBSI )in neonates from 1 January, 1990 to 30 April, 2012,and performed meta-analysis with results from homogenous studies using Rev Man 5. 0 software to assess the odds ratio ( OR ) and 95% confidence intervals (95% Cl). Results Six studies were included. A total of 270 cases were in the group of prophylactic antibiotics ( observation group ), and 272 cases were in the group without antibiotics ( control group ). Meta-analysis showed that the observation group had decreased incidence of CRBSI (OR=0.14, 95% CI: 0. 07 - 0. 29 ), and catheter colonization (OR =0.41, 95% CI: 0. 23 - 0. 71 ). Overall mortality rate, the incidence of intraventricular hemorrhage, necrotizing enterocolitis and antibiotic resistance were similar between the two groups. Subgroup analysis based on the different routes of prophylactic antibiotics showed that there were no statistically significant difference between intravenous antibiotics and antibiotics-heparin lock solution on the outcome. Conclusions Prophylactic intravenous antibiotics in neonates reduced the rate of CRBSI and catheter colonization. However, the overall mortality rate was unaffectd. So, the routine use of prophylactic intravenous antibiotics in neonates with deep venous catheters cannot be recommended. Prophylactic antibiotics-heparin lock solutions in neonates with a deep venous catheter reduced the incidence of CRBSI and catheter colonization. But the small sample size of the included studies and the lack of data on antibiotic resistance mandate further clinical trials with higher quality and larger scale to evaluate its effectiveness and safety.%目的 系统评价抗生素预防新生儿深静脉置管相关感染的价值.方法

  16. Prevention of catheter-related bacteremia with a daily ethanol lock in patients with tunnelled catheters: A randomized, placebo-controlled trial

    NARCIS (Netherlands)

    L. Slobbe (Lennert); J.K. Doorduijn (Jeanette); P.J. Lugtenburg (Pieternella); A.E. Barzouhi (Abdelilah); H. Boersma (Eric); W.B. van Leeuwen (Willem); B.J.A. Rijnders (Bart)

    2010-01-01

    textabstractBackground: Catheter-related bloodstream infection (CRBSI) results in significant attributable morbidity and mortality. In this randomized, double-blind, placebo-controlled trial, we studied the efficacy and safety of a daily ethanol lock for the prevention of CRBSI in patients with a tu

  17. Prevenção de infecções de corrente sanguínea relacionadas a cateter em pacientes em hemodiálise Prevención de infecciones del torrente sanguíneo relacionadas al catéter de pacientes en hemodiálisis Prevention of Catheter-Related Bloodstream Infections in Patients on Hemodialysis

    Directory of Open Access Journals (Sweden)

    Dayana Souza Fram

    2009-01-01

    Full Text Available OBJETIVO: Realizar uma revisão sistemática sobre medidas padronizadas para prevenção de infecções relacionadas a cateter em pacientes em hemodiálise. MÉTODOS: Foi realizada uma revisão sobre a prevenção de infecções em hemodiálise nas bases de dados Medline, Embase, SciElo, Lilacs e Cochrane Library de estudos publicados entre os anos de 1990 e 2008. RESULTADOS: Foram encontrados 293 artigos e destes 12 foram incluídos no estudo. CONCLUSÃO: Foi evidenciada a importância da aplicação de um conjunto de medidas de controle de infecções pelos profissionais da saúde para prevenir a infecção nesta população de pacientes.OBJETIVO: Realizar una revisión sistemática sobre las medidas patronizadas para la prevención de infecciones relacionadas al catéter de pacientes en hemodiálisis. MÉTODOS: Fue realizada una revisión sobre la prevención de infecciones en hemodiálisis en las bases de datos Medline, Embase, SciElo, Lilacs y Cochrane Library de estudios publicados entre los años de 1990 al 2008. RESULTADOS: Fueron encontrados 293 artículos y de éstos 12 fueron incluidos en el estudio. CONCLUSIÓN: Se evidenció la importancia de la aplicación de un conjunto de medidas de control de infecciones por los profesionales de la salud para prevenir la infección en esta población de pacientes.OBJECTIVE: To conduct a systematic review of the literature on the prevention of catheter-related bloodstream infections in patients on hemodialysis. METHODS: A literature search was performed in Medline, Embase, Scielo, Lilacs, and Cochrane databases for articles published from 1990 to 2008. RESULTS: Two hundred ninety- three articles were retrieved. However, only 12 studies were included in this review. CONCLUSIONS: Findings suggest that health care providers use several infection control measures to prevent bloodstream infections in this patient population.

  18. Microbiocidal effects of various taurolidine containing catheter lock solutions

    NARCIS (Netherlands)

    Olthof, E.D.; Nijland, R van; Gulich, A.F.; Wanten, G.J.A.

    2015-01-01

    BACKGROUND & AIMS: We have recently shown that a catheter lock solution containing taurolidine dramatically decreases catheter-related bloodstream infections (CRBSI) in patients on home parenteral nutrition (HPN) when compared to heparin. Since several taurolidine formulations are commercially avail

  19. Método bundle na redução de infecção de corrente sanguínea relacionada a cateteres centrais: revisão integrativa Método bundle en la redución de infecciones relacionadas a catéteres centrales: una revisión integrativa Care bundle to reduce central venous catheter-related bloodstream infection: an integrative review

    Directory of Open Access Journals (Sweden)

    Juliana Dane Pereira Brachine

    2012-12-01

    éter con su retirada inmediata cuando posible. La mayoría de los estudios analizados mostraron una reducción significante de infección sanguínea relacionadas o asociadas con catéteres intravenosos centrales.This is an integrative review of literature aimed to identify evidence-based interventions which make up care bundles to reduce central venous catheter-related or associated bloodstream infections. To collect data in Brazilian and international databases were used the key word bundle and the descriptors catheter-related infection, infection control and central venous catheterization, resulting in fifteen articles, after inclusion criteria application. This work showed five interventions as those commonly employed in the bundles methods: hand hygiene, chlorhexidine gluconate for skin antisepsis, use of maximal sterile barrier precaution during the catheter insertion, avoid the femoral access and daily review of catheter necessity with prompt removal as no longer essential. The majority of the studies showed a significant reduction in bloodstream infection related to or associated with central venous catheters.

  20. 重症医学科中心静脉导管相关性血行感染患者病原菌分布及耐药性分析%Pathogenic Bacteria and Its Drug Resistance of Central Venous Catheter-related Bloodstream Infection in ICU

    Institute of Scientific and Technical Information of China (English)

    王晶; 崔朝勃; 魏秋菊; 亢宏山; 吉金芳; 杨腾; 王金荣

    2015-01-01

    Objective To analyze the pathogenic bacteria and its drug resistance of central venous catheter-related bloodstream infection(CRBSI)in ICU. Methods From 2011 to 2013,a total of 1 821 patients hospitalized and indwelling central venous catheters in ICU of Harrison International Peace Hospital Affiliated to Hebei Medical University were enrolled in this study,82 cases out of the 1 821 patients occurred CRBSI,and the pathogenic bacteria and its drug resistance were analyzed. Results A total of 82 stains of pathogenic bacteria was found,including Gram-negative bacilli(56. 1%),Gram-positive coccus(31. 7%)and fungus(12. 2%). Drug sensitive test results showed that,the drug resistance rate of Gram-negative bacilli is high, mainly including Baumanii, Escherichia coli and Klebsiella pneumoniae, and the drug resistance rate of Baumanii was 7. 7% to Cefperazone-Sulbactam,that of Escherichia coli and Klebsiella pneumoniae both was 0 to Meropenem;drug resistance rate of Gram-positive coccus is 0 to Teicoplanin and Linezolid,including Enterococcus faecium,Staphylococcus aureus,Staphylococcus epidermidis and Staphylococcus haemolyticus. Conclusion The main pathogenic bacteria of CRBSI in ICU includes Gram-negative bacilli and Gram-positive coccus,and Gram-negative bacilli is usually sensitive to Cefperazone-Sulbactam and Meropenem,Gram-positive coccus is usually sensitive to Teicoplanin and Linezolid.%目的:分析重症医学科中心静脉导管相关性血行感染( CRBSI)患者病原菌分布及其耐药性。方法选择2011—2013年入住河北医科大学附属哈励逊国际和平医院重症医学科并留置中心静脉导管的患者1821例,其中82例患者发生CRBSI,分析其病原菌分布及其耐药性。结果82例CRBSI患者共培养出病原菌82株,主要为革兰阴性杆菌(占56.1%),其次为革兰阳性球菌(占31.7%)、真菌(占12.2%)。药敏试验结果显示,革兰阴性杆菌耐药率高,最常见的病原菌为鲍

  1. 洋葱伯克霍尔德菌污染肝素钠封管液致血管导管相关血流感染暴发%Vascular catheter-related bloodstream infection outbreak due to the contamination of heparin sodium sealing solution by Burkholderia cepacia

    Institute of Scientific and Technical Information of China (English)

    李静

    2013-01-01

    目的 调查某院肿瘤病房一起由洋葱伯克霍尔德菌(BC)引起的血管导管相关血流感染(CRBSI)暴发的原因,为预防和控制医院感染提供依据.方法 采用临床资料调查和现场采样检测相结合的方法,对此次医院感染的暴发进行流行病学调查.结果 11例次BC引起的 CRBSI发生时间集中,分别为2008年2月18日(1例)、19日(1例)、20日(6例)、21日(1例)、22日(2例);均为股静脉置管患者,均从患者血液中培养出BC,均使用了同一袋肝素钠封管液.环境卫生学调查,患者所使用的液体、一次性注射器材、环境物品细菌学检测均合格,仅在1份剩余肝素钠封管液中(患者共用此封管液)培养出1株BC,其药敏结果与患者血液培养菌株一致.立即采取措施,拔除患者深静脉置管,并抗感染治疗.11例患者7 d后血培养均无细菌生长,该病区再无相同病例出现.结论 BC污染肝素钠封管液是此次CRBSI暴发的原因,经积极采取措施,感染得到有效控制.%Objective To investigate the causes of an outbreak of Burkholderia cepacia (B. cepacia) vascular catheter-related bloodstream infection(CRBSI) in an oncology department, and provide the basis for the prevention and control of health care-associated infection. Methods Epidemiological investigation was performed by combination of clinical data analysis and on-site sampling . Results The occurrence time of 11 B. cepacia CRBSf cases concentrated on February 18(1 case) , 19 (1 case) , 20 (6 cases) , 21 (1 case) , and 22 (2 cases) of 2008, respectively ; all patients were intubated in the femoral vein, isolated B. cepacia from blood cultures ,and used the same bag of heparin sodium sealing solution. Bacterial culture results of heparin sodium sealing solution , disposable syringes, and environmental samples were all qualified, only 1 tube of used heparin sodium sealing solution (all patients shared this tube) isolated B. cepacia, antimicrobial susceptibility

  2. First reported case of Staphylococcus condimenti infection associated with catheter-related bacteraemia

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    Y. Misawa

    2015-01-01

    Full Text Available We report a case of a patient who experienced a catheter-related bloodstream infection caused by Staphylococcus condimenti, which was first isolated from soy sauce mash. This is the first reported case of human infection. Although blood culture isolates and the catheter tip tube did not reveal coagulase or clumping factor, false-positive results were obtained from latex agglutination tests for clumping factor and protein A due to self-agglutination. Care is needed when performing only latex agglutination test without a coagulase test. Further studies are needed to determine the pathogenic potential of S. condimenti based on appropriate identification.

  3. Bloodstream infections among patients using central venous catheters in intensive care units Infección de corriente sanguínea en pacientes con catéter venosos central en unidades de cuidado intensivo Infecções da corrente sangüínea em pacientes em uso de cateter venoso central em unidades de terapia intensiva

    OpenAIRE

    Eni Rosa Aires Borba Mesiano; Edgar Merchán-Hamann

    2007-01-01

    Central Venous Catheters (CVC), widely used in Intensive Care Units (ICU) are important sources of bloodstream infections (BSI). This prospective cohort epidemiological analytical study, aimed to infer the incidence of BSI, the risk factors associated and evaluate the care actions related to the use of these catheters in seven ICU in the Federal District - Brasília, Brazil. From the 630 patients using CVC, 6.4% developed BSI (1.5% directly related to the catheter and 4.9% clinic BSI). The hos...

  4. Effectiveness of different central venous catheters for catheter-related infections: a network meta-analysis.

    Science.gov (United States)

    Wang, H; Huang, T; Jing, J; Jin, J; Wang, P; Yang, M; Cui, W; Zheng, Y; Shen, H

    2010-09-01

    We aimed to compare the effectiveness of various catheters for prevention of catheter-related infection and to evaluate whether specific catheters are superior to others for reducing catheter-related infections. We identified randomised, controlled trials that compared different types of central venous catheter (CVC), evaluating catheter-related infections in a systematic search of articles published from January 1996 to November 2009 via Medline, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. Network meta-analysis with a mixed treatment comparison method using Bayesian Markov Chain Monte Carlo simulation was used to combine direct within-trial, between-treatment comparisons with indirect trial evidence. Forty-eight clinical trials (12 828 CVCs) investigating 10 intervention catheters contributed to the analyses. For prevention of CVC colonisation, adjusted silver iontophoretic catheters (odds ratio: 0.58; 95% confidence interval: 0.33-0.95), chlorhexidine and silver sulfadiazine catheters (0.49; 0.36-0.64), chlorhexidine and silver sulfadiazine blue plus catheters (0.37; 0.17-0.69), minocycline-rifampicin catheters (0.28; 0.17-0.43) and miconazole-rifampicin catheters (0.11; 0.02-0.33) were associated with a significantly lower rate of catheter colonisation compared with standard catheters. For prevention of CRBSI, adjusted heparin-bonded catheters (0.20; 0.06-0.44) and minocycline-rifampicin catheters (0.18; 0.08-0.34) were associated with a significantly lower rate of CRBSI with standard catheters. Rifampicin-based impregnated catheters seem to be better for prevention of catheter-related infection compared with the other catheters.

  5. Risk factors and the outcomes of central venous catheter-related bloodstream infections in ICU wards%ICU病房中心静脉导管相关性血流感染的高危因素及预后分析

    Institute of Scientific and Technical Information of China (English)

    肖丽; 卢岩; 彭松林; 李国福; 于晓江; 安春丽

    2012-01-01

    目的 调查ICU住院患者中心静脉导管相关性血流感染(CRBSI)的发生情况、高危因素及预后,为制定合适的防治策略提供依据.方法 应用前瞻性研究方法,采用美国国家院内感染监测(NNIS)规定的统一标准系统,对2007年6月1日至2008年5月31日入住中国医科大学附属盛京医院综合性ICU的所有符合条件的病例进行调查.结果 CRBSI感染率为13.2%(23例次/174),感染密度为12.0/1000导管日.单因素分析结果,中心静脉置管的个数、CRBSI发生前抗生素应用个数、导管日差异具有统计学意义(P<0.05);多因素Logistic回归分析结果,CRBSI发生前抗生素应用个数≥3( OR=6.335)和中心静脉置管个数>1(OR=5.981)是CRBSI发生的独立危险因素(P<0.05);CRBSI组的病患粗死亡率、呼吸机日、住院总费用、药费、ICU内住院日、总住院日和平均日花费均高于非CRBSI的病患(P<0.05).结论 该院CRBSI发生率高,感染密度大,多个中心静脉置管以及抗生素应用频繁是CRBSI的高危因素.CRBSI者的预后及医疗费用的经济负担明显高于非CRBSI者.必须进一步加强有效的预防和控制措施.%Objective To identify the incidence rate, pathogenic characteristics, risk factors, and outcomes of catheter-related bloodstream infections ( CRBSI) in ICU wards. Method From June 2007 to May 2008, qualified cases in the ICU ward at the Affiliated Shengjing Hospital of China Medical University were prospectively surveyed. Result A total of 174 patients were included in the study. The duration of catheterization lasted 1,913 days. Twenty-one patients developed an infection, yielding an infection rate of 12.0/1,000, and the application rate of catheters was 72. 8% . Specifically, nine cases of infection involved G- bacteria, seven cases involved G+ bacteria, and seven cases involved fungi. After applying a single-factorial analysis, the number of catheter implantations, the number of pre-CRBS1

  6. Species Distribution and Antibiotic Resistance of Pathogens from Catheter-related Bloodstream Infections in Intensive Care Unit%ICU内中心静脉导管相关性血流感染病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    李骏; 张久之; 万献尧

    2013-01-01

    Objective To investigate the species distribution and antibiotic resistance of pathogens from catheter-related bloodstream infections (CRBSI) in intensive care unit(ICU) ,to provide evidence for the guidance of clinical rational administration. Methods A retrospective analysis was performed to review the microbiological and susceptibility test data of all CRBSI patients in ICU from January 2009 to December 2011. The patterns of antibiotic resistance among the top seven bacteria were compared. Results 67 cases of CRBSI were detected with 81 strains, including 40 Gram-positive (G+ ) bacteria ( 49. 4% ), 38 Gram-negative(G-) bacteria (46. 9% ), and 3 fungi (3. 7% ). The main pathogens causing CRBSI were coagulase negative Staphylococci ( 27 strains, 33. 3% ) , Acinetobacter baumannii ( 12 strains, 14. 8% ) , Klebsiella pneumoniae (9 strains, 11. 1% ) , Staphylococcus aureus ( 8 strains, 9. 9% ) , Pseudomonas aeruginosa ( 7 strains, 8. 6% ) , Escherichia coli ( 6 strains, 7. 4% ) , suggesting that Staphylococcus epidermidis was predominant pathogenic G+ bacteria, and Acinetobacter baumannii was predominant G- bacteria. The antibiotic resistance tests demonstrated that isolated G bacillus was highly sensitive to carbopenem, while vancomycin-resistant G + bacteria were not found. Conclusions Within the latest 3 years, the predominant pathogens of CRBSI in ICU are Staphylococcus epidermidis and Acinetobacter baumannii. Acinetobacter baumannii exhibited high drug resistance to all antibiotics.%目的 了解ICU内中心静脉导管相关性血流感染(CRBSI)病原菌的分布特点及其耐药性,以指导临床合理用药.方法 回顾性分析2009年1月至2011年12月ICU内CRBSI患者的病原菌分布和药物敏感试验资料,比较排位前7位细菌的耐药特征.结果 67例CRBSI患者共检出81株病原菌,其中革兰阳性(G+)菌40株(49.4%),革兰阴性(G-)菌38株(46.9%),真菌3株(3.7%).引起CRBSI的主要病原菌依次

  7. Implementation of central venous catheter bundle in an intensive care unit in Kuwait: Effect on central line-associated bloodstream infections.

    Science.gov (United States)

    Salama, Mona F; Jamal, Wafaa; Al Mousa, Haifa; Rotimi, Vincent

    2016-01-01

    Central line-associated bloodstream infection (CLABSIs) is an important healthcare-associated infection in the critical care units. It causes substantial morbidity, mortality and incurs high costs. The use of central venous line (CVL) insertion bundle has been shown to decrease the incidence of CLABSIs. Our aim was to study the impact of CVL insertion bundle on incidence of CLABSI and study the causative microbial agents in an intensive care unit in Kuwait. Surveillance for CLABSI was conducted by trained infection control team using National Health Safety Network (NHSN) case definitions and device days measurement methods. During the intervention period, nursing staff used central line care bundle consisting of (1) hand hygiene by inserter (2) maximal barrier precautions upon insertion by the physician inserting the catheter and sterile drape from head to toe to the patient (3) use of a 2% chlorohexidine gluconate (CHG) in 70% ethanol scrub for the insertion site (4) optimum catheter site selection. (5) Examination of the daily necessity of the central line. During the pre-intervention period, there were 5367 documented catheter-days and 80 CLABSIs, for an incidence density of 14.9 CLABSIs per 1000 catheter-days. After implementation of the interventions, there were 5052 catheter-days and 56 CLABSIs, for an incidence density of 11.08 per 1000 catheter-days. The reduction in the CLABSI/1000 catheter days was not statistically significant (P=0.0859). This study demonstrates that implementation of a central venous catheter post-insertion care bundle was associated with a reduction in CLABSI in an intensive care area setting.

  8. Epidemiology and prevention of catheter-related thrombosis in patients with cancer

    NARCIS (Netherlands)

    Lee, A. Y. Y.; Kamphuisen, P. W.

    2012-01-01

    . Central venous catheters are extensively used in patients with cancer to secure delivery of chemotherapy and facilitate phlebotomy. Unfortunately, considerable morbidity can result from early complications or late sequelae, ranging from arterial puncture, pneumothorax and bloodstream infections to

  9. Evaluation of mupirocin ointment in control of central venous catheter related infections: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Rezaei J

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Central venous catheter (CVC related infections are important complications of cathter application. This study assessed the usefulness of mupirocin in prevention and control of these infections."n"nMethods: In this randomized clinical trial, consecutive surgical patients requiring central venous catheter (for more than 2 days in Amir-Alam Hospital from 2006-2008 were enrolled. Patients were divided in two groups; in "case group" patients received topical mupirocin 2% every 48 hours at the time of insertion of catheter and dressing change and for "control group" mupirocin was not used. All of the patients received chlorhexidine and enoxoparin as complementary treatments. Two groups were comparable in regard of age, sex and risk factors."n"nResults: One hundred eighteen patients enrolled in the study (57 in case and 61 in control group completed the study. 84 catheters in case group and 88 catheters in control group were inserted. The catheters in 90% of patients were inserted in jugular vein. At the end of study 29(16.8% patients (16 in control versus 13 in case group had catheter colonization (p=NS. Catheter related bloodstream infection was observed in 16(9.3% patients (6 in

  10. Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil

    Directory of Open Access Journals (Sweden)

    Daiane Silva Resende

    2011-12-01

    Full Text Available INTRODUCTION: Catheter-associated bloodstream infection (CA-BSI is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. METHODS: An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. RESULTS: A total of sixty-seven (26.7% CA-BSIs were observed. There were 46 (32% episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]. Neonates in the group after implementation of the intervention had 21 (19.6% episodes of CA-BSI (14.9 per 1,000 CVC days. The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04. In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. CONCLUSIONS: A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

  11. Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients

    Energy Technology Data Exchange (ETDEWEB)

    Bouzad, Caroline, E-mail: caroline.bouzad@gmail.com [Percy Military Teaching Hospital, Radiology Department (France); Duron, Sandrine, E-mail: duronsandrine@yahoo.fr [GSBdD, Military Centre for Epidemiology and Public Health (CESPA) (France); Bousquet, Aurore, E-mail: aurorebousquet@yahoo.fr [Begin Military Teaching Hospital, Bacteriology Department (France); Arnaud, François-Xavier, E-mail: fxa0160@hotmail.com [Percy Military Teaching Hospital, Radiology Department (France); Valbousquet, Laura, E-mail: laura.valbousquet@gmail.com [Begin Military Teaching Hospital, Radiology Department (France); Weber-Donat, Gabrielle, E-mail: weberdonatgabrielle@yahoo.fr; Teriitehau, Christophe, E-mail: cteriitehau@me.com; Baccialone, Jacques, E-mail: jacques.baccialone@wanadoo.fr; Potet, Julien, E-mail: potet-julien@yahoo.fr [Percy Military Teaching Hospital, Radiology Department (France)

    2016-03-15

    PurposeTo determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.Materials and MethodsMedical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.ResultsNine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3 %) with a median age of 58 years. 31 (3.4 %) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1 %) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7 %) septic thrombophlebitis, and 1 (3.2 %) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2–confidence interval (CI) 95 % [1.77–29.5]), auto/allograft (OR 5.9–CI 95 % [1.2–29.2]), and anti-coagulant therapy (OR 2.2–95 % [1.4–12]).ConclusionChemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.Clinical AdvanceChemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections.

  12. Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients

    International Nuclear Information System (INIS)

    PurposeTo determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.Materials and MethodsMedical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.ResultsNine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3 %) with a median age of 58 years. 31 (3.4 %) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1 %) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7 %) septic thrombophlebitis, and 1 (3.2 %) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2–confidence interval (CI) 95 % [1.77–29.5]), auto/allograft (OR 5.9–CI 95 % [1.2–29.2]), and anti-coagulant therapy (OR 2.2–95 % [1.4–12]).ConclusionChemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.Clinical AdvanceChemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections

  13. Prevention of catheter-related Pseudomonas aeruginosa infection by levofloxacin-impregnated catheters in vitro and in vivo

    Institute of Scientific and Technical Information of China (English)

    Yan Ping; Liu Wei; Kong Jinliang; Wu Hong; Chen Yiqiang

    2014-01-01

    Background Implanted medical catheter-related infections are increasing,hence a need for developing catheter polymers bonded to antimicrobials.We evaluated preventive effects of levofloxacin-impregnated catheters in catheterrelated Psuedomonas aeruginosa (strain PAO1) infection.Methods Drug release from levofloxacin-impregnated catheters was measured in vitro.Levofloxacin-impregnated catheters and polyvinyl chloride (PVC) catheters were immersed in 5 ml 50% Luria Bertani medium containing 108 CFU/ml Pseudomonas aeruginosa then incubated for 6,12,24 or 48 hours at 37℃ when bacteria adhering to the catheters and bacteria in the growth culture medium were determined.Impregnated and PVC catheters were singly implanted subcutaneously in mice,50 μl (107CFU) of PAO1 was injected into catheters.After the first and fifth days challenge,bacterial counts on implanted catheters and in surrounding tissues were determined microbiologically.Bacterial colonization and biofilm formation on implanted catheters were assessed by scanning electron microscopy.Results Drug release from levofloxacin-impregnated catheters was rapid.Levofloxacin-impregnated catheters had significantly fewer bacteria compared to PVC in vitro.After first and fifth day of challenge,no or significantly fewer bacteria adhered to impregnated catheters or in surrounding tissues compared to PVC.Scanning electron microscopical images after first day displayed from none to significantly fewer bacteria adhering to impregnated implanted catheters,compared to bacteria and microcolonies adhering to PVC catheters.After the fifth day,no bacteria were found on impregnated catheters,compared to clusters surrounding mucus-like substance and coral-shaped biofilms with polymorphonuclear leukocyte on PVC catheters.After the first day of challenge,secretion occurred in all implanted catheters with surrounding tissues mildly hyperaemic and swollen.After the fifth day,minute secretions inside impregnated catheters and no

  14. Management Of Fever And Suspected Infection In Pediatric Patients With Central Venous Catheters.

    Science.gov (United States)

    Brennan, Courtney; Wang, Vincent J

    2015-12-01

    The use of indwelling central venous catheters is essential for pediatric patients who require hemodialysis, parenteral nutrition, chemotherapy, or other medications. Fever is a common chief complaint in the emergency department, and fever in a patient with a central venous catheter may be related to a common cause of fever, or it may be due to a catheter-associated bloodstream infection. Catheter-associated bloodstream infections may also lead to additional complications such as sepsis, septic shock, or septic complications including suppurative thrombophlebitis, endocarditis, osteomyelitis, septic emboli, and abscesses. Early resuscitation as well as timely and appropriate antibiotic therapy have been shown to improve outcomes. This issue focuses on the approach to fever in pediatric patients with central venous catheters and the management and disposition of patients with possible catheter-associated bloodstream infections. PMID:26569627

  15. Management Of Fever And Suspected Infection In Pediatric Patients With Central Venous Catheters.

    Science.gov (United States)

    Brennan, Courtney; Wang, Vincent J

    2015-12-01

    The use of indwelling central venous catheters is essential for pediatric patients who require hemodialysis, parenteral nutrition, chemotherapy, or other medications. Fever is a common chief complaint in the emergency department, and fever in a patient with a central venous catheter may be related to a common cause of fever, or it may be due to a catheter-associated bloodstream infection. Catheter-associated bloodstream infections may also lead to additional complications such as sepsis, septic shock, or septic complications including suppurative thrombophlebitis, endocarditis, osteomyelitis, septic emboli, and abscesses. Early resuscitation as well as timely and appropriate antibiotic therapy have been shown to improve outcomes. This issue focuses on the approach to fever in pediatric patients with central venous catheters and the management and disposition of patients with possible catheter-associated bloodstream infections.

  16. Distribution of pathogens causing catheter-associated bloodstream infections in hemodialysis patients and analysis of risk factors%血液透析患者导管相关性血流感染病原菌分布与危险因素分析

    Institute of Scientific and Technical Information of China (English)

    杨春琴; 黄敏; 翁明祥

    2015-01-01

    目的:探讨血液透析患者导管相关性血流感染的病原菌分布及相关危险因素,为制定相应的干预措施提供参考依据。方法回顾性分析286例行中心静脉留置透析导管透析患者的临床资料,记录透析患者的年龄、性别、基础疾病、置管种类及部位、导管留置时间、病原菌培养结果。结果286例留置中心静脉透析导管患者,发生CRBSI 28例,发生率为9.79%;共分离出病原菌28株,其中革兰阳性菌20株占71.44%,以表皮葡萄球菌、金黄色葡萄球菌为主,革兰阴性菌8株占28.56%,以铜绿假单胞菌、大肠埃希菌、褪色沙雷菌为主;年龄>60岁、原发病为糖尿病肾病、导管留置时间>2周、行股静脉置管与CRBSI的发生具有相关性(P<0.05)。结论 CRB‐SI感染病原菌以革兰阳性菌为主,高龄、糖尿病、导管留置时间长、股静脉置管为导管相关性血流感染的危险因素。%OBJECTIVE To explore the distribution of pathogens causing catheter‐associated bloodstream infections in the hemodialysis patients and analyze the related risk factors so as to put forward targeted interventions . METHODS The clinical data of 286 patients who underwent indwelling central venous catheter hemodialysis were retrospectively analyzed;the age ,genders ,underlying diseases ,types of indwelling catheter ,intubation sites , catheter indwelling time ,and result of cultures of pathogens were recorded and observed .RESULTS The catheter‐associated bloodstream infections occurred in 28 of 286 patients undergoing indwelling central venous catheter he‐modialysis ,with the incidence rate of 9 .79% .A total of 28 strains of pathogens have been isolated ,including 20 (71 .44% ) strains of gram‐positive bacteria and 8 (28 .56% ) strains of gram‐negative bacteria;the Staphylococcus epidermidis and Staphylococcus aureus were the predominant species of the gram‐positive bacteria

  17. Cefotaxime-heparin lock prophylaxis against hemodialysis catheter-related sepsis among Staphylococcus aureus nasal carriers

    Directory of Open Access Journals (Sweden)

    Anil K Saxena

    2012-01-01

    Full Text Available Staphylococcus aureus nasal carriers undergoing hemodialysis (HD through tunneled cuffed catheters (TCCs form a high-risk group for the development of catheter-related bloodstream infections (CRBSI and ensuing morbidity. The efficacy of antibiotic-locks on the outcomes of TCCs among S. aureus nasal carriers has not been studied earlier. Persistent nasal carriage was defined by two or more positive cultures for methicillin-susceptible (MSSA or methicillin-resistant (MRSA S. aureus of five standardized nasal swabs taken from all the participants dialyzed at a large out-patient HD center affiliated to a tertiary care hospital. Of 218 participants, 82 S. aureus nasal carriers dialyzed through TCCs (n = 88 were identified through April 2005 to March 2006 and randomized to two groups. Group I comprised of 39 nasal carriers who had TCCs (n = 41 "locked" with cefotaxime/heparin while group II included 43 patients with TCCs (n = 47 filled with standard heparin. The CRBSI incidence and TCC survival at 365 days were statistically compared between the two groups. A significantly lower CRBSI incidence (1.47 vs. 3.44/1000 catheter-days, P <0.001 and higher infection-free TCC survival rates at 365 days (80.5 vs. 40.4%, P <0.0001 were observed in the cefotaxime group compared with the stan-dard heparin group. However, no significant difference in MRSA-associated CRBSI incidence was observed between the two groups. Cefotaxime-heparin "locks" effectively reduced CRBSI-incidence associated with gram-positive cocci, including MSSA, among S. aureus nasal carriers. There remains a compelling requirement for antibiotic-locks effective against MRSA.

  18. Catheter-related infection in gastrointestinal fistula patients

    Institute of Scientific and Technical Information of China (English)

    Ge-Fei Wang; Jian-An Ren; Jun Jiang; Cao-Gan Fan; Xin-Bo Wang; Jie-Shou Li

    2004-01-01

    AIM: To study the incidence, bacterial spectrum and drug sensitivity of catheter-related infection (CRI) in gastrointestinal fistula patients.METHODS: A total of 216 patients with gastrointestinal fistulae during January 1998 to April 2001 were studied retrospectively. Two hundred and sixteen catheters of the 358 central venous catheters used in 216 gastrointestinal fistula patients were sent for microbiology analysis.RESULTS: Ninety-five bacteria were cultivated in 88catheters (24.6%). There were 54 Gram-negative bacteria (56.8%), 35 Gram-positive bacteria (36.8%), and 6 fungi (6.4%). During the treatment of CRI, 20 patients changed to use antibiotics or antifungal, and all patients were cured.The mean time of catheters used was 16.9±13.0 d.CONCLUSION: CRI is still the common complication during total parenteral nutrition (TPN) treatment in patients with gastrointestinal fistulae, and Gram-negative bacteria are the main pathogens, and bacterial translocation is considered the common reason for CRI.

  19. Rhodococcus bacteremia in cancer patients is mostly catheter related and associated with biofilm formation.

    Directory of Open Access Journals (Sweden)

    Fadi Al Akhrass

    Full Text Available Rhodococcus is an emerging cause of opportunistic infection in immunocompromised patients, most commonly causing cavitary pneumonia. It has rarely been reported as a cause of isolated bacteremia. However, the relationship between bacteremia and central venous catheter is unknown. Between 2002 and 2010, the characteristics and outcomes of seventeen cancer patients with Rhodococcus bacteremia and indwelling central venous catheters were evaluated. Rhodococcus bacteremias were for the most part (94% central line-associated bloodstream infection (CLABSI. Most of the bacteremia isolates were Rhodococcus equi (82%. Rhodococcus isolates formed heavy microbial biofilm on the surface of polyurethane catheters, which was reduced completely or partially by antimicrobial lock solution. All CLABSI patients had successful response to catheter removal and antimicrobial therapy. Rhodococcus species should be added to the list of biofilm forming organisms in immunocompromised hosts and most of the Rhodococcus bacteremias in cancer patients are central line associated.

  20. A European perspective on intravascular catheter-related infections

    DEFF Research Database (Denmark)

    Bouza, E; San Juan, R; Muñoz, P;

    2004-01-01

    The laboratory workload, microbiological techniques and aetiology of catheter-related infections in European hospitals are mostly unknown. The present study (ESGNI-005) comprised a 1-day (22 October 2001), laboratory-based, point-prevalence survey based on a questionnaire completed by microbiology...... by these institutions was 121,363,800, and the estimated number of admissions during 2000 was 6,712,050. The total number of catheter tips processed during 2000 was 142,727, or 21/1,000 admissions, of which 23.7% were considered to be positive in the institutions using semiquantitative or quantitative techniques....... Overall, EU centres received significantly more catheter tip samples/1,000 admissions and had a significantly higher rate of 'positivity' (p...

  1. Método bundle na redução de infecção de corrente sanguínea relacionada a cateteres centrais: revisão integrativa Método bundle en la redución de infecciones relacionadas a catéteres centrales: una revisión integrativa Care bundle to reduce central venous catheter-related bloodstream infection: an integrative review

    OpenAIRE

    Juliana Dane Pereira Brachine; Maria Angélica Sorgini Peterlini; Mavilde da Luz Gonçalves Pedreira

    2012-01-01

    Trata-se de uma revisão integrativa da literatura, que objetivou identificar intervenções baseadas em evidência que compõem o método bundle, designados à redução de infecção de corrente sanguínea relacionada ou associada a cateter intravenoso central. Para a coleta de dados online, em bases nacionais e internacionais, foram utilizados a palavra-chave bundle e os descritores catheter-related infection, infection control e central venous catheterization, resultando, após aplicação dos critérios...

  2. Catheter-related blood stream infection caused by Raoultella ornithinolytica.

    Science.gov (United States)

    Sękowska, Alicja; Dylewska, Katarzyna; Gospodarek, Eugenia; Bogiel, Tomasz

    2015-11-01

    Raoultella spp. representatives are Gram-negative capsulated, nonmotile rods. These bacteria are found in the natural environment: plants, water, soil and insects. R. ornithinolytica is one of the three species of Raoultella. R. ornithinolytica is the only species within the genus which has the ability to produce ornithine decarboxylase. Human infections related to R. ornithinolytica are exceedingly rare. The present case report describes catheter-related blood stream infection caused by R. ornithinolytica and successfully treated with antibiotic therapy.

  3. The impact of sodium citrate on dialysis catheter function and frequency of catheter-related bacteriemia and haemorrhage

    Directory of Open Access Journals (Sweden)

    Maciej Szymczak

    2009-10-01

    Full Text Available Vascular access is one of the most important problems of hemodialysis therapy. It is known that an arteriovenous fi sutla provides the best vascular access, but its creation is not always possible. Other solutions, such as the insertion of a central venous catheter, are then required. Adequate protection of such catheters by interdialytic fi ll with locking solution affects the frequency of hemodialysis-related complications. The most widespread catheter locking solution is heparin. Sodium citrate is being used more frequent recently. Available data indicate that hemorrhage is 11.9 times more frequent if the catheter locking solution is 5000 IU/ml heparin than if 4�0sodium citrate or 1000 IU/ml heparin is used. Other data indicate that the frequency of infection is statistically decreased when 30�0sodium citrate is used to fi ll the catheter instead of 5000 IU/ml heparin. Analogous data on 46.7�0sodium citrate are not consistent. It seems that the use of 4�0sodium citrate instead of 5000 IU/ml heparin does not decrease the frequency of infections. Numerous studies indicate that sodium citrate at various concentrations exerts a positive infl lence on catheter function. However, not all data are in accord. The spill of sodium citrate from the catheter to the systemic circulation is connected with a risk of adverse events. It may be dangerous if the citrate concentration is 46.7�20However, adequate fi lling of the catheter should prezent such events. Available data indicate that fi lling of the catheter with a solution of citrate of a concentration of no more than 30�0should be safe. Data on 46.7�0citrate are not conclusive, so precautions should be taken.

  4. Central venous catheter-related infections: Risk factors and effects of glycopeptide antibiotics

    Directory of Open Access Journals (Sweden)

    Arsenijević Ljubica

    2007-01-01

    Full Text Available INTRODUCTION Central venous catheters (CVC are used in the treatment of critically ill patients. Indications for placement of CVCs include hemodynamic monitoring, administration of intravenous fluids, medications and total parenteral nutrition. MATERIAL AND METHODS We investigated risk factors and effects of glycopeptide antibiotics on the development of central venous catheter-related infections in 300 patients treated in intensive care units. A semiquntitative culture technique was used. The investigation included: age, diagnosis on admission, catheter insertion site, catheter duration, the first or next catheter and using of glycopeptide drugs. RESULTS 91 catheters (30.3% were colonised, catheter-related infection was found in 50 catheters (16.7%. Infections were more frequent in catheters inserted through the internal jugular vein than in subclavian venous catheters; they were also more frequent if duration of catheterization was longer than seven days, but less frequent in patients who received glycopeptide antibiotics. The isolated microorganism was Staphylococcus aureus. DISCUSSION According to the literature, a number of catheter-related risk factors for infections include: insertion site, type of catheter, the number of manipulations, inadequat asepsis, lumen number, type of antiseptic. The relative importance of one risk factor over another is difficult to assess, given that studies have no priority report. CONCLUSION The duration of catheterization and the insertion site were the most frequent risk factors for infection. The use of glycopeptide antibiotics during catheterization has protective effects.

  5. 基层医院ICU中心静脉导管相关性血流感染的危险因素分析%Risk Factors of Catheter-Associated Bloodstream Infections in Intensive Care Unit of Primary Hospital

    Institute of Scientific and Technical Information of China (English)

    张细江

    2012-01-01

    Objective To explore the risk factors of catheter-associated bloodstream infections (CRBSI) in intensive care unit (ICU) of primary hospital. Methods A total of 623 patients with central venous catheters were recruited in the study. 60 of them suffered from CRBSI served as an observation group and other 563 cases without CRBSI served as control. Univariate analysis was used to scan possible risk factors. Then logistic regression analysis was used to exclude the confounding factors. Results The overall incidence rate of CRBSI was 9. 63% (60/623). There were significant differences in APACHE score, type of catheter,location of catheter,duration of central venous catheter,intravenous nutrition, use of steroid,times of intubation, urgent intubations, nutritional status, diabetes, and MODS between the two groups. Logistic regression analysis revealed that higher APACHE score, double-lumen catheter, femoral vein catheter, catheter indwelling more than two weeks, intravenous nutrition, intubation more than 2 times, and emergency intubation were risk factors of CRBSI. Conclusions Higher APACHE score,double-lumen catheter,femoral vein catheter,catheter indwelling more than two weeks,intravenous nutrition,intubation more than 2 times, and emergency intubation were major risk factors of CRBSI in ICU of primary hospital.%目的 探讨基层医院ICU中心静脉导管相关血流感染(CRBSI)的危险因素.方法 以台州市立医院ICU就诊的中心静脉导管留置患者为研究对象,根据是否发生CRBSI分成感染组(60例)和非感染组(563例),首先单因素分析初步筛查CRBSI的危险因素,然后以是否发生CRBSI(1=是,0=否)为因变量,以单因素分析有差别的危险因素为自变量,进行Logistic多因素回归分析,寻找CRBSI的危险因素.结果 CRBSI的发生率为9.63% (60/623);感染组与非感染组APACHE评分、导管类型、导管留置部位、留置时间、静脉营养、激素使用、插管次数、紧急插管、营

  6. Investigation of biofilm formation on a charged intravenous catheter relative to that on a similar but uncharged catheter

    Directory of Open Access Journals (Sweden)

    Richards GA

    2014-06-01

    Full Text Available Guy A Richards,1,2 Adrian J Brink,3 Ross McIntosh,4 Helen C Steel,5,6 Riana Cockeran5,61Department of Critical Care, Charlotte Maxeke Johannesburg Academic Hospital, 2Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 3Department of Clinical Microbiology, Ampath National Laboratory Services, Milpark Hospital, Johannesburg, South Africa; 4Nano-Scale Transport Physics Laboratory, School of Physics, University of the Witwatersrand, Johannesburg, South Africa; 5Medical Research Council Unit for Inflammation and Immunity, Department of Immunology, University of Pretoria, Pretoria, South Africa; 6National Health Laboratory Service, Pretoria, South AfricaAbstract: Catheter-related blood stream infections increase morbidity, mortality, and costs. This study investigated whether Certofix® protect antimicrobial catheters carry a surface charge and whether this inhibits biofilm formation. The capacitance of the catheter surfaces was measured and, to determine if the catheters released ions, distilled water was passed through and current measured as a function of voltage. With probes touching the inner and outer surfaces, capacitance was not voltage-dependent, indicating surfaces were uncharged or carried a similar charge. When one probe penetrated the catheter wall, capacitance was weakly voltage-dependent, indicating the presence of a surface charge. Standard and charged catheters were also exposed to phosphate buffered saline as controls or 2×106 colony forming units/mL (in phosphate buffered saline of six different microorganisms for 60 or 120 minutes. When the growth of detached bacteria was measured, biofilm formation was significantly reduced, (P<0.05, for charged catheters for all organisms.Keywords: central venous catheters, electrical charge, biofilm

  7. Biofilm-based central line-associated bloodstream infections.

    Science.gov (United States)

    Yousif, Ammar; Jamal, Mohamed A; Raad, Issam

    2015-01-01

    Different types of central venous catheters (CVCs) have been used in clinical practice to improve the quality of life of chronically and critically ill patients. Unfortunately, indwelling devices are usually associated with microbial biofilms and eventually lead to catheter-related bloodstream infections (CLABSIs).An estimated 250,000-400,000 CLABSIs occur every year in the United States, at a rate of 1.5 per 1,000 CVC days and a mortality rate of 12-25 %. The annual cost of caring for patients with CLABSIs ranges from 296 million to 2.3 billion dollars.Biofilm formation occurs on biotic and abiotic surfaces in the clinical setting. Extensive studies have been conducted to understand biofilm formation, including different biofilm developmental stages, biofilm matrix compositions, quorum-sensing regulated biofilm formation, biofilm dispersal (and its clinical implications), and multi-species biofilms that are relevant to polymicrobial infections.When microbes form a matured biofilm within human hosts through medical devices such as CVCs, the infection becomes resistant to antibiotic treatment and can develop into a chronic condition. For that reason, many techniques have been used to prevent the formation of biofilm by targeting different stages of biofilm maturation. Other methods have been used to diagnose and treat established cases of CLABSI.Catheter removal is the conventional management of catheter associated bacteremia; however, the procedure itself carries a relatively high risk of mechanical complications. Salvaging the catheter can help to minimize these complications.In this article, we provide an overview of microbial biofilm formation; describe the involvement of various genetic determinants, adhesion proteins, organelles, mechanism(s) of biofilm formation, polymicrobial infections, and biofilm-associated infections on indwelling intravascular catheters; and describe the diagnosis, management, and prevention of catheter-related bloodstream infections

  8. Dialysis catheter-related septicaemia--focus on Staphylococcus aureus septicaemia

    DEFF Research Database (Denmark)

    Nielsen, J; Ladefoged, S D; Kolmos, H J

    1998-01-01

    BACKGROUND: Dialysis catheters are a common cause of nosocomial septicaemia in haemodialysis units usually due to staphylococci, of which Staphylococcus aureus is the most pathogenic. In this study, the epidemiology and pathogenesis of dialysis catheter-related infections were studied, and methods...... to identify patients with these infections were evaluated. METHODS: A one-year prospective study of 67 catheters in 43 haemodialysis patients was performed. Details about patients and catheters were obtained successively during the catheter period, and biochemical parameters expected to be related...... to infection were measured. After catheter insertion, all patients were screened for nasal carriage of S. aureus, and a culture was taken from the skin overlying the catheter insertion site. Once a week, cultures were taken from the insertion site and from the hub, and aerobic and anaerobic blood cultures were...

  9. Biofilm formation in long-term central venous catheters in children with cancer

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Fuursted, Kurt; Funch, Peter;

    2012-01-01

    Taurolidine has demonstrated inhibition of biofilm formation in vitro. The aim of this study was to compare the effect of catheter locking with taurolidine vs heparin in biofilm formation in central venous catheters. Forty-eight children with cancer were randomized to catheter locking by heparin (n...... = 22) or taurolidine (n = 26), respectively. After removal, catheters were examined by standardized scanning electron microscopy to assess quantitative biofilm formation. Biofilm was present if morphologically typical structures and bacterial cells were identified. Quantitative and semi......-quantitative cultures were also performed. Biofilm was identified in 23 of 26 catheters from the taurolidine group and 21 of 22 catheters from the heparin group. A positive culture was made of six of the catheters locked with taurolidine and heparin, respectively (p = 0.78). The rate of catheter-related bloodstream...

  10. Prevention of central venous catheter-associated bloodstream infections: A questionnaire evaluating the knowledge of the selected 11 evidence-based guidelines by Polish nurses.

    Science.gov (United States)

    Dedunska, Karina; Dyk, Danuta

    2015-12-01

    This study evaluated the questionnaire testing nurses' knowledge about the maintenance of a central venous catheter (CVC) and assessed it with regard to age, work experience, type of ward, frequency of trainings, and postgraduate education. There were 1,180 questionnaires (N = 784; 66.4% of the total sample) distributed in several regions of Poland for a period of 7 months. The difficulty level for each question ranged from 0.22-0.88.

  11. Clinical effectiveness and cost-effectiveness of central venous catheters treated with Minocycline and Rifampicin in preventing bloodstream infections in intensive care patients [Medizinische Wirksamkeit und Kosteneffektivität von Minocyclin/Rifampicin-beschichteten zentralvenösen Kathetern zur Prävention von Blutbahninfektionen bei Patienten in intensivmedizinischer Betreuung

    OpenAIRE

    Neusser, Silke; Bitzer, Eva Maria; Mieth, Ingeborg; Krauth, Christian

    2012-01-01

    [english] The use of central venous catheters coated with antibiotics can avoid bloodstream infections with intensive care patients. This is the result of a scientific examination which has been published by the DIMDI. Costs could be also saved in this way. However, according to the authors, the underlying studies do not allow absolutely valid statements.[german] Der Einsatz bestimmter Antibiotika-beschichteter Venenkatheter kann bei Intensivpatienten Blutbahninfektionen vermeiden. So das Erg...

  12. Catheter-related Complications in Postoperative Intraperitoneal Chemotherapy for Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To analyze catheter-related complications during postoperative Intraperitoneal chemotherapy (IPCT) for gastric cancer. Methods: From December 2003 to April 2007, 80 patients with gastric cancer were treated with postoperative IPCT using central venous catheters (CVCs), during which the complications that occurred in association with CVCs were documented and analyzed. Results: Catheter-related complications were seen in 10 out of the 80 patients, yielding a total complication rate of 12.5%. Main complications included abdominal pain (3.8%), local infection (1.3%), catheter obstruction (2.5%), leakage (2.5%) and dislocation (2.5%). All patients successfully finished their IPCT, the success rate was 100%. There occurred no severe complications or treatment-related deaths. Conclusion: It is convenient and safe to carry out postoperative IPCT for gastric cancer using CVCs, which, with a low catheter-related complication rate, should be recommended for more clinic use.

  13. PROPHYLACTIC ADMINISTRATION OF DOXYCYCLINE REDUCES CENTRAL VENOUS CATHETER INFECTIONS IN PATIENTS UNDERGOING HEMATOPOIETIC CELL TRANSPLANTATION

    OpenAIRE

    Mohamed Kharfan-Dabaja; Mohamed Baydoun; Zaher Otrock; Samar Okaily; Rita Nehme; Racha Abu-Chahine; Ali Hamdan; Samar Noureddine; Souha Kanj; Zeina Kanafani; Ali Bazarbachi

    2013-01-01

    Hematopoietic stem cells are usually transfused through a central venous catheter (CVC), which also facilitates administration of medications and intravenous fluids. We had observed high rate of catheter-related blood-stream infection (CR-BSI) at our Bone Marrow Transplantation (BMT) unit despite prescribing fluoroquinolones for anti-bacterial prophylaxis. Accordingly, we implemented prophylactic use of a relatively inexpensive broad spectrum antibiotic, namely doxycycline to address this pro...

  14. Bacterial profile and antimicrobial susceptibility pattern in catheter related nosocomial infections.

    Directory of Open Access Journals (Sweden)

    Tullu M

    1998-01-01

    Full Text Available This prospective study was carried out over a period of 6 months in the Paediatric Intensive Care Unit (PICU of a tertiary care teaching hospital. The aim of the study was to determine the organisms causing catheter related nosocomial infections in the PICU and to study their antimicrobial susceptibility pattern. Patients with endotracheal intubation, indwelling urinary catheters and central venous catheters (CVC/venous cutdown catheters were included in the study. Colonization of the endotracheal tube, urinary catheter related infections (UCRI and colonization of the CVC/venous cutdown catheters was studied. E. coli was the commonest organism colonizing the endotracheal tube tip with maximum susceptibility to cefotaxime and amikacin. E. coli was also was the commonest organism causing UCRI with maximum susceptibility to nitrofurantoin and amikacin. Acinetobacter was the commonest organism colonizing the CVC/venous cutdown catheters with maximum susceptibility to ciprofloxacin. All these sites of catheter related infections considered together, E. coli and Klebsiella were the commonest nosocomial organisms. Both had maximum susceptibility to amikacin. Methicillin resistant Staphylococcus aureus (MRSA was isolated only from one culture. All the organisms had a poor susceptibility to cefazolin and amoxycillin. A knowledge of the resident microbial flora and their antimicrobial susceptibility pattern is necessary for formulating a rational antibiotic policy in an ICU.

  15. Implanted central venous catheter-related acute superior vena cava syndrome: management by metallic stent and endovascular repositioning of the catheter tip

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    Qanadli, S.D.; Mesurolle, B.; Sissakian, J.F.; Chagnon, S.; Lacombe, P. [Service de Radiologie, Hopital Ambroise Pare, 92 - Boulogne (France)

    2000-08-01

    We describe a case of a 49-year-old woman with stage-IIIB lung adenocarcinoma who experienced an acute superior vena cava syndrome related to an implanted central venous catheter without associated venous thrombosis. The catheter was surgically implanted for chemotherapy. Superior vena cava syndrome appeared after the procedure and was due to insertion of the catheter through a subclinical stenosis of the superior vena cava. Complete resolution of the patient's symptoms was obtained using stent placement and endovascular repositioning of the catheter tip. (orig.)

  16. Co-release of dicloxacillin and thioridazine from catheter material containing an interpenetrating polymer network for inhibiting device-associated Staphylococcus aureus infection

    DEFF Research Database (Denmark)

    Stenger, Michael; Klein, Kasper; Grønnemose, Rasmus B;

    2016-01-01

    Approximately half of all nosocomial bloodstream infections are caused by bacterial colonization of vascular catheters. Attempts have been made to improve devices using anti-adhesive or antimicrobial coatings; however, it is often difficult to bind coatings stably to catheter materials, and the low...... to an enhanced loading capacity of DCX when co-loaded with TDZ. Lastly, the IPN catheters were tested in a novel porcine model of central venous catheter-related infection, in which drug-loaded IPN catheters were found to significantly decrease the frequency of infection....

  17. The role of staphylothrombin-mediated fibrin deposition in catheter-related Staphylococcus aureus infections.

    Science.gov (United States)

    Vanassche, Thomas; Peetermans, Marijke; Van Aelst, Lucas N L; Peetermans, Willy E; Verhaegen, Jan; Missiakas, Dominique M; Schneewind, Olaf; Hoylaerts, Marc F; Verhamme, Peter

    2013-07-01

    Staphylococcus aureus (S. aureus) is a frequent cause of catheter-related infections. S. aureus secretes the coagulases staphylocoagulase and von Willebrand factor-binding protein, both of which form a staphylothrombin complex upon binding to prothrombin. Although fibrinogen and fibrin facilitate the adhesion of S. aureus to catheters, the contribution of staphylothrombin-mediated fibrin has not been examined. In this study, we use a S. aureus mutant lacking both coagulases (Δcoa/vwb) and dabigatran, a pharmacological inhibitor of both staphylothrombin and thrombin, to address this question. Genetic absence or chemical inhibition of pathogen-driven coagulation reduced both fibrin deposition and the retention of S. aureus on catheters in vitro. In a mouse model of jugular vein catheter infection, dabigatran reduced bacterial load on jugular vein catheters, as well as metastatic kidney infection. Importantly, inhibition of staphylothrombin improved the efficacy of vancomycin treatment both in vitro and in the mouse model. PMID:23532100

  18. The Incidence of Peripheral Catheter-Related Thrombosis in Surgical Patients

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    Amy Leung

    2016-01-01

    Full Text Available Background. Central venous catheters and peripherally inserted central catheters are well established risk factors for upper limb deep vein thrombosis. There is limited literature on the thrombosis rates in patients with peripheral catheters. A prospective observational study was conducted to determine the incidence of peripheral catheter-related thrombosis in surgical patients. Methods. Patients deemed high risk for venous thrombosis with a peripheral catheter were considered eligible for the study. An ultrasound was performed on enrolment into the study and at discharge from hospital. Participants were reviewed twice a day for clinical features of upper limb deep vein thrombosis during their admission and followed up at 30 days. Results. 54 patients were included in the study. The incidence of deep vein thrombosis and superficial venous thrombosis was 1.8% and 9.2%, respectively. All cases of venous thrombosis were asymptomatic. Risk factor analysis was limited by the low incidence of thrombosis. Conclusion. This study revealed a low incidence of deep vein thrombosis in surgical patients with peripheral catheters (1.8%. The study was underpowered; therefore the association between peripheral catheters and thrombosis is unable to be established. Future studies with larger sample sizes are required to determine the association between peripheral catheters and thrombosis.

  19. Sonication for diagnosis of catheter-related infection is not better than traditional roll-plate culture: a prospective cohort study with 975 central venous catheters.

    Science.gov (United States)

    Erb, Stefan; Frei, Reno; Schregenberger, Katharina; Dangel, Marc; Nogarth, Danica; Widmer, Andreas F

    2014-08-15

    This prospective randomized controlled study with 975 nontunneled central venous catheters (CVCs) showed that the semiquantitative roll-plate culture technique (SQC) was as accurate as the sonication method for diagnosis of catheter-related infections. Sonication is difficult to standardize, whereas SQC is simpler, faster, and as reliable as the sonication method for culturing CVCs.

  20. Chlorhexidine-based antiseptic solutions effectively reduce catheter-related bacteremia.

    Science.gov (United States)

    Onder, Ali Mirza; Chandar, Jayanthi; Billings, Anthony; Diaz, Rosa; Francoeur, Denise; Abitbol, Carolyn; Zilleruelo, Gaston

    2009-09-01

    The aim of this retrospective study was to investigate if the application of chlorhexidine-based solutions (ChloraPrep) to the exit site and the hub of long-term hemodialysis catheters could prevent catheter-related bacteremia (CRB) and prolong catheter survival when compared with povidone-iodine solutions. There were 20,784 catheter days observed. Povidone-iodine solutions (Betadine) were used in the first half of the study and ChloraPrep was used in the second half for all the patients. Both groups received chlorhexidine-impregnated dressings at the exit sites. The use of ChloraPrep significantly decreased the incidence of CRB (1.0 vs 2.2/1,000 catheter days, respectively, P = 0.0415), and hospitalization due to CRB (1.8 days vs 4.1 days/1,000 catheter days, respectively, P = 0.0416). The incidence of exit site infection was similar for the two groups. Both the period of overall catheter survival (207.6 days vs 161.1 days, P = 0.0535) and that of infection-free catheter survival (122.0 days vs 106.9 days, P = 0.1100) tended to be longer for the catheters cleansed with ChloraPrep, with no statistical significance. In conclusion, chlorhexidine-based solutions are more effective for the prevention of CRB than povidone-iodine solutions. This positive impact cannot be explained by decreased number of exit site infections. This study supports the notion that the catheter hub is the entry site for CRB. PMID:19296135

  1. A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies.

    Science.gov (United States)

    Sakai, Toshiro; Kohda, Kyuhei; Konuma, Yuichi; Hiraoka, Yasuko; Ichikawa, Yukari; Ono, Kaoru; Horiguchi, Hiroto; Tatekoshi, Ayumi; Takada, Kouichi; Iyama, Satoshi; Kato, Junji

    2014-12-01

    Central venous catheter-related blood stream infections (CR-BSIs) are a serious complication in patients with hematological malignancies. However, it remains unclear whether there is a difference in the rate of CR-BSI associated with the conventional type of central venous catheters (cCVCs) and peripherally inserted CVCs (PICCs) in such patients. To address this question, we retrospectively investigated the incidence of CR-BSIs associated with PICCs versus cCVCs in patients with hematological malignancies. We used PICCs in all consecutive patients requiring CVC placement between February 2009 and February 2013. We compared the CR-BSI rate in patients with PICCs with that in patients with cCVCs treated between September 2006 and January 2009 (control group). Eighty-four patients received PICCs and 85 received cCVCs. The most common reason for removal due to catheter-related complications was CR-BSI. The CR-BSI rate in the PICC group was significantly lower than that in the cCVC group (PICCs: 1.23/1000 catheter days; cCVCs: 5.30/1000 catheter days; P Catheter-related complications other than CR-BSIs occurred at an extremely low rate in the PICC group. The median catheter-related complication-free survival duration was significantly longer in the PICC group than in the cCVC group. Our study shows that PICCs are useful in patients with hematological malignancies.

  2. A catheter related sepsis case caused by Pantoea agglomerans

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    Fadime Yılmaz

    2015-04-01

    microorganism was sensitive to piperacillin-tazobactam, so, patient's therapy was not changed. After treatment, when the general condition of the patient healed, he was discharged by ending antibiotics on the sixteenth day. This case report, is intended to call attention to the risk of the growth of catheter-associated sepsis and antibioterapi are lated to P. agglomerans which is rarely seen on immunocompromised patients.

  3. Biofilm formation in long-term central venous catheters in children with cancer: a randomized controlled open-labelled trial of taurolidine versus heparin

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Fuursted, Kurt; Funch, Peter;

    2012-01-01

    Taurolidine has demonstrated inhibition of biofilm formation in vitro. The aim of this study was to compare the effect of catheter locking with taurolidine vs heparin in biofilm formation in central venous catheters. Forty-eight children with cancer were randomized to catheter locking by heparin (n...... = 22) or taurolidine (n = 26), respectively. After removal, catheters were examined by standardized scanning electron microscopy to assess quantitative biofilm formation. Biofilm was present if morphologically typical structures and bacterial cells were identified. Quantitative and semi......-quantitative cultures were also performed. Biofilm was identified in 23 of 26 catheters from the taurolidine group and 21 of 22 catheters from the heparin group. A positive culture was made of six of the catheters locked with taurolidine and heparin, respectively (p = 0.78). The rate of catheter-related bloodstream...

  4. Minocycline-EDTA Lock Solution Prevents Catheter-Related Bacteremia in Hemodialysis

    OpenAIRE

    Campos, Rodrigo Peixoto; do Nascimento, Marcelo Mazza; Chula, Domingos Candiota; Riella, Miguel Carlos

    2011-01-01

    There is growing concern about the development of antibacterial resistance with the use of antibiotics in catheter lock solutions. The use of an antibiotic that is not usually used to treat other serious infections may be an alternative that may reduce the clinical impact should resistance develop. We conducted a randomized controlled trial to compare a solution of minocycline and EDTA with the conventional unfractionated heparin for the prevention of catheter-related bacteremia in hemodialys...

  5. Infecção de corrente sanguínea relacionada a cateter venoso central (ICSRC em enfermarias: estudo prospectivo comparativo entre veia subclávia e veia jugular interna Catheter-associated bloodstream infections (CA-BSI in wards: a prospective comparative study between subclavian and jugular access

    Directory of Open Access Journals (Sweden)

    Gustavo Lopes Gomes Siqueira

    2011-09-01

    Full Text Available CONTEXTO: Hemocultura positiva associada a cateter venoso central tem sido estudada em unidades de terapia intensiva (UTI, mas ainda é controverso se o acesso jugular tem maior incidência de complicações infecciosas que o acesso na veia subclávia. OBJETIVO: Comparar índice de infecção entre os acessos na jugular interna e os na veia subclávia em pacientes internados nas enfermarias de cirurgia. MÉTODOS: Estudo prospectivo, descritivo e comparativo com 114 cateteres em 96 pacientes admitidos nas enfermarias de cirurgia de um Hospital Quaternário, tendo como variáveis o local de inserção, número de lumens, tempo de uso, comparando-os com o índice de complicações infecciosas. RESULTADOS: O índice de infecção foi de 9,64% (11 cateteres, sem significância estatística quando comparados o número de lumens (mono versus duplo e infecção (p=0,274; também sem significância estatística a comparação entre o tempo de uso (>14 dias e infecção (p=0,156. Comparando os acessos jugular e subclávia, encontramos significância estatística tendo infecção em 17,2% na subclávia e 1,8% na jugular, com p=0,005. Índice de Hemocultura positivo associado a cateter venoso central foi maior no acesso subclávia quando comparado com jugular interna, com OR 11,2, IC95% (1,4-90,9; p=0,023. CONCLUSÕES: O acesso venoso central na jugular interna tem menor risco de infecção se comparado com subclávia em enfermarias.BACKGROUND: Positive hemoculture associated with central venous catheters has been studied in intensive care units (ICU, but is still controversial if the internal jugular vein access has a higher incidence of infection than subclavian or femoral vein access. OBJECTIVE: To compare catheter-related bloodstream infection (CABSI rates between internal jugular and subclavian vein access in patients admitted to surgical wards. METHODS: This is a prospective, descriptive and comparative study of 114 central venous catheters placed in

  6. Culture Positivity of CVCs Used for TPN: Investigation of an Association with Catheter-Related Infection and Comparison of Causative Organisms between ICU and Non-ICU CVCs

    Directory of Open Access Journals (Sweden)

    Criona Walshe

    2012-01-01

    Full Text Available A relationship between central venous catheter (CVC tip colonisation and catheter-related blood-stream infection (CRBSI has been suggested. We examined culture positivity of CVC tips (colonised and infected CVCs in a total parenteral nutrition (TPN population. Our aims were to define the relationship between culture positivity and CRBSI, and to compare causative organisms between culture positive and CRBSI CVCS, and between ward and ICU CVCs. All patients receiving TPN via non-tunnelled CVCs during the study (1997–2009 were included. All CVC tips were analysed. Data were collated contemporaneously. A TPN audit committee determined whether CVC tip culture positivity reflected colonisation/CRBSI using CDC criteria. 1,392 patients received TPN via 2,565 CVCs over 15,397 CVC days. 25.4% of CVCs tips were culture positive, of these 32% developed CRBSI. There was a nonsignificant trend of higher Gram negative Bacilli isolation in ICU CVCs (=0.1, ward CVCs were associated with higher rates of staphylococcal isolation (=0.01. A similar pattern of organisms were cultured from CRBSI and culture positive CVCs. The consistent relationship between CRBSI and culture positive CVCs, and similar pattern of causative organisms further supports an aetiological relationship between culture positive CVC tips and CRBSI, supporting the contention that CVC culture-positivity may be a useful surrogate marker for CRBSI rates.

  7. Utilização de cateter central de inserção periférica e ocorrência da infecção da corrente sanguínea em uma Unidade de Terapia Intensiva Neonatal | Use of peripherally inserted central catheters and occurrence of bloodstream infections in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Márcia Yumi Yonekura

    2015-02-01

    Full Text Available Objetivo: Analisar a prevalência de infecção hospitalar primária da corrente sanguínea em uma Unidade de Terapia Intensiva Neonatal. Métodos: Estudo retrospectivo, com análise de prontuários de uma Unidade de Terapia Intensiva Neonatal, no período de janeiro a dezembro de 2010. Foi calculada a densidade de incidência de infecção de corrente sanguínea associada ao cateter por 1000 cateteres-dia. Resultados: Dos 192 recém-nascidos, 16 (8,3% apresentaram infecção da corrente sanguínea e todos estes utilizaram o cateter central de inserção periférica. A densidade de infecção confirmada por hemocultura foi de 5,9 e a baseada em critérios clínicos foi de 3,5 por 1000 pacientes com cateter vascular central-dia. A distribuição por faixa de peso foi de: 30,9 (750-999g; 11 (1000-1499g; 8,5 (1500-2499g e 6,8 (> 2500g por 1000 pacientes com cateter vascular dia. A média do tempo de uso do cateter foi de 11 dias. O sítio de inserção mais comum foi o acesso jugular (37,5% e a mortalidade associada à infecção da corrente sanguínea foi de 31%. Conclusões: A utilização do cateter central de inserção periférica é uma prática não isenta de riscos, considerando que este é um dispositivo invasivo e pode predispor à ocorrência de infecção. ------------------------------------------------------------------------------------------ Objective: To analyze the prevalence of hospital primary bloodstream infections in a neonatal intensive care unit (NICU. Methods: A retrospective study involving analyses of records of patients admitted to the NICU from January to December 2010 was conducted. The incidence density of catheter-associated bloodstream infections per 1000 catheter-days was calculated. Results: Among 192 newborns, 16 (8.3% who used peripherally inserted central catheters had bloodstream infections. The infection density confirmed by blood culture reached 5.9, while the density based on clinical criteria accounted for

  8. Bloodstream infections among patients using central venous catheters in intensive care units Infección de corriente sanguínea en pacientes con catéter venosos central en unidades de cuidado intensivo Infecções da corrente sangüínea em pacientes em uso de cateter venoso central em unidades de terapia intensiva

    Directory of Open Access Journals (Sweden)

    Eni Rosa Aires Borba Mesiano

    2007-06-01

    Full Text Available Central Venous Catheters (CVC, widely used in Intensive Care Units (ICU are important sources of bloodstream infections (BSI. This prospective cohort epidemiological analytical study, aimed to infer the incidence of BSI, the risk factors associated and evaluate the care actions related to the use of these catheters in seven ICU in the Federal District - Brasília, Brazil. From the 630 patients using CVC, 6.4% developed BSI (1.5% directly related to the catheter and 4.9% clinic BSI. The hospitalization term was 3.5 times greater among these patients. Different modalities of catheter insertion and antiseptic substances use were observed. Time of CVC permanence was significantly associated to infection incidence (pLos catéteres venosos centrales (CVC utilizados principalmente en unidades de cuidados intensivos - UCIs, son importantes fuentes de infección de la corriente sanguínea (ICS. Este estudio epidemiológico analítico, de corte prospectivo, enfoca la incidencia de ICS, factores de riesgo asociados y medidas asistenciales relacionadas con el uso de estos catéteres en 7 UCIs del Distrito Federal. Del total de 630 pacientes con CVC, 6,4% presentaron ICS (1,5% relacionado al catéter y 4,9% ICS-Clínica. El tiempo de hospitalización fue 3,5 veces mayor para este grupo de pacientes. Fueron observadas diferentes conductas con relación a la inserción de catéteres y al uso de antisépticos. El tiempo de permanencia del CVC estuvo asociado a la incidencia de infección (pOs cateteres venosos centrais (CVC, utilizados, principalmente em unidades de terapia intensiva-UTIs, são importantes fontes de infecção da corrente sangüínea (ICS. Este estudo epidemiológico analítico, tipo coorte prospectiva, enfoca a incidência de ICS, fatores de risco associados e ações assistenciais relacionadas ao uso desses cateteres em 7 UTIs no Distrito Federal. Dos 630 pacientes com CVC, 6,4% apresentaram ICS (1,5% relacionadas ao cateter e 4,9% ICS

  9. [Risk factors for catheter-related bloodstream infection in non-critical patients with total parenteral nutrition].

    Science.gov (United States)

    Ocón Bretón, María Julia; Mañas Martínez, Ana Belén; Medrano Navarro, Ana Lidia; García García, Blanca; Gimeno Orna, José Antonio

    2013-01-01

    Introducción: La bacteriemia asociada al catéter (BAC) es una de las complicaciones más importantes en pacientes portadores de un catéter venoso central (CVC) debido a su asociación con un incremento en la mortalidad, morbilidad y gasto sanitario. La administración de nutrición parenteral total (NPT) aumenta el riesgo de aparición de BAC. El objetivo de nuestro estudio fue determinar la tasa de incidencia y los factores de riesgo de BAC en pacientes con NPT hospitalizados en plantas médico-quirúrgicas. Métodos: Estudio observacional, analítico, retrospectivo donde se analizaron a todos los pacientes adultos no críticos que precisaron NPT desde enero de 2010 hasta noviembre de 2011. El punto final clínico fue la BAC. La tasa de incidencia de BAC se calculó en forma de episodios por cada 1.000 pacientes-día de cateterización. Los factores predictivos independientes de BAC se determinaron mediante regresión logística. Resultados: Durante el periodo de estudio precisaron NPT un total de 331 pacientes. La duración media del CVC fue de 12,4 (DE 8,7) días y la NPT fue infundida durante un periodo medio de 10,4 (DE 8,3) días. 47 pacientes presentaron BAC, con una tasa de incidencia de 11,4/1.000 pacientes- día de CVC y de 13,7/1.000 pacientes-día de NPT. Los factores predictores univariantes de aparición de BAC fueron la permanencia del CVC superior a 20 días (OR = 2,48; IC 95%: 1,16-5,26), la duración de la NPT superior a 2 semanas (OR = 4,63; IC 95%: 2,16-9,90) y la presencia de fístulas (OR = 3,08; IC 95%: 1,24-7,63). En análisis multivariante, el único predictor independiente de BAC fue la duración de la NPT (OR para una duración superior a 14 días = 4,9; IC 95%: 2,2-10,9; p < 0,0001). Conclusiones: En pacientes adultos hospitalizados en plantas diferentes a UCI, hemos demostrado que la duración de la infusión de la NPT incrementa el riesgo de BAC. El incremento de riesgo es especialmente marcado, llegando a multiplicarse por 5, con duraciones superiores a las 2 semanas.

  10. Catheter-related Rahnella aquatilis bacteremia in a pediatric bone marrow transplant recipient.

    OpenAIRE

    Hoppe, J E; Herter, M.; Aleksic, S; Klingebiel, T; Niethammer, D

    1993-01-01

    Rahnella aquatilis, a rarely encountered member of the family Enterobacteriaceae, was twice isolated from the blood of a pediatric bone marrow transplant recipient. This is the first report of a pediatric case of R. aquatilis bacteremia, and it was probably related to inappropriate handling of a Hickman catheter.

  11. Catheter-Related Bacteremia Due to Kocuria kristinae in a Patient with Ovarian Cancer

    OpenAIRE

    Basaglia, G.; Carretto, E; D. Barbarini; Moras, L.; Scalone, S; Marone, P; P. De Paoli

    2002-01-01

    We report on the first case of a catheter-related recurrent bacteremia caused by Kocuria kristinae, a gram-positive microorganism belonging to the family Micrococcaceae, in a 51-year-old woman with ovarian cancer. This unusual pathogen may cause opportunistic infections in patients with severe underlying diseases.

  12. Implementation of a children's hospital-wide central venous catheter insertion and maintenance bundle

    NARCIS (Netherlands)

    K. Helder MScN (Onno); R.F. Kornelisse (René); C. van der Starre (Cynthia); D. Tibboel (Dick); C.W.N. Looman (Caspar); R.M.H. Wijnen (Rene); M.J. Poley (Marten); E. Ista (Erwin)

    2013-01-01

    textabstractBackground: Central venous catheter-associated bloodstream infections in children are an increasingly recognized serious safety problem worldwide, but are often preventable. Central venous catheter bundles have proved effective to prevent such infections. Successful implementation requir

  13. Epidemiology, surveillance, and prevention of bloodstream infections in hemodialysis patients.

    Science.gov (United States)

    Patel, Priti R; Kallen, Alexander J; Arduino, Matthew J

    2010-09-01

    Infections cause significant morbidity and mortality in patients undergoing hemodialysis. Bloodstream infections (BSIs) are particularly problematic, accounting for a substantial number of hospitalizations in these patients. Hospitalizations for BSI and other vascular access infections appear to have increased dramatically in hemodialysis patients since 1993. These infections frequently are related to central venous catheter (CVC) use for dialysis access. Regional initiatives that have shown successful decreases in catheter-related BSIs in hospitalized patients have generated interest in replicating this success in outpatient hemodialysis populations. Several interventions have been effective in preventing BSIs in the hemodialysis setting. Avoiding the use of CVCs in favor of access types with lower associated BSI risk is among the most important. When CVCs are used, adherence to evidence-based catheter insertion and maintenance practices can positively influence BSI rates. In addition, facility-level surveillance to detect BSIs and stimulate examination of vascular access use and care practices is essential to a comprehensive approach to prevention. This article describes the current epidemiology of BSIs in hemodialysis patients and effective prevention strategies to decrease the incidence of these devastating infections.

  14. Clinical effectiveness and cost-effectiveness of central venous catheters treated with Minocycline and Rifampicin in preventing bloodstream infections in intensive care patients [Medizinische Wirksamkeit und Kosteneffektivität von Minocyclin/Rifampicin-beschichteten zentralvenösen Kathetern zur Prävention von Blutbahninfektionen bei Patienten in intensivmedizinischer Betreuung

    Directory of Open Access Journals (Sweden)

    Neusser, Silke

    2012-10-01

    Full Text Available [english] The use of central venous catheters coated with antibiotics can avoid bloodstream infections with intensive care patients. This is the result of a scientific examination which has been published by the DIMDI. Costs could be also saved in this way. However, according to the authors, the underlying studies do not allow absolutely valid statements.[german] Der Einsatz bestimmter Antibiotika-beschichteter Venenkatheter kann bei Intensivpatienten Blutbahninfektionen vermeiden. So das Ergebnis einer wissenschaftlichen Untersuchung, die das DIMDI veröffentlicht hat. Auch ließen sich damit Kosten einsparen. Allerdings erlauben, laut den Autoren, die zugrunde gelegten Studien keine uneingeschränkt gültigen Aussagen.

  15. Incidence of bloodstream infection among patients on hemodialysis by central venous catheter Incidencia de infección de la corriente sanguínea em los pacientes sometidos a hemodiálisis por catéter venoso central Incidência de infecção da corrente sanguínea nos pacientes submetidos à hemodiálise por cateter venoso central

    Directory of Open Access Journals (Sweden)

    Cibele Grothe

    2010-02-01

    Full Text Available This study evaluated the incidence and risk factors of bloodstream infection (BSI among patients with a double-lumen central venous catheter (CVC for hemodialysis (HD and identified the microorganisms isolated from the bloodstream. A follow-up included all patients (n=156 who underwent hemodialysis by double-lumen CVC at the Federal University of São Paulo - UNIFESP, Brazil, over a one-year period. From the group of patients, 94 presented BSI, of whom 39 had positive cultures at the central venous catheter insertion location. Of the 128 microorganisms isolated from the bloodstream, 53 were S. aureus, 30 were methicillin-sensitive and 23 were methicillin-resistant. Complications related to BSI included 35 cases of septicemia and 27 cases of endocarditis, of which 15 cases progressed to death. The incidence of BSI among these patients was shown to be very high, and this BSI progressed rapidly to the condition of severe infection with a high mortality rate.El objetivo de este estudio fue evaluar la incidencia y los factores de riesgo de infección de la corriente sanguínea (ICS en pacientes con catéter venoso central (CVC doble lumen, para hemodiálisis (HD e identificar los microorganismos aislados en la corriente sanguínea. Como método, se uso el acompañamiento, realizado en el período de un año, incluyendo todos los 156 pacientes que estaban en tratamiento de HD por CVC doble lumen, en la Universidad Federal de Sao Paulo - UNIFESP. Los resultados mostraron que de los 156 pacientes estudiados, 94 presentaron ICS, de estos, 39 tuvieron culturas positivas en el local de inserción del catéter. De los 128 microorganismos aislados de la corriente sanguínea, 53 eran S.aureus, de los cuales 30 eran sensibles a la metilcilina y 23 resistentes. Entre las complicaciones relacionadas a la ICS, hubo 35 casos de septicemia y 27 casos de endocarditis, de los cuales 15 resultaron en muerte. La incidencia de ICS en este grupo de pacientes se mostr

  16. Eradication of Staphylococcus aureus Catheter-Related Biofilm Infections Using ML:8 and Citrox.

    Science.gov (United States)

    Hogan, S; Zapotoczna, M; Stevens, N T; Humphreys, H; O'Gara, J P; O'Neill, E

    2016-10-01

    Staphylococci are a leading cause of catheter-related infections (CRIs) due to biofilm formation. CRIs are typically managed by either device removal or systemic antibiotics, often in combination with catheter lock solutions (CLSs). CLSs provide high concentrations of the antimicrobial agent at the site of infection. However, the most effective CLSs against staphylococcal biofilm-associated infections have yet to be determined. The purpose of this study was to evaluate the efficacy and suitability of two newly described antimicrobial agents, ML:8 and Citrox, as CLSs against Staphylococcus aureus biofilms. ML:8 (1% [vol/vol]) and Citrox (1% [vol/vol]), containing caprylic acid and flavonoids, respectively, were used to treat S. aureus biofilms grown in vitro using newly described static and flow biofilm assays. Both agents reduced biofilm viability >97% after 24 h of treatment. Using a rat model of CRI, ML:8 was shown to inactivate early-stage S. aureus biofilms in vivo, while Citrox inactivated established, mature in vivo biofilms. Cytotoxicity and hemolytic activity of ML:8 and Citrox were equivalent to those of other commercially available CLSs. Neither ML:8 nor Citrox induced a cytokine response in human whole blood, and exposure of S. aureus to either agent for 90 days was not associated with any increase in resistance. Taken together, these data reveal the therapeutic potential of these agents for the treatment of S. aureus catheter-related biofilm infections. PMID:27458213

  17. Chronic Complications After Femoral Central Venous Catheter-related Thrombosis in Critically Ill Children.

    Science.gov (United States)

    Sol, Jeanine J; Knoester, Hennie; de Neef, Marjorie; Smets, Anne M J B; Betlem, Aukje; van Ommen, C Heleen

    2015-08-01

    Prescription of thromboprophylaxis is not a common practice in pediatric intensive care units. Most thrombi are catheter-related and asymptomatic, without causing acute complications. However, chronic complications of these (a)symptomatic catheter-related thrombi, that is, postthrombotic syndrome (PTS) and residual thrombosis have not been studied. To investigate these complications, critically ill children of 1 tertiary center with percutaneous inserted femoral central venous catheters (FCVCs) were prospectively followed. Symptomatic FCVC-thrombosis occurred in 10 of the 134 children (7.5%; 95% confidence interval [CI], 2.4-9.5). Only FCVC-infection appeared to be independently associated (P=0.001) with FCVC-thrombosis. At follow-up 2 of the 5 survivors diagnosed with symptomatic thrombosis developed mild PTS; one of them had an occluded vein on ultrasonography. A survivor without PTS had a partial occluded vein at follow-up. Asymptomatic FCVC-thrombosis occurred in 3 of the 42 children (7.1%; 95% CI, 0.0-16.7) screened by ultrasonography within 72 hours after catheter removal. At follow-up, mild PTS was present in 6 of the 33 (18.2%; 95% CI, 6.1-30.3) screened children. Partial and total vein occlusion was present in 1 (3%) and 4 (12%) children, respectively. In conclusion, children on pediatric intensive care units are at risk for (a)symptomatic FCVC-thrombosis, especially children with FCVC-infection. Chronic complications of FCVC-thrombosis are common. Therefore, thromboprophylaxis guidelines are warranted in pediatric intensive care units to minimize morbidity as a result of FCVC-thrombosis.

  18. Catheter-related infection in Irish intensive care units diagnosed with HELICS criteria: a multi-centre surveillance study.

    LENUS (Irish Health Repository)

    Conrick-Martin, I

    2013-03-01

    Catheter-related infection (CRI) surveillance is advocated as a healthcare quality indicator. However, there is no national CRI surveillance programme or standardized CRI definitions in Irish intensive care units (ICUs).

  19. 导管相关血流感染临床分析%Clinical analysis of cathetei-related bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    卓婕; 孙永昌; 李莉; 李然

    2011-01-01

    目的 分析我院2008年1月至2010年12月重症监护病房(ICU)和普通病房导管相关血流感染(CRBSI)的发生情况,为CRBSI的预防和治疗提供依据.方法 将我院131例CRBSI病例分为ICU组和普通病房组,对临床资料、病原菌、导管位置、预后等进行回顾性分析.结果 ICU组(88例)和普通病房组(43例)在年龄和性别构成上差异无统计学意义(P>0.05).ICU组患者APACHE Ⅱ评分高于普通病房组(P=0.039).CRBSI在股静脉置管的患者中发生率最高.两组患者共培养出致病菌株152株.ICU组106株,其中革兰阳性球菌43株(40.6%),革兰阴性杆菌41株(38.7%),真菌22株(20.7%);普通病房组46株,其中革兰阳性球菌29株(63.0%).革兰阴性杆菌13株(28.3%),真菌4株(8.7%).因CRBSI导致死亡病例ICU组16例(18.2%),普通病房组4例(9.3%)(P>0.05).混合感染患者死亡率显著高于单一菌株感染(P=0.004).死亡病例感染病原菌前三位分别为真菌(12株)、肠球菌(6株)、铜绿假单胞菌(3株).结论 CRBSI在ICU和普通病房患者中病原菌分布存在差异,是抗菌药物选择和预后判断中需要考虑的因素.%Objective To study the incidence and pathogenic etiology of catheter-related bloodstream infection (CRBSI) in intensive care unit (ICU) and general ward, and to provide basis for the prevention and therapy of CRBSI. Methods 131 cases of CRBSI were divided into ICU group and general ward group. The clinical data, pathogens, catheter location, and prognosis were analyzed retrospectively. Results There was no statistical significance on age and gender between ICU group (88 cases) and general ward group (43 cases) ( P >0. 05). APACHE Ⅱ score in ICU group was higher than that in general ward group ( P =0.039). The incidence of CRBSI in the femoral vein was the highest. There were 152 pathogenic strains isolated from the two groups. There were 106 strains in ICU group, in which 43 strains (40.6%) were gram-positive cocci, 41

  20. Real-Time Monitoring of Catheter-Related Biofilm Infection in Mice.

    Science.gov (United States)

    Liu, Xu; Yin, Hong; Xu, Xianxing; Cheng, Yuanguo; Cai, Yun; Wang, Rui

    2015-10-01

    This study was done to establish a mouse model for catheter-related biofilm infection suitable to bioluminescence imaging (BLI). Biofilm formation of Pseudomonas aeruginosa (P. aeruginosa) Xen5 grown on catheter disks in vitro and in an implanted mouse model was real-time monitored during a 7-day study period using BLI. The numbers of integrated brightness (IB) and viable bacterial count (VBC) in the biofilm disks in vitro were highest at 24 h after inoculation; the IB of biofilm in vivo was increased until 24 h after implantation. A statistical correlation was observed between IB and VBC in vitro by linear regression analysis. The actual VBC value in vivo can be estimated accurately by IB without sacrifice. In addition, we monitored the change in white blood cells (WBCs) during infection. The number of WBCs on day 7 was significantly higher in the infection group than in the control group. This study indicates that BLI is a simple, fast, and sensitive method to measure catheter biofilm infection in mice.

  1. Variables associated with peripherally inserted central catheter related infection in high risk newborn infants

    Directory of Open Access Journals (Sweden)

    Uesliz Vianna Rangel

    2014-10-01

    Full Text Available OBJECTIVE: to relate the variables from a surveillance form for intravenous devices in high risk newborn infants with peripherally inserted central catheter related infection.METHODOLOGY: approximately 15 variables were studied, being associated with peripherally inserted central catheter related infection, this being defined by blood culture results. The variables analyzed were obtained from the surveillance forms used with intravenous devices, attached to the medical records of newborn infants weighing between 500 and 1,499 g. The statistical association was defined using the Chi-squared and Student t tests. The study was approved by the Research Ethics Committee of the Instituto Fernandes Figueira under process N. 140.703/12.RESULTS: 63 medical records were analyzed. The infection rate observed was 25.4%. Of the variables analyzed, only three had a statistically-significant relationship with the blood culture - the use of drugs capable of inhibiting acid secretion, post-natal steroid use, and undertaking more than one invasive procedure (p-value of 0.0141, 0.0472 and 0.0277, respectively.CONCLUSION: the absence of significance of the variables of the form may be related to the quality of the records and to the absence of standardization. It is recommended that the teams be encouraged to adhere to the protocol and fill out the form.

  2. Hemodialysis Catheter Heat Transfer for Biofilm Prevention and Treatment.

    Science.gov (United States)

    Richardson, Ian P; Sturtevant, Rachael; Heung, Michael; Solomon, Michael J; Younger, John G; VanEpps, J Scott

    2016-01-01

    Central line-associated bloodstream infections (CLABSIs) are not easily treated, and many catheters (e.g., hemodialysis catheters) are not easily replaced. Biofilms (the source of infection) on catheter surfaces are notoriously difficult to eradicate. We have recently demonstrated that modest elevations of temperature lead to increased staphylococcal susceptibility to vancomycin and significantly soften the biofilm matrix. In this study, using a combination of microbiological, computational, and experimental studies, we demonstrate the efficacy, feasibility, and safety of using heat as an adjuvant treatment for infected hemodialysis catheters. Specifically, we show that treating with heat in the presence of antibiotics led to additive killing of Staphylococcus epidermidis with similar trends seen for Staphylococcus aureus and Klebsiella pneumoniae. The magnitude of temperature elevation required is relatively modest (45-50°C) and similar to that used as an adjuvant to traditional cancer therapy. Using a custom-designed benchtop model of a hemodialysis catheter, positioned with tip in the human vena cava as well as computational fluid dynamic simulations, we demonstrate that these temperature elevations are likely achievable in situ with minimal increased in overall blood temperature. PMID:26501916

  3. Hemodialysis Catheter Heat Transfer for Biofilm Prevention and Treatment.

    Science.gov (United States)

    Richardson, Ian P; Sturtevant, Rachael; Heung, Michael; Solomon, Michael J; Younger, John G; VanEpps, J Scott

    2016-01-01

    Central line-associated bloodstream infections (CLABSIs) are not easily treated, and many catheters (e.g., hemodialysis catheters) are not easily replaced. Biofilms (the source of infection) on catheter surfaces are notoriously difficult to eradicate. We have recently demonstrated that modest elevations of temperature lead to increased staphylococcal susceptibility to vancomycin and significantly soften the biofilm matrix. In this study, using a combination of microbiological, computational, and experimental studies, we demonstrate the efficacy, feasibility, and safety of using heat as an adjuvant treatment for infected hemodialysis catheters. Specifically, we show that treating with heat in the presence of antibiotics led to additive killing of Staphylococcus epidermidis with similar trends seen for Staphylococcus aureus and Klebsiella pneumoniae. The magnitude of temperature elevation required is relatively modest (45-50°C) and similar to that used as an adjuvant to traditional cancer therapy. Using a custom-designed benchtop model of a hemodialysis catheter, positioned with tip in the human vena cava as well as computational fluid dynamic simulations, we demonstrate that these temperature elevations are likely achievable in situ with minimal increased in overall blood temperature.

  4. Reduction in catheter-related infections after switching from povidone-iodine to chlorhexidine for the exit-site care of tunneled central venous catheters in children on hemodialysis.

    Science.gov (United States)

    Paglialonga, Fabio; Consolo, Silvia; Biasuzzi, Antonietta; Assomou, Jolanda; Gattarello, Elisabetta; Patricelli, Maria Grazia; Giannini, Alberto; Chidini, Giovanna; Napolitano, Luisa; Edefonti, Alberto

    2014-10-01

    Only a few studies have investigated the optimal exit site management of tunneled central venous catheters (CVCs) in pediatric patients on chronic hemodialysis (HD). The aim of this study was to assess the efficacy of chlorhexidine solutions and a 5% povidone-iodine solution on the incidence of CVC-related infections in children on HD. The incidence of exit-site infection (ESI), tunnel infection (TI), and bloodstream infection (BSI) was assessed in two groups of tunneled CVCs. The iodopovidone group consisted of 14 CVCs used between 1 January 2011 and 30 June 2012 in 10 children, whose median age at the time of CVC placement was 11.8 years (range 1.2-19.2): 5% povidone-iodine was used for CVC exit-site care. From 1 August 2012 to 31 January 2014, 0.5% chlorhexidine gluconate/70% isopropyl alcohol was used for the exit site, and 2% chlorhexidine gluconate/70% isopropyl alcohol spray for the hub in 13 CVCs was used in 10 patients (chlorhexidine group), whose median age at the time of CVC placement was 10 years (range 1.2-19.2). Ten episodes of ESI were diagnosed in the iodopovidone group (incidence 3.4/1000 CVC days), and only one in the chlorhexidine group (incidence 0.36/1000 CVC days, P = 0.008). One TI was observed in the iodopovidone group (0.34/1000 CVC days), and none in the chlorhexidine group. The incidence of BSIs decreased from 1.7/1000 CVC days (5 cases) to 0.36/1000 CVC days (1 case, P = 0.06) after switching to chlorhexidine. Two CVCs were lost due to CVC-related infections in the iodopovidone group, whereas no CVC was lost due to infections in the chlorhexidine group. In comparison with 5% povidone-iodine, the use of chlorhexidine gluconate was associated with a reduction in the incidence of ESI, TI, and BSI in children on HD.

  5. Radiofrequency catheter ablation of atrial tachycardias related to myocardial scar or incision

    Institute of Scientific and Technical Information of China (English)

    Jianqiang HU; Jiang CAO; Shengqiang WANG; Yongwen QIN; Bingyan ZHOU

    2006-01-01

    Intra-atrial re-entrant tachycardias (IARTs) are common late after heart surgery. Conventional mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry loops. In this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) induced by myocardial scar or incision. Methods In 6 patients (three male and three female, aged 33.3+ 11.8 years) who had AT related to myocardial scar or incision,electrophysiological study and radiofrequency catheter ablation (RFCA) were performed. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results Re-entry related to the lateral atriotomy scar was inducible in 5 of6 patients. With entrainment mapping, the PPI (post-pacing interval)-TCL (tachycardia cycle length) difference was <30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 3 patients had successful linear ablation between scar area to inferior vena cava, and 2 patients between scar area to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 6 patients. PPI-TCL differences <30 ms were observed when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of AT related to incision was observed during follow-up except for the failed patient. Conclusion Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.

  6. Catheter-related infections in a northwestern São Paulo reference unit for burned patients care

    Directory of Open Access Journals (Sweden)

    Cláudio Penido Campos Júnior

    2010-04-01

    Full Text Available Despite improvements in care and rehabilitation of burned patients, infections still remain the main complication and death cause. Catheter-related infections are among the four most common infections and are associated with skin damage and insertion site colonization. There are few studies evaluating this kind of infection worldwide in this special group of patients. Padre Albino Hospital Burn Care Unit (PAHBCU is the only reference center in the Northwestern São Paulo for treatment of burned patients. This paper presents the results of a retrospective study aiming at describing the epidemiological and clinical features of catheter-related infections at PAHBCU.

  7. Tricuspid valve endocarditis following central venous cannulation: The increasing problem of catheter related infection

    Directory of Open Access Journals (Sweden)

    Suresh Babu Kale

    2013-01-01

    Full Text Available A central venous catheter (CVC is inserted for measurement of haemodynamic variables, delivery of nutritional supplements and drugs and access for haemodialysis and haemofiltration. Catheterization and maintenance are common practices and there is more to the technique than routine placement as evident when a procedure-related complication occurs. More than 15% of the patients who receive CVC placement have some complications and infectious endocarditis involving the tricuspid valve is a rare and serious complication with high morbidity and mortality. Overenthusiastic and deep insertion of the guide wire and forceful injection through the CVC may lead to injury of the tricuspid valve and predispose to bacterial deposition and endocarditis. We report a case of tricuspid valve endocarditis, probably secondary to injury of the anterior tricuspid leaflet by the guide wire or the CVC that required open heart surgery with vegetectomy and repair of the tricuspid valve.

  8. Catheter-related infections caused by Pseudomonas aeruginosa: virulence factors involved and their relationships.

    Science.gov (United States)

    Olejnickova, Katerina; Hola, Veronika; Ruzicka, Filip

    2014-11-01

    The nosocomial pathogen Pseudomonas aeruginosa is equipped with a large arsenal of cell-associated and secreted virulence factors which enhance its invasive potential. The complex relationships among virulence determinants have hitherto not been fully elucidated. In the present study, 175 catheter-related isolates were observed for the presence of selected virulence factors, namely extracellular enzymes and siderophore production, biofilm formation, resistance to antibiotics, and motility. A high percentage of the strains produced most of the tested virulence factors. A positive correlation was identified between the production of several exoproducts, and also between the formation of both types of biofilm. An opposite trend was observed between the two types of biofilm and the production of siderophores. Whereas the relationship between the submerged biofilm production (i.e. the biofilm formed on the solid surface below the water level) and the siderophore secretion was negative, the production of air-liquid interface (A-L) biofilm (i.e. the biofilm floating on the surface of the cultivation medium) and the siderophore secretion were positively correlated. All correlations were statistically significant at the level P = 0.05 with the correlation coefficient γ ≥ 0.50. Our results suggest that: (1) the co-production of the lytic enzymes and siderophores can play an important role in the pathogenesis of the catheter-related infections and should be taken into account when the virulence potential is assessed; (2) biofilm-positive strains are capable of forming both submerged and non-attached A-L biofilms; and (3) the different micro-environment in the submerged biofilm and A-L biofilm layers have opposite consequences for the production of other virulence factors.

  9. Catheter-related infections caused by Pseudomonas aeruginosa: virulence factors involved and their relationships.

    Science.gov (United States)

    Olejnickova, Katerina; Hola, Veronika; Ruzicka, Filip

    2014-11-01

    The nosocomial pathogen Pseudomonas aeruginosa is equipped with a large arsenal of cell-associated and secreted virulence factors which enhance its invasive potential. The complex relationships among virulence determinants have hitherto not been fully elucidated. In the present study, 175 catheter-related isolates were observed for the presence of selected virulence factors, namely extracellular enzymes and siderophore production, biofilm formation, resistance to antibiotics, and motility. A high percentage of the strains produced most of the tested virulence factors. A positive correlation was identified between the production of several exoproducts, and also between the formation of both types of biofilm. An opposite trend was observed between the two types of biofilm and the production of siderophores. Whereas the relationship between the submerged biofilm production (i.e. the biofilm formed on the solid surface below the water level) and the siderophore secretion was negative, the production of air-liquid interface (A-L) biofilm (i.e. the biofilm floating on the surface of the cultivation medium) and the siderophore secretion were positively correlated. All correlations were statistically significant at the level P = 0.05 with the correlation coefficient γ ≥ 0.50. Our results suggest that: (1) the co-production of the lytic enzymes and siderophores can play an important role in the pathogenesis of the catheter-related infections and should be taken into account when the virulence potential is assessed; (2) biofilm-positive strains are capable of forming both submerged and non-attached A-L biofilms; and (3) the different micro-environment in the submerged biofilm and A-L biofilm layers have opposite consequences for the production of other virulence factors. PMID:24842562

  10. Intravascular catheter related infections and antimicrobial susceptibility pattern of isolated bacteria in a tertiary care hospital of Bangladesh

    Directory of Open Access Journals (Sweden)

    F J Mansur

    2014-01-01

    Full Text Available The aim of this study was to evaluate the rate of bacterial colonisation and catheter related blood stream infections (CRBSI together with the antibiotic susceptibility patterns in a tertiary care hospital. CRBSI was detected with semi-quantitative and quantitative methods. The antimicrobial susceptible patterns of the isolated organisms were performed by Kirby Bauer disk diffusion method. The rate of catheter colonisation and CRBSI were 42.1% and 14% (16.1/1000 catheter days respectively. The most common causative pathogens were Pseudomonas sp. (23.7%, Acinetobacter sp. (18.4%, Staphylococcus aureus (13.2% and Enterobacteriaceae (10.5%. The rate of isolation of methicillin resistance S. aureus, imipenem resistant Pseudomonas sp. and extended spectrum β lactamase producing Enterobacteriaceae were 60%, 44.0% and 100%. The result of this study would be useful for control and treatment of CRBSI.

  11. Adverse events and technical complaints related to central venous catheters marketed in Brazil

    Directory of Open Access Journals (Sweden)

    Luciene de Oliveira Morais

    2013-06-01

    Full Text Available Aim: The objective of this study was to critically analyze data of the National Notification System for Adverse Events and Technical Complaints (Notivisa related to central venous catheters, through an evaluation of the description of notifications recorded between 2006 and 2009. Methods: Notifications were categorized and evaluated to: (i determine the number of adverse events and technical complaints, (ii verify compliance with the classification criteria defined by the legislation, (iii reclassify notifications, when necessary, in order for them to fit in with the legal definitions, (iv verify registered companies in Brazil, (v quantify the notifications according to the registered company and product lot, and (vi identify the country of original of the notified product. Microsoft Excel® 2010 was used to categorize and systematize the data. Results: Some conceptual errors and incomplete records were found. Altogether, 228 notifications of technical complaints and 119 of adverse events were identified. Some notifications on guidewires and broken catheters were reported which led to the necessity of duplicating some medical procedures and to the occurrence of lesions/lacerations of vessels and tissue injury. Forty-seven percent of companies presented at least one notification in Notivisa and in all, 38 product lots had more than one notification. Conclusion: These data support a necessity for cooperation between all entities of the National Health Surveillance System to check compliance of this type of product and to properly report adverse events and technical complaints. It is also important to incorporate minimum standards for the management of technologies in health services, including in the acquisition of products and training of staff.

  12. Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients.

    NARCIS (Netherlands)

    Nieboer, P.; Vries, E.G. de; Mulder, N.H.; Rodenhuis, S.; Bontenbal, M.; Wall, E. van der; Hoesel, Q.G.C.M. van; Smit, W.M.; Hupperets, P.; Voest, E.E.; Nooij, M.A.; Boezen, H.M.; Graaf, W.T.A. van der

    2008-01-01

    Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and

  13. Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients

    NARCIS (Netherlands)

    Nieboer, P; de Vries, Elisabeth G. E.; Mulder, Nanno; Rodenhuis, S; Bontenbal, M; van der Wall, E; van Hoesel, Q G; Smit, W M; Hupperets, P; Voest, E E; Nooij, M A; Boezen, H M; van der Graaf, W T A

    2008-01-01

    Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and

  14. Central venous catheter-related bacteremia caused by Kocuria kristinae: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    David Michael Z

    2011-08-01

    Full Text Available Abstract Kocuria species are unusual human pathogens isolated most commonly from immunocompromised hosts, such as transplant recipients and cancer patients undergoing chemotherapy, or from patients with chronic medical conditions. A case of catheter-related bacteremia with pulmonary septic emboli in a pregnant adult female without chronic medical conditions is described. A review of other reported Kocuria infections is provided.

  15. Cefotaxime resistance and outcome of Klebsiella spp bloodstream infection.

    Science.gov (United States)

    Ortega, M; Marco, F; Soriano, A; Almela, M; Martínez, J A; López, J; Pitart, C; Mensa, J

    2011-12-01

    We attempt to describe the epidemiology and outcome associated with cefotaxime-resistant (CTX-R) Klebsiella spp bacteraemia. Klebsiella spp bloodstream infection episodes prospectively collected through a blood culture surveillance programme from January 1991 to December 2008 in a single institution were analysed. A total of 910 monomicrobial episodes of Klebsiella spp bacteraemia were identified during the study period. The most important sources were from urinary tract infection, unknown sources, billiary focus and catheter related infection. There were 112 (12%) CTX-R isolates. Out of 112 isolates, 98 were CTX-R by Extended-Spectrum β-Lactamase production. Shock on presentation and mortality were significantly more frequent in CTX-R than in CTX susceptible isolates. Inappropriate empirical therapy was received in 50 (45%) cases in the CTX-R Klebsiella spp group (13 cases of death, 26%). Predictive factors associated with CTX-R Klebsiella spp isolate were: previous β-lactam therapy (OR = 4.16), nosocomial acquired bacteraemia (OR = 1.93), solid organ trasplantation (OR = 2.09) and shock (OR = 1.90). Independent risk factors associated with mortality in Klebsiella spp bacteraemia were: age (OR = 1.03), liver cirrhosis (OR = 2.63), ultimately or rapidly fatal prognosis of underlying disease (OR = 2.44), shock (OR = 8.60), pneumonia (OR = 4.96) or intraabdominal (OR = 3.85) source of bacteraemia and CTX-R isolate (OR = 4.63). Klebsiella spp is an important cause of bloodstream infection. CTX-R isolates have been increasing since 2000. CTX-R is an independent factor associated with mortality in Klebsiella spp bacteraemia.

  16. Subphrenic Abscess as a Complication of Hemodialysis Catheter-Related Infection

    Directory of Open Access Journals (Sweden)

    Fernando Caravaca

    2014-01-01

    Full Text Available We describe an unusual case of subphrenic abscess complicating a central venous catheter infection caused by Pseudomonas aeruginosa in a 59-year-old woman undergoing hemodialysis. The diagnosis was made through computed tomography, and Pseudomonas aeruginosa was isolated from the purulent drainage of the subphrenic abscess, the catheter tip and exit site, and the blood culture samples. A transesophageal echocardiography showed a large tubular thrombus in superior vena cava, extending to the right atrium, but no evidence of endocarditis or other metastatic infectious foci. Catheter removal, percutaneous abscess drainage, anticoagulation, and antibiotics resulted in a favourable outcome.

  17. Current strategies for the prevention and management of central line-associated bloodstream infections

    Directory of Open Access Journals (Sweden)

    Zhuolin Han

    2010-11-01

    Full Text Available Zhuolin Han, Stephen Y Liang, Jonas MarschallDivision of Infectious Diseases, Washington University School of Medicine in St Louis, St Louis, MO, USAAbstract: Central venous catheters are an invaluable tool for diagnostic and therapeutic purposes in today’s medicine, but their use can be complicated by bloodstream infections (BSIs. While evidence-based preventive measures are disseminated by infection control associations, the optimal management of established central line-associated BSIs has been summarized in infectious diseases guidelines. We prepared an overview of the state-of-the-art of prevention and management of central line-associated BSIs and included topics such as the role of antibiotic-coated catheters, the role of catheter removal in the management, and a review of currently used antibiotic compounds and the duration of treatment.Keywords: central venous catheters, bloodstream infections, guidelines, prevention

  18. In Vitro Assessment of the Antimicrobial Efficacy of Optimized Nitroglycerin-Citrate-Ethanol as a Nonantibiotic, Antimicrobial Catheter Lock Solution for Prevention of Central Line-Associated Bloodstream Infections.

    Science.gov (United States)

    Reitzel, Ruth A; Rosenblatt, Joel; Hirsh-Ginsberg, Cheryl; Murray, Kimberly; Chaftari, Anne-Marie; Hachem, Ray; Raad, Issam

    2016-09-01

    The rapid, broad-spectrum, biofilm-eradicating activity of the combination of 0.01% nitroglycerin, 7% citrate, and 20% ethanol and its potential as a nonantibiotic, antimicrobial catheter lock solution (ACLS) were previously reported. Here, a nitroglycerin-citrate-ethanol (NiCE) ACLS optimized for clinical assessment was developed by reducing the nitroglycerin and citrate concentrations and increasing the ethanol concentration. Biofilm-eradicating activity was sustained when the ethanol concentration was increased from 20 to 22% which fully compensated for reducing the citrate concentration from 7% to 4% as well as the nitroglycerin concentration from 0.01% to 0.0015% or 0.003%. The optimized formulations demonstrated complete and rapid (2 h) eradication of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate Staphylococcus aureus (VISA), methicillin-resistant Staphylococcus epidermidis (MRSE), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, MDR Enterobacter cloacae, MDR Acinetobacter baumannii, MDR Escherichia coli, MDR Stenotrophomonas maltophilia, Candida albicans, and Candida glabrata biofilms. The optimized NiCE lock solutions demonstrated anticoagulant activities comparable to those of heparin lock solutions. NiCE lock solution was significantly more effective than taurolidine-citrate-heparin lock solution in eradicating biofilms of Staphylococcus aureus and Candida glabrata The optimized, nonantibiotic, heparin-free NiCE lock solution demonstrates rapid broad-spectrum biofilm eradication as well as effective anticoagulant activity, making NiCE a high-quality ACLS candidate for clinical assessment.

  19. Dialysis catheter-related superior vena cava syndrome with patent vena cava: Long term efficacy of unilateral viatorr stent-graft avoiding catheter manipulation

    International Nuclear Information System (INIS)

    Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.

  20. Dialysis catheter-related superior vena cava syndrome with patent vena cava: Long term efficacy of unilateral viatorr stent-graft avoiding catheter manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Quaretti, Pietro; Galli, Franco; Maramarco, Lorenzo Paplo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Maestri, Marcello [IRCCS Policlinico San Matteo Foundation, Pavia (Italy)

    2014-06-15

    Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.

  1. Bloodstream infections during the onset of necrotizing enterocolitis and their relation with the pro-inflammatory response, gut wall integrity and severity of disease in NEC

    NARCIS (Netherlands)

    Heida, F. H.; Hulscher, J. B. F.; Schurink, M.; van Vliet, M. J.; Kooi, E. M. W.; Kasper, D. C.; Pones, M.; Bos, A. F.; Benkoe, T. M.

    2015-01-01

    Introduction: Bacterial involvement is believed to play a pivotal role in the development and disease outcome of NEC. However, whether a bloodstream infection (BSI) predisposes to NEC (e.g. by activating the pro-inflammatory response) or result from the loss of gut wall integrity during NEC developm

  2. Bloodstream infections during the onset of necrotizing enterocolitis and their relation with the pro-inflammatory response, gut wall integrity and severity of disease in NEC

    NARCIS (Netherlands)

    Heida, F.H.; Hulscher, J.B.; Schurink, M.; Vliet, M.J. van; Kooi, E.M.; Kasper, D.C.; Pones, M.; Bos, A.F; Benkoe, T.M.

    2015-01-01

    INTRODUCTION: Bacterial involvement is believed to play a pivotal role in the development and disease outcome of NEC. However, whether a bloodstream infection (BSI) predisposes to NEC (e.g. by activating the pro-inflammatory response) or result from the loss of gut wall integrity during NEC developm

  3. 抗感染中心静脉导管在减少导管相关性感染和细菌定植中的临床随机对照研究%Reduction of bacterial colonization and catheter-related infection with antiseptic central venous catheter: a randomized controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    杨钧; 程芮; 公静; 奚晶晶

    2011-01-01

    目的 比较用磺胺嘧啶银和洗必泰抗感染的中心静脉导管(CVC)与普通导管在减少细菌定植和导管相关性感染方面的差异.方法 采用前瞻性、随机对照分析方法,对2007年6月-2009年6月武警总医院ICU收治的70例需要深静脉置管患者进行随机分组,留置双腔抗感染CVC(抗感染组,n=28)和双腔普通CVC(对照组,n=42),两组采用相同的穿刺部位和消毒护理措施,观察记录患者的一般情况、APACHE Ⅱ评分、导管留置天数、拔除导管原因等,通过对导管尖端及皮下部分的细菌半定量培养、血培养以及局部皮肤有无红肿、脓性分泌物来确定有无导管定植(CBC)、导管相关性血流感染(CRBSI)和局部导管相关感染(CRI).采用SPSS 11.5软件包进行统计分析,CVC留置时间与细菌定植和感染发生率采用Kaplan-Meier曲线分析,组间差异比较用Log-rank检验.结果 抗感染组由于感染原因被迫提前拔管1例,占3.6%,对照组9例,占21.4%,比较差异有统计学意义(x2=5.143,P 15 CFU was found by semi-quantitative roll-plate technique from a proximal or distal catheter segment. A catheter-related infection ( CRI) was defined as a colonized catheter with local signs of inflammation. A catheter-related bloodstream infection ( CR-BSI) was defined as a colonized catheter with isolation of the same organism from the patient' s blood with accompanying clinical signs of infection. SPSS 11.5 software was used for statistical analysis. Kaplan Meier curve was used to evaluate the association between CVC retention time and bacterial colonization or infection, and Log-rank test was performed to compare between the groups. Results CVC was removed from 3.6% (1/28) patients of antiseptic group and 21.4% (9/42) patients of control group because of infection (x2 = 5. 143, P 2 weeks, the colonization and infection will increase significantly in both standard or antiseptic CVC, so to shorten the insertion time is an

  4. Antibiofilm activity of Cobetia marina filtrate upon Staphylococcus epidermidis catheter-related isolates

    OpenAIRE

    Trentin, D.S.; Gorziza, D. F.; Abraham, W. R.; Antunes, A.L.S.; Lerner, C.; Mothes, B.; Termignoni, C.; A.J Macedo

    2011-01-01

    We report the antibiofilm activity by the sponge-associated bacterium Cobetia marina upon Staphylococcus epidermidis clinical isolates obtained from central venous catheters. Antibiofilm activity/antimicrobial susceptibility correlation might predict the action of the metabolite(s) upon Staphylococcus epidermidis in the clinic, making it a possible adjuvant in therapies against biofilm-associated infections.

  5. Antibiofilm activity of Cobetia marina filtrate upon Staphylococcus epidermidis catheter-related isolates

    Directory of Open Access Journals (Sweden)

    D.S Trentin

    2011-12-01

    Full Text Available We report the antibiofilm activity by the sponge-associated bacterium Cobetia marina upon Staphylococcus epidermidis clinical isolates obtained from central venous catheters. Antibiofilm activity/antimicrobial susceptibility correlation might predict the action of the metabolite(s upon Staphylococcus epidermidis in the clinic, making it a possible adjuvant in therapies against biofilm-associated infections.

  6. Preventing central venous catheter-related infection in a surgical intensive-care unit

    NARCIS (Netherlands)

    Bijma, R; Girbes, AR; Kleijer, DJ; Zwaveling, JH

    1999-01-01

    The cumulative effect of five measures (introduction of hand disinfection with alcohol, a new type of dressing, a one-bag system for parenteral nutrition, a new intravenous connection device, and surveillance by an infection control practitioner) on central venous catheter colonization and bacteremi

  7. Preventing catheter-associated infections in the Pediatric Intensive Care Unit: impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital

    Directory of Open Access Journals (Sweden)

    Marcelo Luiz Abramczyk

    2011-12-01

    Full Text Available Objectives: To determine the impact of an educational program on the prevention of central venous catheter-related infections in a Brazilian Pediatric Intensive Care Unit. Patients and Methods: All patients admitted to the unit between February 2004 and May 2005 were included in the cohort study in a longitudinal assessment. An educational program was developed based on the Centers for Disease Control and Prevention recommendations for prevention of catheter-associated infections and was adapted to local conditions and resources after an initial observational phase. Incidence of catheter-associated infections was measured by means of on-site surveillance. Results: One hundred eighteen nosocomial infections occurred in 253 patients (46.6 infections per 100 admissions and in 2,954 patient-days (39.9 infections per 1,000 patient-days. The incidence-density of catheter infections was 31.1 episodes per 1.000 venous central catheter-days before interventions, and 16.5 episodes per 1,000 venous central catheter-days afterwards (relative risk 0.53 [95% CI 0.28-1.01]. Corresponding rates for exit-site catheter infections were 8.0 and 2.5 episodes per 1,000 venous central catheter-days [0.32 (0.07-1.49], and the rates for bloodstream infections were 23.1 and 13.9 episodes per 1,000 venous central catheter-days, before and after interventions [0.61 (0.32-1.14]. Conclusion: A prevention strategy targeted at the insertion and maintenance of vascular access can decrease rates of vascular-access infections in pediatric intensive care unit.

  8. Risk factors for nosocomial bloodstream infection caused by multidrug resistant gram-negative bacilli in pediatrics

    Directory of Open Access Journals (Sweden)

    Mariana V. Arnoni

    2007-04-01

    Full Text Available The aim of this study was to identify the risk factors for nosocomial bloodstream infections by multidrug resistant Gram-negative bacilli. From November 2001 to December 2003, in the Pediatric Department of the Santa Casa de São Paulo, a retrospective case-control study was developed concerning patients who had nosocomial bloodstream infection caused by Gram-negative bacilli. Patients with multidrug resistant infections were designated as case patients, and control patients were those with an infection that did not meet the criteria for multidrug resistance. Previous use of central venous catheter and previous use of vancomycin plus third generation cephalosporins were associated to a higher chance of infections by multidrug resistant Gram-negative bacilli (Odds ratio - 5.8 and 5.2, respectively. Regarding sensitivity of the isolated agents, 47.8% were multidrug resistant, 54.2% were Klebsiella spp. ESBL producers and 36.4% were imipenem resistant Pseudomonas aeruginosa. The lethality rate was 36.9% in the studied cases and this rate was significantly higher in the group of patients with multidrug resistant infections (p=0.013. Risk factor identification as well as the knowledge of the susceptibility of the nosocomial infectious agents gave us the possibility to perform preventive and control strategies to reduce the costs and mortality related to these infections.

  9. Catheter-Related Right Atrial Thrombus and Pulmonary Embolism: A Case Report and Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    Karen EA Burns

    2009-01-01

    Full Text Available Central venous catheters (CVCs are commonly used in clinical practice. One of the foremost complications associated with their use is the potential for symptomatic or asymptomatic thrombosis. CVC thrombosis, in turn, may not only result in vascular and catheter occlusion but also infection, pulmonary embolism, and formation of right heart thromboemboli. Thrombi within cardiac chambers are associated with an increased risk of mortality due to their potential for embolization to the pulmonary vasculature. We describe the case of a 77-year-old man, who was successfully thrombolyzed following detection of a right atrial thrombus and hemodynamically significant pulmonary embolism resulting from thrombus formation on the tip of a peripherally inserted central catheter (PICC. The present article is the first report of a PICC-related right atrial thrombus in an adult treated with thrombolysis. A systematic review of the literature suggests that the true incidence of this complication may be underestimated because the diagnosis may not be considered in asymptomatic and symptomatic patients, or may be missed by transthoracic echocardiography. The present case highlights the importance of maintaining a high index of suspicion for thromboembolic complications and heparin-induced thrombocytopenia in patients with CVCs or a PICC. It also underscores the important role of transesophageal echocardiography and thrombolysis in the diagnosis and management, respectively, of right heart thromboemboli with associated pulmonary embolism.

  10. Mechanic and surface properties of central-venous port catheters after removal: A comparison of polyurethane and silicon rubber materials.

    Science.gov (United States)

    Braun, Ulrike; Lorenz, Edelgard; Weimann, Christiane; Sturm, Heinz; Karimov, Ilham; Ettl, Johannes; Meier, Reinhard; Wohlgemuth, Walter A; Berger, Hermann; Wildgruber, Moritz

    2016-12-01

    Central venous port devices made of two different polymeric materials, thermoplastic polyurethane (TPU) and silicone rubber (SiR), were compared due their material properties. Both naïve catheters as well as catheters after removal from patients were investigated. In lab experiments the influence of various chemo-therapeutic solutions on material properties was investigated, whereas the samples after removal were compared according to the implanted time in patient. The macroscopic, mechanical performance was assessed with dynamic, specially adapted tests for elasticity. The degradation status of the materials was determined with common tools of polymer characterisation, such as infrared spectroscopy, molecular weight measurements and various methods of thermal analysis. The surface morphology was analysed using scanning electron microscopy. A correlation between material properties and clinical performance was proposed. The surface morphology and chemical composition of the polyurethane catheter materials can potentially result in increased susceptibility of the catheter to bloodstream infections and thrombotic complications. The higher mechanic failure, especially with increasing implantation time of the silicone catheters is related to the lower mechanical performance compared to the polyurethane material as well as loss of barium sulphate filler particles near the surface of the catheter. This results in preformed microscopic notches, which act as predetermined sites of fracture. PMID:27552159

  11. A 12-year review of Staphylococcus aureus bloodstream infections in haemodialysis patients: more work to be done.

    LENUS (Irish Health Repository)

    Fitzgerald, S F

    2012-02-01

    Staphylococcus aureus bloodstream infections (BSI) are a significant cause of morbidity and mortality in haemodialysis patients. This study describes a 12-year retrospective review of S. aureus BSI in a large haemodialysis centre in a tertiary referral hospital. The overall rate of S. aureus BSI was 17.9 per 100 patient-years (range 9.7-36.8). The rate of meticillin-resistant S. aureus (MRSA) BSI was 5.6 per 100 patient-years (range 0.9-13.8). Infective complications occurred in 11% of episodes, the most common being infective endocarditis (7.6%). Ten percent of patients died within 30 days of S. aureus being isolated from blood. Most cases of S. aureus BSI (83%) were related to vascular catheters. The provision of lower-risk vascular access, such as arteriovenous fistulae, and reduced use of intravascular catheters should be priorities in all haemodialysis units. Where alternative vascular access cannot be established, interventions to reduce the risk of catheter-related infections should be implemented to reduce morbidity and mortality in this vulnerable patient group.

  12. Risk factors and current recommendations for prevention of infections associated with central venous catheters: a literature review

    Directory of Open Access Journals (Sweden)

    Danielle de Mendonça Henrique

    2014-04-01

    Full Text Available Backgound and Objectives: Infections related to central venous catheter (CVC use constitute an important a problem. It is estimated that approximately 90% of bloodstream infections (BSI are caused by CVC use. This study aims at reviewing the risk factors and current recommendations for prevention of infections associated with central venous catheter use. Methods: A total of 12 articles published in the last 5 years and indexed in the databases of the Latin American and Caribbean Literature on Health Sciences (LILACS, Nursing Database (BDENF, International Literature on Health Sciences (Medline/Pubmed were selected, as well as publications related to the recommendations for BSI prevention, such as: Institute for Healthcare Improvement (IHI, Centers for Disease Control and Prevention (CDC and the National Health Surveillance Agency (ANVISA. Results: Two categories were identified: prevention and control measures and risk factors for BSI associated with central venous catheter use. Conclusions: Some recommendations that were well-defined over the years have been questioned by some authors and continuing training and education of the multidisciplinary team are the most important factors for the prevention of bloodstream infections associated with CVC use.

  13. Comparison of NHSN-defined central venous catheter day counts with a method that accounts for concurrent catheters.

    Science.gov (United States)

    Talbot, Thomas R; Johnson, James G; Anders, Theodore; Hayes, Rachel M

    2015-01-01

    Central venous catheter (CVC) day definitions do not consider concurrent CVCs. We examined traditional CVC day counts and resultant central line-associated bloodstream infection (CLABSI) rates with a CVC day definition that included concurrent CVCs. Accounting for concurrent CVCs increased device day counts by 8.5% but only mildly impacted CLABSI rates.

  14. Efficacy of Linezolid and Fosfomycin in Catheter-Related Biofilm Infection Caused by Methicillin-Resistant Staphylococcus aureus.

    Science.gov (United States)

    Chai, Dong; Liu, Xu; Wang, Rui; Bai, Yan; Cai, Yun

    2016-01-01

    As long-standing clinical problems, catheter-related infections and other chronic biofilm infections are more difficult to treat due to the high antibiotic resistance of biofilm. Therefore, new treatments are needed for more effective bacteria clearance. In this study, we evaluated the antibacterial activities of several common antibiotics alone and their combinations against biofilm-embedded methicillin-resistant staphylococcus aureus (MRSA) infections, both in vitro and in vivo. In brief, fosfomycin, levofloxacin, and rifampin alone or in combination with linezolid were tested in vitro against planktonic and biofilm-embedded MRSA infection in three MRSA stains. The synergistic effects between linezolid and the other three antibiotics were assessed by fractional inhibitory concentration index (FICI) and time-kill curves, where the combination of linezolid plus fosfomycin showed the best synergistic effect in all strains. For further evaluation in vivo, we applied the combination of linezolid and fosfomycin in a catheter-related biofilm rat model and found that viable bacteria counts in biofilm were significantly reduced after treatment (P fosfomycin treatment had improved therapeutic effects on biofilm-embedded MRSA infection both in vitro and in vivo, which provided important basis for new clinical therapy development. PMID:27366751

  15. Efficacy of Linezolid and Fosfomycin in Catheter-Related Biofilm Infection Caused by Methicillin-Resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Dong Chai

    2016-01-01

    Full Text Available As long-standing clinical problems, catheter-related infections and other chronic biofilm infections are more difficult to treat due to the high antibiotic resistance of biofilm. Therefore, new treatments are needed for more effective bacteria clearance. In this study, we evaluated the antibacterial activities of several common antibiotics alone and their combinations against biofilm-embedded methicillin-resistant staphylococcus aureus (MRSA infections, both in vitro and in vivo. In brief, fosfomycin, levofloxacin, and rifampin alone or in combination with linezolid were tested in vitro against planktonic and biofilm-embedded MRSA infection in three MRSA stains. The synergistic effects between linezolid and the other three antibiotics were assessed by fractional inhibitory concentration index (FICI and time-kill curves, where the combination of linezolid plus fosfomycin showed the best synergistic effect in all strains. For further evaluation in vivo, we applied the combination of linezolid and fosfomycin in a catheter-related biofilm rat model and found that viable bacteria counts in biofilm were significantly reduced after treatment (P<0.05. In summary, we have shown here that the combination of linezolid and fosfomycin treatment had improved therapeutic effects on biofilm-embedded MRSA infection both in vitro and in vivo, which provided important basis for new clinical therapy development.

  16. 肿瘤患者中心静脉置管相关性感染研究%A Study on Catheter Related Infection in Cancer Patient Treated with Central Venous Catheterization

    Institute of Scientific and Technical Information of China (English)

    张晓霞; 陈惠蓉; 付岚; 陈旭霞; 张智; 许辉琼; 李俊英

    2011-01-01

    目的 了解肿瘤患者中心静脉置管相关性感染情况.方法 对四川大学华西医院196例肿瘤患者进行前瞻性研究,分析导管相关性感染类型和病原菌类型,以及导管相关性感染与置管部位、性别、年龄、置管时间和骨髓抑制程度的关系.结果 196例患者中发生导管相关性感染16例,感染率8.2%,其中病原菌定植5例、出口部位感染4例、导管相关性血流感染7例.共送检标本244份,其中20份病原菌培养阳性,培养出革兰氏阳性和革兰氏阴性两类共7种病原菌,病原菌以金葡菌、表葡菌、鲍曼不动杆菌和肺炎克雷伯杆菌为主.相关性分析显示,导管相关性感染与置管部位和年龄有关,两者均为独立危险因素.结论 应树立预防为主的观念,采取综合措施降低导管相关性感染,如选择合适的置管部位和严格导管植入患者的纳入标准等.%Objective To study the catheter-related infection (CRI) in cancer patients treated with central venous catheterization. Methods A prospective study with 196 cancer patients was conducted to analyze the types of catheter-related infection and pathogen, as well as the relationship between CRI and the following factors: insert location, gender, age, remained time, or bone marrow suppression. Results Of the total 196 cases, 16 cases were diagnosed as CRI and the CRI rate was 8.2%. The types of CRI were five cases of pathogen colonization, four cases of insert location infection and seven cases of catheter-related bloodstream infection. Of the total 244 specimens, 20 were positive including 7 pathogenic bacteria in either Gram positive or Gram negative types, the dominating pathogens were staphylococcus aureus, staphylo-coccus epidermidis, acinetobacter baumannii and klebsiella pneumoniae. CRI was related to both insert location and age which were both the independent risk factors. Conclusion The concept of prevention should be set up, and the comprehensive

  17. Peripherally Inserted Central Catheter Related Infection in Neonate%新生儿经外周置入中心静脉导管相关感染研究

    Institute of Scientific and Technical Information of China (English)

    吴本清; 林真珠; 李志光; 马晓利

    2011-01-01

    Objective To investigate the type,main pathogens and risk factors of peripherally inserted central catheter(PICC)related infections.Methods Three hundred neonates with PICC from January 2003 to December 2009 were included in this study.The incidence rate of PICC related infection and main pathogens of catheter-related bloodstream infections(CRBSI) were analyzed retrospectively.The risk factors of CRBSI were analyzed by using Logistic regression.Results The incidence rate of catheter colonization,local infection(exit-site infection plus tunnel infection) and CRBSI were 3.0%, 1.2/1000 PICC days,7.4%,2.8/1 000 PICC days ,9.0% ,3.6/1000 PICC days respectively.The ratio of Gram-positive bacilli, Gram-negative bacilli and fungi in CRBSI was 57% ,18% and 25% ,respectively.Coagulase negative staphylococcus was the most common microorganism,followed by Candida spp and Klebsiella spp.Multiple logistic regression analysis showed that the significant contributors to CRBSI was duration of the PICC placement [OR = 1.58 ( 1.12 - 1.73)].Conclusion CRBSI is the most common type of catheter-related infection; coagulase negative staphylococcus was the most common microorganism, followed by fungi.Duration of catheterization is the independent risk factor of CRBSI.%目的 本研究旨在探讨PICC相关感染的类型、主要病原菌和危险因素.方法 回顾性分析300例应用PICC治疗的新生儿导管相关感染的发生率,导管相关性血流感染(CRBSI)的病原菌构成.对CRBSI的危险因素进行Logistic回归分析.结果 导管定植的发生率为3.0%,1.2/1000导管日.局部感染(出口部位感染+隧道感染)率为7.4%,2.8/1000导管日.CRBSI发生率为9.0%,3.6/1000导管日.CRBSI病原茵G+菌占57%,主要为凝固酶阴性的表皮葡萄球菌.G-菌占18%,以肺炎克雷伯杆菌为主,真菌占25%,主要为念珠茵.Logistic回归分析显示仅置管时间为CRBSI的独立危险因素[OR=1.58(1.12~1.73)].结论 PICC相关感染以CRBSI

  18. Catheter-Related Acremonium kiliense Fungemia in a Patient with Ulcerative Colitis under Treatment with Infliximab

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    Fernando A. Díaz-Couselo

    2011-01-01

    Full Text Available Acremonium spp. are filamentous, cosmopolitan fungi commonly isolated from plant debris and soil. They are infrequent pathogens in humans. Acremonium fungemia has been reported in neutropenic patients associated with central venous catheters and in nonneutropenic patients receiving long-term total parenteral nutrition. TNF-α blockade is associated with fungal infections, but no Acremonium spp. infection had been reported up to the present. In this paper, we present a patient with ulcerative colitis who developed Acremonium kiliense fungemia associated with infliximab therapy while receiving total parenteral nutrition. The patient was successfully treated with voriconazole. Acremonium sp. infection must be suspected as another cause of fungal infection in patients under treatment with infliximab.

  19. The effectiveness of an educational intervention in changing nursing practice and preventing catheter-related infection for patients receiving total parenteral nutrition.

    Science.gov (United States)

    Dinç, L; Erdil, F

    2000-10-01

    Catheter-related infections are one of the most serious complications of TPN therapy. Nurses have important responsibilities in the care of patients who are receiving TPN. This quasi-experimental study was conducted for the purpose of investigating the effectiveness of an educational intervention on changing nursing practice and preventing catheter-related infections in patients receiving total parenteral nutrition. The nurses' practice and the colonisation rate of control and comparative group patients in the surgical clinics of Hacettepe University Hospital (Turkey), and related variables were examined before and after an educational intervention. The findings of the study indicate that the intervention was successful in improving appropriate nursing practice, mean scores of nurses' practices were 45.7 before and 66.5 after the intervention (p<0.05). The rate of microorganism colonisation was also decreased but statistical analysis demonstrated no association between nursing practices and microorganism colonisation of catheter cultures.

  20. 乳腺癌患者携带PICC化疗并发导管败血症的诊治探讨%Diagnosis and treatment of peripherally inserted central catheters (PICC)-related sepsis in breast cancer patients carrying PICC catheter for chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Lei Xing; Vishnu Prasad Adhikari; Lingquan Kong; Hongyuan Li; Guosheng Ren; Feng Luo; Kainan Wu

    2012-01-01

    Objective: The aim of our research was to study the incidence, clinical diagnosis and treatment of peripherally inserted central catheters (PICC)-related sepsis in breast cancer patients carrying PICC catheter for chemotherapy. Methods: The data of the incidence, diagnosis and treatment of PICC-related sepsis in 215 cases of breast cancer patients carrying PICC catheter for chemotherapy in our hospital from August, 2009 to September, 2011 were analyzed retrospectively. Results: 216 PICCs had been successfully applied in 215 cases of breast cancer patients and followed for a total of 19,109 catheter days, (median catheterization duration, 88.9 days, range 1-212 days). Among those, 3 (1.39%) PICCs were removed respectively as a result of PICC-related sepsis in 29, 73 and 108 catheter-days (median 70 d), with a rate of 0.16 per 1000 catheter-days. Conclusion: Chemotherapeutic treatment via PICC for breast cancer patients is one of the most secure and effective measures but there exists small number of cases in which PICC catheter related sepsis is possible. Careful observation of relevant symptoms and signs, early diagnosis and treatment, not relying completely on blood culture tests and timely removal of PICC catheter can be very effective in treating PICC-related sepsis in these patients.

  1. [Catheter-related infection in home-based parenteral nutrition: outcomes from the NADYA group and presentation of a new protocol].

    Science.gov (United States)

    Cuerda, Compés C; Bretón, Lesmes I; Bonada Sanjaume, A; Planas Vila, M

    2006-01-01

    Hom parenteral nutrition (HPN) is a nutritional support modality that allows for the supply of parenteral nutrition bags to the patient's home. Since its first use in the late 60s, this therapy has allowed maintaining patients with intestinal failure alive that previously were doomed to death. In our country, this therapy is used by 2.15 patients pmp. According to the NADYA data, catheter-related infections account for 50% of all HPN-related complications. In larger series, infection rates are 0.5-2 infections/1000 days or 0.3-0.5 infections/patient/year. Most of them are produced by gram-positive organisms that migrate from the skin or from catheter connections to the tip. These infections are diagnosed by means of clinical data and with different microbiological cultures. When treating these infections, it is important to keep the catheter in place, and administering antibiotics through it, conventionally or with the antibioticolade technique.

  2. Massive catheter-related thrombosis of vena cava superior protruding into the right atrium in a hemodialysis patient.

    Science.gov (United States)

    Mach, Lukas; Ondruskova, Olga; Nemec, Petr; Orban, Marek

    2015-10-01

    A 36-year-old man with chronic renal insufficiency secondary to type 1 diabetes mellitus was on hemodialysis via central venous catheter (CVC), newly placed into the right subclavian vein after his arteriovenous fistula became dysfunctional. Seven days after CVC insertion, the patient developed fever and on day 11 echocardiography showed a large nearly occluding thrombus in the superior vena cava (SVC) extending into the right atrium (RA). Emergency surgical thrombectomy was successfully performed and an 11 cm long thrombus extending from the RA cranially into the SVC occupying majority of the vein's lumen was removed. Cultures from the thrombus and CVC were negative, but polymerase chain reaction was positive for Staphylococcus aureus. This particular case was interesting for a marked discrepancy between large SVC occluding thrombosis and a relatively mild clinical presentation with fever, and it highlights the importance of correct timing of echocardiography exam which might prevent potentially fatal consequences such as pulmonary embolism. PMID:25645521

  3. Systemic anticoagulation related to heparin locking of non-tunnelled venous dialysis catheters in intensive care patients.

    Science.gov (United States)

    Bong, Y C; Walsham, J

    2016-07-01

    Heparin locking of venous dialysis catheters is routinely performed in intensive care to maintain catheter patency when the catheters are not being used. Leakage of heparin into the circulation can potentially cause systemic anticoagulation and may present a risk to intensive care patients. To assess the effect of 5000 units per millilitre heparin locking of non-tunnelled dialysis catheters on systemic anticoagulation, we performed a prospective observational study of ten intensive care patients receiving heparin locking of dialysis catheters in an adult tertiary intensive care unit between July and September 2015. Activated partial thromboplastin time (APTT) was measured prior to, and three minutes after, heparin locking of catheter lumens with the manufacturer's recommended locking volume to assess the effect on systemic anticoagulation. Heparin locking of venous dialysis catheters resulted in a significant rise in APTT (P=0.002). The median rise was by 56 seconds (interquartile range 30-166.5). Following heparin locking, 80% of patients had APTT values within or above the range associated with therapeutic anticoagulation. Heparin locking of non-tunnelled venous dialysis catheters can cause systemic anticoagulation in intensive care patients and therefore poses a potential risk to patient safety.

  4. Systemic anticoagulation related to heparin locking of non-tunnelled venous dialysis catheters in intensive care patients.

    Science.gov (United States)

    Bong, Y C; Walsham, J

    2016-07-01

    Heparin locking of venous dialysis catheters is routinely performed in intensive care to maintain catheter patency when the catheters are not being used. Leakage of heparin into the circulation can potentially cause systemic anticoagulation and may present a risk to intensive care patients. To assess the effect of 5000 units per millilitre heparin locking of non-tunnelled dialysis catheters on systemic anticoagulation, we performed a prospective observational study of ten intensive care patients receiving heparin locking of dialysis catheters in an adult tertiary intensive care unit between July and September 2015. Activated partial thromboplastin time (APTT) was measured prior to, and three minutes after, heparin locking of catheter lumens with the manufacturer's recommended locking volume to assess the effect on systemic anticoagulation. Heparin locking of venous dialysis catheters resulted in a significant rise in APTT (P=0.002). The median rise was by 56 seconds (interquartile range 30-166.5). Following heparin locking, 80% of patients had APTT values within or above the range associated with therapeutic anticoagulation. Heparin locking of non-tunnelled venous dialysis catheters can cause systemic anticoagulation in intensive care patients and therefore poses a potential risk to patient safety. PMID:27456177

  5. Central venous catheter-related bacteremia caused by Kocuria kristinae: Case report and review of the literature

    OpenAIRE

    David Michael Z; Bares Sara; Dunn Ryan

    2011-01-01

    Abstract Kocuria species are unusual human pathogens isolated most commonly from immunocompromised hosts, such as transplant recipients and cancer patients undergoing chemotherapy, or from patients with chronic medical conditions. A case of catheter-related bacteremia with pulmonary septic emboli in a pregnant adult female without chronic medical conditions is described. A review of other reported Kocuria infections is provided.

  6. EARLY AND LATE COMPLICATIONS RELATED TO CENTRAL VENOUS CATHETERS IN HAEMATOLOGICAL MALIGNANCIES: A RETROSPECTIVE ANALYSIS OF 1102 PATIENTS

    Directory of Open Access Journals (Sweden)

    Salvatore Giacomo Morano

    2014-02-01

    Full Text Available Several severe complications may be associated with the use of central venous catheters (CVC. We retrospectively evaluated on a large cohort of patients the incidence of CVC-related early and late complications. From 7/99 to 12/2005, 1102 CVC have been implanted at our Institution in 881 patients with haematological malignancies (142,202 total day number of implanted CVC. Early mechanic complications were 79 (7.2% - 0.55/1,000 days/CVC. Thirty-nine episodes of early infective complications (<1 week from CVC implant occurred (3.5% - 0.3/1000 days/CVC: furthermore, 187 episodes of CVC-related sepsis (17% - 1.3/1000 days/CVC were recorded. There were 29 episodes (2.6% of symptomatic CVC-related thrombotic complications, with a median interval from CVC implant of 60 days (range 7 – 395. The rate of CVC withdrawal due to CVC-related complications was 26%. The incidence of CVC-related complications in our series is in the range reported in the literature, notwithstanding cytopenia often coexisting in haematological patients.

  7. Prevention of biofilm colonization by Gram-negative bacteria on minocycline-rifampin-impregnated catheters sequentially coated with chlorhexidine.

    Science.gov (United States)

    Jamal, Mohamed A; Rosenblatt, Joel S; Hachem, Ray Y; Ying, Jiang; Pravinkumar, Egbert; Nates, Joseph L; Chaftari, Anne-Marie P; Raad, Issam I

    2014-01-01

    Resistant Gram-negative bacteria are increasing central-line-associated bloodstream infection threats. To better combat this, chlorhexidine (CHX) was added to minocycline-rifampin (M/R) catheters. The in vitro antimicrobial activity of CHX-M/R catheters against multidrug resistant, Gram-negative Acinetobacter baumannii, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia was tested. M/R and CHX-silver sulfadiazine (CHX/SS) catheters were used as comparators. The novel CHX-M/R catheters were significantly more effective (P catheters in preventing biofilm colonization and showed better antimicrobial durability.

  8. Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections.

    Science.gov (United States)

    Bustos, Cesar; Aguinaga, Aitziber; Carmona-Torre, Francisco; Del Pozo, Jose Luis

    2014-01-01

    Since the first description in 1982, totally implanted venous access ports have progressively improved patients' quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique) is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port. PMID:24570595

  9. 儿童中心静脉置管相关性血流感染病原菌分布及耐药性分析%Analysis of the distribution and drug resistance of pathogenic bacteria of children′s PICC related bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    李智英; 罗学群; 余慕雪

    2014-01-01

    OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in peripherally insert‐ed central catheter (PICC) related bloodstream infection on children ,and to provide the foundation for the clinical prevention and treatment .METHODS The clinical data of 72 children with PICC related bloodstream infection were chosen in our hospital from Jan .2009 to Jan .2014 ,the distribution and drug resistance of pathogenic bacte‐ria were analyzed .SPSS13 .0 was adopted for a statistic analysis .RESULTS Totally 98 strains of pathogenic bacte‐ria were isolated and identified ,including 48 strains of gram‐positive bacteria (48 .98% ) ,37 strains of gram‐nega‐tive bacteria (37 .75% ) and 13 strains of fungi (13 .27% ) .The main gram‐positive bacteria were with high resist‐ance to penicillin ,erythromycin and ampicillin G ,and the resistance rate was 61 .11% ~100 .00% .The gram‐neg‐ative bacteria were with high resistance to ceftazidime ,cefepime ,cefuroxime and ampicillint ,and the resistance rate was 58 .30% ~88 .89% .Fungi were sensitive to itraconazole ,amphotericin B ,fluconazole and flucytosine , and the resistance rate was less than 20 .00% ;The children with the PICC indwelling time less than 7 days accaunted for 6 .9% ,while the children with the indwelling time more than 21days accounted for 50 .00% ;with the increase of the indwelling time ,the proportion of the chlidren with blooclstream infections was increased . CONCLUSION To strengthen the monitoring of pathogenic bacteria in PICC related bloodstream infections can help us better understand the dynamic changes of pathogenic bacteria in bloodstream infection .It′s benefit for guiding the clinical rational use of antimicrobial drugs and improving the clinical effect to master the drug resistance of pathogenic bacteria .%目的:分析儿童中心静脉置管(PICC )相关性血流感染的感染病原菌分布及其耐药性,为临床防治奠

  10. Catheter-related right atrial thrombus and pulmonary embolism: A case report and systematic review of the literature

    OpenAIRE

    Karen EA Burns; Andrew McLaren

    2009-01-01

    Central venous catheters (CVCs) are commonly used in clinical practice. One of the foremost complications associated with their use is the potential for symptomatic or asymptomatic thrombosis. CVC thrombosis, in turn, may not only result in vascular and catheter occlusion but also infection, pulmonary embolism, and formation of right heart thromboemboli. Thrombi within cardiac chambers are associated with an increased risk of mortality due to their potential for embolization to the pulmonary ...

  11. Clinical impact of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay related to methicillin-resistant Staphylococcus aureus bloodstream infections.

    LENUS (Irish Health Repository)

    de Kraker, Marlieke E A

    2011-04-01

    Antimicrobial resistance is threatening the successful management of nosocomial infections worldwide. Despite the therapeutic limitations imposed by methicillin-resistant Staphylococcus aureus (MRSA), its clinical impact is still debated. The objective of this study was to estimate the excess mortality and length of hospital stay (LOS) associated with MRSA bloodstream infections (BSI) in European hospitals. Between July 2007 and June 2008, a multicenter, prospective, parallel matched-cohort study was carried out in 13 tertiary care hospitals in as many European countries. Cohort I consisted of patients with MRSA BSI and cohort II of patients with methicillin-susceptible S. aureus (MSSA) BSI. The patients in both cohorts were matched for LOS prior to the onset of BSI with patients free of the respective BSI. Cohort I consisted of 248 MRSA patients and 453 controls and cohort II of 618 MSSA patients and 1,170 controls. Compared to the controls, MRSA patients had higher 30-day mortality (adjusted odds ratio [aOR] = 4.4) and higher hospital mortality (adjusted hazard ratio [aHR] = 3.5). Their excess LOS was 9.2 days. MSSA patients also had higher 30-day (aOR = 2.4) and hospital (aHR = 3.1) mortality and an excess LOS of 8.6 days. When the outcomes from the two cohorts were compared, an effect attributable to methicillin resistance was found for 30-day mortality (OR = 1.8; P = 0.04), but not for hospital mortality (HR = 1.1; P = 0.63) or LOS (difference = 0.6 days; P = 0.96). Irrespective of methicillin susceptibility, S. aureus BSI has a significant impact on morbidity and mortality. In addition, MRSA BSI leads to a fatal outcome more frequently than MSSA BSI. Infection control efforts in hospitals should aim to contain infections caused by both resistant and susceptible S. aureus.

  12. A single-center experience of 2153 tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein: An evaluation of technical success and complication rates relative to underlying disease conditions

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan; Yim, Nm Yeol; Kim, Yong Tae; Noh, Hoon; Ki, So Yeon; Kim Jae Kyu; Kim, Hyoung Ook; Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2015-01-15

    To evaluate the technical success and complication rates of tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein in patients with different types of underlying diseases. A total of 2153 tunneled-cuffed catheter insertions performed in 1926 patients between January 2008 and December 2012 were retrospectively reviewed. All procedures were conducted using sonography and fluoroscopy. The number of catheter maintenance days, technical success rates, and complication rates were analyzed based on radiologic and medical records. A total of 204809 catheter maintenance days (mean, 95.35 days; range, 0-1710 days) were recorded. Technical success was achieved in 2148 insertions (99.77%). A total of 185 complications (8.61%, 0.903/1000 catheter days) were observed, including 22 procedure-related complications (1.02%). A total of 143 catheters (6.66%) were removed due to complications. Significant differences in complication rates were observed between patients with or without underlying hematologic diseases (11.65% vs. 7.02%, respectively; p = 0.000). Significant differences in catheter thrombosis were observed between patients in which right-sided or left-sided venous approaches were used (0.81% vs. 2.70%, respectively; p = 0.010). The very high technical success rates and very low procedure-related complication rates indicate insertion of a tunneled-cuffed catheter radiologically placed via the internal jugular vein is safe and effective.

  13. Catheter-related blood stream infection in patients receiving long-term home parenteral nutrition: Tertiary care hospital experience in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Esraa S Al-Tawil

    2016-01-01

    Full Text Available Background/Aim: Parenteral nutrition (PN is a lifesaving therapy for patients with many severe conditions, including intestinal failure. Some patients require long-term PN therapy, which makes home parenteral nutrition (HPN an attractive option to improve the quality of life. Among the most common and serious complications observed in these patients are catheter-related blood stream infections (CRBSIs. The aim of our study is to determine the frequency of CRBSI among patients receiving long-term HPN. Patients and Methods: A retrospective chart review was conducted for patients enrolled in the HPN program between 2006 and 2012. Data on the demographic characteristics, indications and duration of PN therapy, catheter type, number of admissions because of CRBSI, and blood culture results were recorded. Results: Eight pediatric patients were included (mean age of 3.5 years at the start of HPN. Microvillus inclusive disease was noted in 50% of these patients, and 75% of them received HPN under parents' care. CRBSI resulted in 60 admissions with a median of 182 days of hospital stay and 74 changes of central venous catheters. The rate of CRBSI was 2.9 per 1000 catheter days. Staphylococcus species were the most prevalent pathogens (32%, followed by Klebsiella pneumoniae (5%. Conclusion: In this small group of HPN patients, the BSI rate was 2.9 infections per 1000 catheter days, and most common causative organisms were Staphylococcus species. We believe that a well-established training program for caregivers can reduce the rate of infectious complications associated with long-term PN support.

  14. The catheter hub disinfection cap as esophageal foreign body.

    Science.gov (United States)

    Tawfik, Kareem O; Myer, Charles M; Shikary, Tasneem; Goldschneider, Kenneth R

    2015-12-01

    Disinfection caps are increasingly being used to prevent catheter-associated bloodstream infections. These devices, designed for continuous passive disinfection of catheter hubs, are typically small and often brightly colored. As such, they have the potential to become pediatric airway and esophageal foreign bodies. We report two patients who developed esophageal foreign body following ingestion of disinfection caps. Given the increasing use of these devices, it is imperative that health care providers be aware of this potential iatrogenic problem. We propose that the use of disinfection caps may not be appropriate in pediatric patients with risk factors for foreign body ingestion.

  15. Retained Urethral Catheter Secondary to Placement in Proximal Ureter

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    Thomas B. McGregor

    2016-01-01

    Full Text Available We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter.

  16. Retained Urethral Catheter Secondary to Placement in Proximal Ureter.

    Science.gov (United States)

    McGregor, Thomas B; Sharda, Rajan

    2016-01-01

    We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter.

  17. Venous port catheter dislocation as an unusual cause of pneumonia

    Directory of Open Access Journals (Sweden)

    Umut Serhat Sanrı

    2014-06-01

    Full Text Available The use of central venous port catheter is a very useful method for long-term therapy in patients with malignancy. Catheter insertion technique and maintenance of equipment is very important to the prevention of catheter-related complications. The most frequent complications are deep venous thrombosis, port infection, catheter obstruction. İn this article, pneumonia occurrence after chemotherapy infusion in a patient who has a completely extravasated central venous port catheter discussed.

  18. Downhill Esophageal Varices Associated With Central Venous Catheter-Related Thrombosis Managed With Endoscopic and Surgical Therapy

    Science.gov (United States)

    Berkowitz, Joshua C.; Bhusal, Sushma; Desai, Deepak; Cerulli, Maurice A.

    2016-01-01

    Downhill esophageal varices are a rare cause of upper gastrointestinal hemorrhage. We present a case of downhill variceal bleeding due to superior vena cava thrombosis resulting from a prior central venous catheter. The patient was managed with endoscopic band ligation and later with surgical axillary vein to right atrium bypass grafting. Successful long-term resolution of varices was achieved at 1 year of follow-up. This is the longest follow-up described for combined endoscopic and surgical management in the existing literature for catheter-associated downhill varices. PMID:27807564

  19. Central venous catheter-related infection and catheter retention time after heart surgery%心脏术后中心静脉导管相关性感染与置管时间的探讨

    Institute of Scientific and Technical Information of China (English)

    芮炳峰; 安淑芬; 李宝祥

    2012-01-01

    目的 探讨心脏术后中心静脉导管相关性感染(CRI)的发生率与中心静脉导管留置时间的关系及CRI感染的途径.方法 选取242例心脏直视术后留置深静脉导管的病例,依据拔管时间将患者分为1~5 d组、6~8 d组及9~11 d组,对拔除导管的尖端进行细菌培养,并统计三组病原菌菌株数及相关构成比.结果 共38例患出现CRI,培养出病原菌48株,留置时间1~5 d、6~8 d、9~11 d时患者CRI发生率分别为8.26%、18.18%和36.36%,三组间CRI感染率有统计学差异(P<0.01).48株病原菌中革兰阳性菌占54.16%,革兰阴性菌占37.5%,真菌占8.33%.结论 随中心静脉导管留置时间延长CRI呈显著增加趋势,以革兰阳性菌感染为主,CRI以局部细菌侵入途径为主.%Objective To investigate the relationship between the incidence of central venous catheter related infections ( CRI ) and catheter retention time after heart surgery, and the pathway of CRI. Methods The patients ( n = 242 ) with deep vein catheter retention after open-heart surgery were selected and divided into 1 ~ 5 day group, 6 ~ 8 day group and 9 ~ 11 day group according to the time of extubation. The bacteria on the tip of catheter were cultured, and strains and relevant constituent ratio of pathogenic bacteria were counted in three groups. Results There were totally 38 patients suffering from CRI and 48 stains of pathogenic bacteria cultured. The incidence of CRI was, respective1y,8.26% ,18. 18% and 36. 36% in three groups ( P <0. 01 ). Among 48 stains of pathogenic bacteria,Gram-positive bacteria accounted for 54. 16% ,Gram-negative bacteria,37. 5% ,and fungus,8. 33% . Conclusion The incidence of CRI has a significant increasing tendency as the prolong of catheter retention time. The infections are mainly Gram-positive bacteria infection and the pathway of CRI is focal invasion.

  20. Multi-sequence magnetic resonance imaging integration framework for image-guided catheter ablation of scar-related ventricular tachycardia

    Science.gov (United States)

    Tao, Qian; Milles, Julien; van Huls van Taxis, Carine; Reiber, Johan H. C.; Zeppenfeld, Katja; van der Geest, Rob J.

    2012-02-01

    Catheter ablation is an important option to treat ventricular tachycardias (VT). Scar-related VT is among the most difficult to treat, because myocardial scar, which is the underlying arrhythmogenic substrate, is patient-specific and often highly complex. The scar image from preprocedural late gadolinium enhancement magnetic resonance imaging (LGE- MRI) can provide high-resolution substrate information and, if integrated at the early stage of the procedure, can largely facilitate the procedure with image guidance. In clinical practice, however, early MRI integration is difficult because available integration tools rely on matching the MRI surface mesh and electroanatomical mapping (EAM) points, which is only possible after extensive EAM has been performed. In this paper, we propose to use a priori information on patient posture and a multi-sequence MRI integration framework to achieve accurate MRI integration that can be accomplished at an early stage of the procedure. From the MRI sequences, the left ventricular (LV) geometry, myocardial scar characteristics, and an anatomical landmark indicating the origin of the left main coronary artery are obtained preprocedurally using image processing techniques. Thereby the integration can be realized at the beginning of the procedure after acquiring a single mapping point. The integration method has been evaluated postprocedurally in terms of LV shape match and actual scar match. Compared to the iterative closest point (ICP) method that uses high-intensity mapping (225+/-49 points), our method using one mapping point reached a mean point-to-surface distance of 5.09+/-1.09 mm (vs. 3.85+/-0.60 mm, p<0.05), and scar correlation of -0.51+/-0.14 (vs. -0.50+/-0.14, p=NS).

  1. Risk Factors and interventions for bloodstream infections after cardiac interventional therapy%心脏介入术后血管相关性血流感染因素分析及干预对策

    Institute of Scientific and Technical Information of China (English)

    赵雪芳; 狄韵漫

    2012-01-01

    目的 探讨心脏介入手术后发生中心静脉相关性血流感染因素及干预对策.方法 对心脏介入手术患者进行目标性临测及导管室的管理监控,分析、干预和总结感染因素.结果 通过开展目标性监测及干预对策,中心静脉导管相关性血流感染的感染率由开展前的1.9%下降为0,差异有统计学意义(P<0.01).结论 加强导管室管理,对介入手术进行监测和感染因素的干预,是预防心脏介入手术发生中心静脉导管相关性血流感染的有效方法.%OBJECTIVE To explore risk factors and intervention countermeasures for central venous catheter-related bloodstream infections after cardiac interventional therapy. METHODS By carrying out targeted surveillance in cardiac interventional therapy and monitoring of catheterization lab, the risk factors for the infections were analyzed, intervened, and summarized. RESULTS The incidence of the central venous catheter-related infections dropped from 1. 9% to 0 after the targeted surveillance and intervention countermeasures, and the difference was statistically significant (P<0. 01). CONCLUSION To strengthen the management of cauterization lab, monitor the interventional surgery, and intervene in the risk factors are effective ways to prevent central venous catheter-related bloodstream infections after cardiac interventional therapy.

  2. Response of high-sensitive C-reactive protein to catheter ablation of atrial fibrillation and its relation with rhythm outcome.

    Directory of Open Access Journals (Sweden)

    Jelena Kornej

    Full Text Available AIMS: This study investigated the possible association between hs-CRP as well as hs-CRP changes and rhythm outcome after AF catheter ablation. METHODS: We studied 68 consecutive patients with AF undergoing catheter ablation. hs-CRP levels were measured using commercially available assays before and 6 months after catheter ablation. Serial 7-day Holter ECGs were used to detect AF recurrences. RESULTS: Early AF recurrence (ERAF, within one week was observed in 38%, while late AF recurrence (LRAF, between 3 and 6 months occurred in 18% of the patients. None of the baseline clinical or echocardiographic variables was predictive of ERAF or LRAF. Baseline hs-CRP measured 2.07 ± 1.1 µg/ml and was not associated with ERAF and LRAF. At 6 months, hs-CRP levels were comparable with baseline values (2.14±1.19 µg/ml, p = 0.409 and were also not related with LRAF. However, patients with LRAF showed an hs-CRP increase from 2.03 ± 0.61 to 2.62 ± 1.52 µg/ml (p = 0.028. Patients with an hs-CRP change in the upper tertile (>0.2 µg/ml had LRAF in 32% as opposed to 11% (p = 0.042 in patients in the lower (<-0.3 µg/ml or intermediate (-0.3-0.2 µg/ml tertile. CONCLUSIONS: Changes in hs-CRP but not baseline hs-CRP are associated with rhythm outcome after AF catheter ablation. This finding points to a link between an inflammatory response and AF recurrence in this setting.

  3. Catheter-related UTI

    Science.gov (United States)

    ... fluids that irritate your bladder, such as alcohol, citrus juices, and drinks that contain caffeine. After you ... Dolin R, eds. Principles and Practice of Infectious Diseases . 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009: ...

  4. Role of duration of catheterization and length of hospital stay on the rate of catheter-related hospital-acquired urinary tract infections

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    Al-Hazmi H

    2015-03-01

    : three patients had UTI out of 37 catheterized patients (8% at 10 days LOS, while 42 patients had UTI out of 49 catheterized patients (85.7% at 18 days LOS. The longer the LOS, the higher the UTI rate: LOS for each patient (median 18 days for infected patients versus 10 days for noninfected patients; P-value <0.05, and number of hospital-acquired catheter-related UTI (100 patients had UTI out of 250 catheterized patients, P=0.04.Conclusion: Reduction of the duration of catheterization and LOS of the patient have a positive impact in reduction of catheter-related UTI.Keywords: urinary catheters, catheter duration, adult

  5. Peripherally-inserted central catheter-related fungemia due to hansenula polymorpha in a patient with pancreatic cancer.

    Science.gov (United States)

    Garbati, Musa Abubakar

    2012-10-01

    The methylotrophic yeast Hansenula polymorpha, used mainly as an industrial agent in the production of pharmaceuticals, has rarely been reported to cause disease. The case of a 47-year old Pilipino male with pancreatic cancer presented here is the second reported in the literature. Major risk factors for this infection included underlying malignancy, abdominal surgery and the use of a peripherally-inserted central catheter for total parenteral nutrition. He was successfully treated with a two-week's course of voriconazole. PMID:23326083

  6. Role of Echinocandins in Fungal Biofilm-Related Disease: Vascular Catheter-Related Infections, Immunomodulation, and Mucosal Surfaces.

    Science.gov (United States)

    Katragkou, Aspasia; Roilides, Emmanuel; Walsh, Thomas J

    2015-12-01

    Biofilm-related infections have become an increasingly important clinical problem. Many of these infections occur in patients with multiple comorbidities or with impaired immunity. Echinocandins (caspofungin, micafungin, and anidulafungin) exert their fungicidal activity by inhibition of the synthesis of the (1→3)-β-d-glucan. They are active among in vitro and in vivo model systems against a number of Candida species and filamentous fungi in their planktonic and biofilm phenotype. Their superior activity against biofilms poses them in an advantageous position among the antifungal armamentarium. However, additional studies are warranted to expand our knowledge on the role of echinocandins against biofilm-related infections.

  7. Infections associated with the central venous catheters.

    Science.gov (United States)

    Drasković, Biljana; Fabri, Izabella; Benka, Anna Uram; Rakić, Goran

    2014-01-01

    Central venous catheters are of an essential importance to critically ill patients who require long-term venous access for various purposes. Their use made the treatment much easier, but still they are not harmless and are prone to numerous complications. Catheter infections represent the most significant complication in their use. The frequency of infections varies in different patient care settings, but their appearance mostly depends on the patient's health condition, catheter insertion time, localization of the catheter and type of the used catheter. Since they are one of the leading causes of nosocomial infections and related to significant number of morbidity and mortality in intensive care units, it is very important that maximal aseptic precautions are taken during the insertion and the maintenance period. Prevention of infection of the central venous catheters demands several measures that should be applied routinely.

  8. Molecular Comparison of Bacterial Communities on Peripheral Intravenous Catheters and Matched Skin Swabs.

    Science.gov (United States)

    Choudhury, Md Abu; Marsh, Nicole; Banu, Shahera; Paterson, David L; Rickard, Claire M; McMillan, David J

    2016-01-01

    Skin bacteria at peripheral intravenous catheter (PIVC) insertion sites pose a serious risk of microbial migration and subsequent colonisation of PIVCs, and the development of catheter related bloodstream infections (CRBSIs). Common skin bacteria are often associated with CRBSIs, therefore the bacterial communities at PIVC skin sites are likely to have major implications for PIVC colonisation. This study aimed to determine the bacterial community structures on skin at PIVC insertion sites and to compare the diversity with associated PIVCs. A total of 10 PIVC skin site swabs and matching PIVC tips were collected by a research nurse from 10 hospitalised medical/surgical patients at catheter removal. All swabs and PIVCs underwent traditional culture and high-throughput sequencing. The bacterial communities on PIVC skin swabs and matching PIVCs were diverse and significantly associated (correlation coefficient = 0.7, pskin swabs. Sixty-one percent of all reads from the PIVC tips and 36% of all reads from the skin swabs belonged to this genus. Staphylococcus spp., (26%), Pseudomonas spp., (10%) and Acinetobacter spp. (10%) were detected from skin swabs but not from PIVC tips. Most skin associated bacteria commonly associated with CRBSIs were observed on skin sites, but not on PIVCs. Diverse bacterial communities were observed at skin sites despite skin decolonization at PIVC insertion. The positive association of skin and PIVC tip communities provides further evidence that skin is a major source of PIVC colonisation via bacterial migration but microbes present may be different to those traditionally identified via culture methods. The results provide new insights into the colonisation of catheters and potential pathogenesis of bacteria associated with CRBSI, and may assist in developing new strategies designed to reduce the risk of CRBSI.

  9. A Rare Case of Aeromonas Hydrophila Catheter Related Sepsis in a Patient with Chronic Kidney Disease Receiving Steroids and Dialysis: A Case Report and Review of Aeromonas Infections in Chronic Kidney Disease Patients

    Directory of Open Access Journals (Sweden)

    Muhammad Abdul Mabood Khalil

    2013-01-01

    Full Text Available Aeromonas hydrophila (AH is an aquatic bacterium. We present a case of fifty-five-year-old gentleman with chronic kidney disease (CKD due to crescentic IgA nephropathy who presented to us with fever. He was recently pulsed with methyl prednisolone followed by oral prednisolone and discharged on maintenance dialysis through a double lumen dialysis catheter. Blood culture from peripheral vein and double lumen dialysis catheter grew AH. We speculate low immunity due to steroids and uremia along with touch contamination of dialysis catheter by the patient or dialysis nurse could have led to this rare infection. Dialysis catheter related infection by AH is rare. We present our case here and take the opportunity to give a brief review of AH infections in CKD patients.

  10. Presternal peritoneal catheter.

    Science.gov (United States)

    Twardowski, Zbylut J

    2002-04-01

    The swan neck presternal catheter is composed of 2 flexible (silicon rubber) tubes joined by a titanium connector at the time of implantation. The exit site is located in the parasternal area. The catheter located on the chest was designed to reduce the incidence of exit site infections compared to peritoneal dialysis catheters with abdominal exits. From August 1991 to September 30, 2001, 974 swan neck presternal catheters were implanted worldwide. At the university of Missouri, 150 of these catheters were implanted and followed for over 130 patient years. Presternal catheters tended to perform better than swan neck abdominal catheters regarding exit and tunnel infections, even though they were implanted in several patients in whom regular catheters with the exit on the abdomen would be difficult or impossible to implant. Two-year survival probability of presternal catheters was 0.95. Recurrent/refractory peritonitis was the only reason for catheter failure. The catheter is particularly useful in obese patients (body mass index >35), patients with ostomies, children with diapers and fecal incontinence, and patients who want to take baths without the risk of exit contamination. Many patients prefer presternal catheter because of better body image. Disadvantages of the presternal catheter are minimal. Compared with abdominal catheters, dialysis-solution flow is slightly slower because of the increased catheter length; however, slower flow is insignificant clinically. There is a possibility of catheter disconnection in the tunnel, but this complication is extremely rare in adults and easily corrected. Finally, the implantation technique is more challenging compared with that of single-piece, abdominal catheters. PMID:12085389

  11. Comparative Efficacies of Tedizolid Phosphate, Linezolid, and Vancomycin in a Murine Model of Subcutaneous Catheter-Related Biofilm Infection Due to Methicillin-Susceptible and -Resistant Staphylococcus aureus.

    Science.gov (United States)

    Bayer, Arnold S; Abdelhady, Wessam; Li, Liang; Gonzales, Rachelle; Xiong, Yan Q

    2016-08-01

    Tedizolid, a novel oxazolidinone, exhibits bacteriostatic activity through inhibition of protein synthesis. The efficacies of tedizolid, linezolid, and vancomycin were compared in a murine catheter-related biofilm infection caused by methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA, respectively) strains engineered for bioluminescence. We observed significantly improved efficacy in terms of decreased S. aureus densities and bioluminescent signals in the tedizolid-treated group versus the linezolid- and vancomycin-treated groups in the model of infection caused by the MSSA and MRSA strains. PMID:27297485

  12. Suprapubic catheter care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000145.htm Suprapubic catheter care To use the sharing features on this page, please enable JavaScript. A suprapubic catheter (tube) drains urine from your bladder. It is ...

  13. Postoperative coagulopathy after live related donor hepatectomy: Incidence, predictors and implications for safety of thoracic epidural catheter

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    S T Karna

    2015-01-01

    Full Text Available Background: Coagulopathy after living donor hepatectomy (LDH may endanger donor safety during removal of thoracic epidural catheter (TEC. The present study was conducted to evaluate the extent and duration of immediate postoperative coagulopathy after LDH. Materials and Methods: A retrospective analysis of perioperative record of LDH over three years was conducted after IRB approval. Variables such as age, gender, BMI, ASA classification, liver volume on CT scan, preoperative and postoperative INR, platelet count (PC and ALT of each donor for five days was noted. In addition, duration of surgery, remnant as percentage total liver volume (Remnant%, blood loss, day of peak in PC and INR were also noted. Coagulopathy was defined as being present if INR exceeded 1.5 or platelet count fell below 1 × 10 5 /mm 3 on any day. Data was analyzed using SPSS 20 for Windows. Between group comparison was made using the Student ′t′ test for continuous variables and chi square test for categorical variables. Univariate analysis was done. Multiple logistic regression analysis was used to find independent factor associated with coagulopathy. Results: Eighty four (84 donors had coagulopathy on second day (mean INR 1.9 ± 0.42. Low BMI, % of remnant liver and duration of surgery were independent predictors of coagulopathy. Right lobe hepatectomy had more coagulopathy than left lobe and low BMI was the only independent predictor. There was no correlation of coagulopathy with age, gender, blood loss, presence of epidural catheter, postoperative ALT or duration of hospital stay. High INR was the main contributor for coagulopathy. Conclusions: Coagulopathy is seen after donor hepatectomy. We recommend removal of the epidural catheter after the fifth postoperative day when INR falls below 1.5.

  14. Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review 1

    Science.gov (United States)

    Perin, Daniele Cristina; Erdmann, Alacoque Lorenzini; Higashi, Giovana Dorneles Callegaro; Sasso, Grace Teresinha Marcon Dal

    2016-01-01

    ABSTRACT Objective: to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. Method: systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. Results: the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. Conclusions: care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units. PMID:27598378

  15. PROPHYLACTIC ADMINISTRATION OF DOXYCYCLINE REDUCES CENTRAL VENOUS CATHETER INFECTIONS IN PATIENTS UNDERGOING HEMATOPOIETIC CELL TRANSPLANTATION

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    Mohamed Kharfan-Dabaja

    2013-02-01

    Full Text Available Hematopoietic stem cells are usually transfused through a central venous catheter (CVC, which also facilitates administration of medications and intravenous fluids. We had observed high rate of catheter-related blood-stream infection (CR-BSI at our Bone Marrow Transplantation (BMT unit despite prescribing fluoroquinolones for anti-bacterial prophylaxis. Accordingly, we implemented prophylactic use of a relatively inexpensive broad spectrum antibiotic, namely doxycycline to address this problem. We wanted to investigate whether doxycycline prophylaxis reduces CR-BSI rate. Data was collected retrospectively on 54 consecutive patients, 26 of whom received doxycycline (doxycycline group, and we compared their outcomes to a previous cohort of 28 patients who did not receive doxycycline (comparison group. The groups were comparable in regards to age, gender, hematopoietic cell transplant type, and primary diagnosis. No CVC infection (0% was observed in the doxycycline group, while 5 infection episodes (18.5% occurred in 4 patients in the comparison group (p<0.001. Episodes of CR-BSI were due to: Escherichia-coli (EC=1, coagulase-negative Staphylococcus-spp (CNSS=2, both EC & CNSS=1. Our results demonstrate that CR-BSI was reduced significantly after introducing doxycycline. This finding suggests a beneficial role for systemic use of doxycycline prophylaxis to prevent CR-BSI in adult BMT patients. Nevertheless, a randomized controlled study is warranted to confirm these findings.

  16. 降钙素原与真菌血流感染的相关性研究%Research on relativity between procalcitonin and fungal bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    任丽娟; 郑文亮; 艾根伟

    2011-01-01

    目的 分析降钙素原(PCT)与真菌血流感染的相关性,研究不同真菌感染PCT的差异及PCT与疾病预后的关系.方法 回顾性分析2009年1月-2010年12月血液培养真菌感染的患者33例,结合其PCT的检测结果,与随机抽取的100例血液培养阴性患者作统计学分析,研究真菌血流感染与PCT的相关性,同时分析不同真菌感染时PCT结果的差异及感染预后与PCT的相关性.结果 33例血液真菌感染患者中,检出假丝酵母菌属感染18例,隐球酵母菌属感染7例,荚膜组织胞浆菌及球孢子菌感染各4例;PCT<0.5 ng/L者5例,PCT>2 ng/L者23例,100例血液培养阴性的患者中,PCT<0.5 ng/L者83例,PCT>2 ng/L者9例,按行×列表的x2检验,x2=17.79,查x2界值表,得P<0.05,认为血流真菌感染时,PCT的检测结果有统计学意义;采用单因素方差分析的统计学方法研究不同真菌感染时PCT的检测均数,计算F值=3.341,查F界值表,得P>0.05,表明不同真菌感染时,PCT的检测结果差异无统计学意义;采用t检验的方法研究有效控制和死亡患者PCT的检测均数,t=-2.989,查t界值表,得P<0.01,表明真菌血流感染患者的预后与PCT的检测结果明显相关.结论 重视PCT的检测结果,结合患者感染症状,及时有效的控制真菌感染非常必要.%OBJECTIVE To. Analyze the relativity between procalcitonin and blood fungus infection, study the difference of PCT of different fungus infection and the connections between PCT and the prognosis. METHODS A total of 33 cases of blood fungus infection patients were analyzed, according to PCT value, and statistically compared to 100 patients with negative blood culture. The relativity between blood fungus infection and PCT was studied and the difference of PCT when different fungus infect and the connection between PCT and the prognosis were analyzed at the same time. RESULTS There were 18 infections caused by Candida, 7 by cryptococcus, 4 by Histoplasma

  17. Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections

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    Bustos C

    2014-02-01

    Full Text Available Cesar Bustos,1 Aitziber Aguinaga,1 Francisco Carmona-Torre,2 Jose Luis Del Pozo1,3 1Department of Clinical Microbiology, 2Department of Internal Medicine, 3Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain Abstract: Since the first description in 1982, totally implanted venous access ports have progressively improved patients' quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port. Keywords: catheter-related infection, bacteremia, biofilm

  18. The Changing Epidemiology of Bloodstream Infections and Resistance in Hematopoietic Stem Cell Transplantation Recipients

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    Mücahit Yemişen

    2016-08-01

    Full Text Available Objective: Patients receiving hematopoietic stem cell transplantation (HSCT are exposed to highly immunosuppressive conditions and bloodstream infections (BSIs are one of the most common major complications within this period. Our aim, in this study, was to evaluate the epidemiology of BSIs in these patients retrospectively. Materials and Methods: The epidemiological properties of 312 patients with HSCT were retrospectively evaluated. Results: A total of 312 patients, followed between 2000 and 2011, who underwent autologous (62% and allogeneic (38% HSCT were included in the study. The most common underlying malignancies were multiple myeloma (28% and Hodgkin lymphoma (21.5%. A total of 142 (45% patients developed at least 1 episode of BSI and 193 separate pathogens were isolated from the blood cultures. There was a trend of increase in the numbers of BSIs in 2005-2008 and a relative increase in the proportion of gram-positive infections in recent years (2009-2011, and central venous catheter-related BSI was found to be most common source. Coagulase-negative staphylococci (49.2% and Acinetobacter baumannii (8.8% were the most common pathogens. Extended-spectrum beta-lactamase-producing strains were 23% and 22% among Escherichia coli and Klebsiella spp. isolates, respectively. Quinolone resistance was detected in 10% of Enterobacteriaceae. Resistance to carbapenems was not detected in Enterobacteriaceae, while it was seen at 11.1% and 23.5% in Pseudomonas and Acinetobacter strains, respectively. Conclusion: A shift was detected from gram-negative bacteria to gram-positive in the etiology over the years and central lines were the most common sources of BSIs.

  19. Hematologic patients' clinical and psychosocial experiences with implanted long-term central venous catheter

    DEFF Research Database (Denmark)

    Møller, Tom; Adamsen, Lis

    2010-01-01

    A significant decrease in catheter-related infections was demonstrated in our earlier randomized controlled trial of central venous catheter (CVC) care in hematologic patients.......A significant decrease in catheter-related infections was demonstrated in our earlier randomized controlled trial of central venous catheter (CVC) care in hematologic patients....

  20. Early oral switch therapy in low-risk Staphylococcus aureus bloodstream infection (SABATO) : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Kaasch, Achim J.; Fätkenheuer, Gerd; Prinz-Langenohl, Reinhild; Paulus, Ursula; Hellmich, Martin; Weiß, Verena; Jung, Norma; Rieg, Siegbert; Kern, Winfried V.; Seifert, Harald; Lewalter, Karl; Lemmen, Sebastian; Stijnis, Cornelis; Van der Meer, Jan; Soriano, Alex; Ruiz, Laura Morata; Arastéh, Keikawus; Stocker, Hartmut; Kluytmans, Jan; Veenemans, Jacobien; Brodt, Hans Reinhard; Stephan, Christoph; Wolf, Timo; Kessel, Johanna; Joost, Insa; Sinha, Bhanu; van Assen, Sander; Wilting, Kasper; Tobias Welte, Welte; Christiane Mölgen, Mölgen; Julia Freise, Freise; Brunkhorst, Frank; Pletz, Mathias; Hagel, Stefan; Becker, Christian; Frieling, Thomas; Kösters, Katrin; Reuter, Stefan; Hsiao, Mikai; Rupp, Jan; Dalhoff, Klaus; Turner, David; Snape, Susan; Crusz, Shanika; Venkatesan, Pradhib; Salzberger, Bernd; Hanses, Frank; Rodriguez-Baño, Jesùs; Méndez, Adoración Valiente; López-Cortés, Luis Eduardo; Cisneros, José Miguel; Navarro-Amuedo, Maria Dolores; Bonten, Marc; Oosterheert, Jan Jelrik; Ekkelenkamp, Miquel

    2015-01-01

    Background: Current guidelines recommend that patients with Staphylococcus aureus bloodstream infection (SAB) are treated with long courses of intravenous antimicrobial therapy. This serves to avoid SAB-related complications such as relapses, local extension and distant metastatic foci. However, in

  1. Alternatives to Indwelling Catheters Cause Unintended Complications.

    Science.gov (United States)

    Nguyen, Jessica; Harvey, Ellen M; Lollar, Daniel I; Bradburn, Eric H; Hamill, Mark E; Collier, Bryan R; Love, Katie M

    2016-08-01

    To reduce the risk of catheter-associated urinary tract infection (CAUTI), limiting use of indwelling catheters is encouraged with alternative collection methods and early removal. Adverse effects associated with such practices have not been described. We also determined if CAUTI preventative measures increase the risk of catheter-related complications. We hypothesized that there are complications associated with early removal of indwelling catheters. We described complications associated with indwelling catheterization and intermittent catheterization, and compared complication rates before and after policy updates changed catheterization practices. We performed retrospective cohort analysis of trauma patients admitted between August 1, 2009, and December 31, 2013 who required indwelling catheter. Associations between catheter days and adverse outcomes such as infection, bladder overdistention injury, recatheterization, urinary retention, and patients discharged with indwelling catheter were evaluated. The incidence of CAUTI and the total number of catheter days pre and post policy change were similar. The incidence rate of urinary retention and associated complications has increased since the policy changed. Practices intended to reduce the CAUTI rate are associated with unintended complications, such as urinary retention. Patient safety and quality improvement programs should monitor all complications associated with urinary catheterization practices, not just those that represent financial penalties. PMID:27657581

  2. Catheter Embolization

    Science.gov (United States)

    ... Comment: E-mail: Area code: Phone no: Images × Image Gallery Radiologist and patient consultation. View full size with caption Related Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body Uterine Fibroid Embolization ( ...

  3. Risk factors for central venous catheter-related infections in NICU%NICU患者中心静脉导管相关性感染的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王法欣

    2013-01-01

    目的 控制神经重症监护病房(NICU)患者中心静脉导管相关性感染的危险因素.方法 收集自2007-2011年入住NICU并进行中心静脉导管置管的患者资料,按照是否发生中心静脉导管感染进行分组,使用logistic回归分析方法明确NICU患者发生中心静脉导管相关性感染的危险因素.结果 自2007-2011年NICU进行中心静脉置管778例次,发生中心静脉导管感染175例次,发生率为22.4%,发生中心静脉导管相关性感染的平均时间9.1d;送检导管中病原菌检出阳性率为40.2%,导管血送检病原菌检出率为42.5%;logistic回归分析结果显示,糖尿病史及置入三腔导管进入最终的回归模型,OR值分别为3.777、9.094和7.342.结论 NICU患者中心静脉导管相关性感染的发病率高,中重度昏迷、糖尿病史及置入三腔导管是发生中心导管相关性感染的危险因素,建议临床对该类患者进行重点防护.%OBJECTIVE To identify the risk factors of central venous catheter-related infections in neurosurgery intensive care unit (NICU). METHODS We recruited the patients with central venous catheter-related infections in NICU from 2007 to 2011. The patients were divided according to the status of the infections, the logistic regression analysis method was employed to define the risk factors for the central venous catheter-related infections. RESULTS Of 778 case-time of patients who underwent central venous catheterization during 2007 - 2011, the centralvenous catheter-related infections occurred in 175 case-times of patients with the incidence rate of 22. 4% , the median time to onset of central venous catheters related infections was 9. 1 days. The positive rate of the pathogens isolated from submitted catheters was 40. 2%, 42. 5% of the submitted catheter blood. Logistic regression analysis showed that three factors including the history of diabetes mellitus and use of three-cavity catheter entered the final regression

  4. 小儿心脏术后中心静脉导管相关性感染与导管留置时间关系的探讨%Probe into relationship between central venous catheter related infection and catheter indwelling time in children af-ter pediatric cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    陈桂花; 陈付萍; 吴兰华

    2015-01-01

    [目的]探讨小儿心脏术后中心静脉导管相关性感染与导管留置时间的关系,期望能够找到置管最安全的留置时间,指导临床合理拔管,降低置管相关性感染的发生率。[方法]进行心脏直视手术的334例先心病患儿的临床资料进行回顾性分析,并对中心静脉导管相关性感染与导管留置时间的关系进行总结。[结果]334例先心病患儿均按实际病情拔除导管,其中3 d 内拔除219例,占65.56%,导管感染率为7.76%(17/219);99例在4 d~6 d 内拔出,占29.64%,导管感染率为20.20%(20/99);7 d~10 d 内拔除16例,占4.79%,导管感染率为31.25%(5/16)。[结论]随着导管留置时间的延长,导管相关性感染发生率逐渐升高,并且多组之间的比较差异有统计学意义(P <0.01)。小儿心脏外科术后适宜的置管时间应在3 d 内,可以显著减少导管相关性感染的发生。%Objective:To probe into the relationship between central venous catheter related infection and cathe-ter indwelling time in patients after pediatric cardiac surgery,in order to find the most safe indwelling time,to guide clinical rational extubation and reduce the incidence of the catheter related infections.Methods:The clinical data of 334 cases with congenital heart disease were retrospectively analyzed.And the relationship between cen-tral venous catheter related infection and catheter indwelling time was summarized.Results:The catheter in all 334 cases with congenital heart disease was removed based on the actual condition.The catheter in 21 9 cases was removed in 3 days,accounting for 65.56%,the infection rate was 7.76% (17/21 9).The catheter in 99 cases was pulled out in 4 6 days,accounting for 29.64% and the infection rate was 20.20% (20/99).1 6 cases were extracted from 7 to 10 days,accounting for 4.79%.The infection rate was 31.25% (5/1 6).Conclusion:With the prolonging of indwelling time,the incidence of catheter related infection

  5. Diferença de tempo de positividade: método útil no diagnóstico de infecção de corrente sanguínea relacionada com cateter? Differential time to positivity: a useful tool for the diagnosis of catheter-related infections?

    Directory of Open Access Journals (Sweden)

    Karoline de Lemes Giuntini Corrêa

    2012-06-01

    Full Text Available INTRODUÇÃO: As infecções de corrente sanguínea relacionadas com cateter (ICSRCs apresentam impacto significativo na morbidade e na mortalidade de pacientes internados, além de elevar custos hospitalares. A utilização de equipamentos automatizados no processamento de hemoculturas gerou uma alternativa para diagnóstico de ICSRC por meio da análise da diferença de tempo de positividade (DTP entre hemoculturas pareadas (coletadas simultaneamente de sangue periférico e sangue de cateter. Um diagnóstico acurado e rápido dessas infecções pode otimizar as condutas clínicas e terapêuticas, poupando a retirada precoce dos cateteres. OBJETIVOS: Avaliar na rotina a DTP como ferramenta auxiliar no diagnóstico de ICSRC e determinar os principais microrganismos isolados. MÉTODOS: Foram avaliadas retrospectivamente hemoculturas coletadas no complexo do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP de maio a agosto de 2008. Somente amostras que apresentaram DTP maior que 120 minutos foram consideradas possíveis ICSRCs pelo critério laboratorial. RESULTADOS: A seção processou 11.017 hemoculturas aeróbias durante o período de estudo; somente 5% foram coletadas de forma pareada. Destas, 148 (28% foram positivas, sendo 9% com crescimento somente em sangue periférico, 41% somente em sangue de cateter e 50% em ambas as amostras com 88% de homologia de microrganismos identificados. A DTP apresentou valores acima de 120 minutos em 50% dos casos e os microrganismos mais isolados foram Staphylococcus aureus (22%, Candida spp. (18%, Klebsiella spp. (7% e Enterobacter spp. (7%. CONCLUSÃO: A determinação da DTP como ferramenta auxiliar no diagnóstico de ICSRC é viável e fácil de ser executada em laboratórios de rotina com automação, porém o processo de coleta das amostras pareadas deve ser rigidamente padronizado.INTRODUCTION: Not only do catheter related bloodstream infections (CRBSIs have

  6. Going with the flow or swimming against the tide: should children with central venous catheters swim?

    Science.gov (United States)

    Miller, Jessica; Dalton, Meghan K; Duggan, Christopher; Lam, Shirley; Iglesias, Julie; Jaksic, Tom; Gura, Kathleen M

    2014-02-01

    Children who require long-term parenteral nutrition (PN) have central venous catheters (CVCs) in place to allow the safe and effective infusion of life-sustaining fluids and nutrition. Many consider recreational swimming to be a common part of childhood, but for some, the risk may outweigh the benefit. Children with CVCs may be at increased risk of exit site, tunnel, and catheter-related bloodstream infections (CRBSIs) if these catheters are immersed in water. The purpose of this review is to evaluate the current literature regarding the risk of infection for patients with CVCs who swim and determine if there is consensus among home PN (HPN) programs on this controversial issue. A total 45 articles were reviewed and 16 pediatric HPN programs were surveyed regarding swimming and CVCs. Due to the limited data available, a firm recommendation cannot be made. Recreational water associated outbreaks are well documented in the general public, as is the presence of human pathogens even in chlorinated swimming pools. As a medical team, practitioners can provide information and education regarding the potential risk, but ultimately the decision lies with the parents. If the parents decide swimming is worth the risk, they are encouraged to use products designed for this use and to change their child's dressing immediately after swimming. Due to our experience with a fatal event immediately after swimming, we continue to strongly discourage patients with CVCs from swimming. Further large and well-designed studies regarding the risk of swimming with a CVC are needed to make a strong, evidence-based recommendation.

  7. Antimicrobial activity and cytocompatibility of silver nanoparticles coated catheters via a biomimetic surface functionalization strategy

    Directory of Open Access Journals (Sweden)

    Wu K

    2015-12-01

    Full Text Available Ke Wu,1 Yun Yang,2,3 Yanmei Zhang,2,3 Jiexi Deng,1 Changjian Lin2,31Department of Cardiology, The Affiliated Dongnan Hospital of Xiamen University, Zhangzhou, 2Department of Medical Materials, Beijing Medical Implant Engineering Research Center, Beijing Naton Technology Group, Beijing, 3State Key Laboratory of Physical Chemistry of Solid Surfaces, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, People’s Republic of ChinaAbstract: Catheter-related bloodstream infections are a significant problem in the clinic and may result in a serious infection. Here, we developed a facile and green procedure for buildup of silver nanoparticles (AgNPs on the central venous catheters (CVCs surface. Inspired by mussel adhesive proteins, dopamine was used to form a thin polydopamine layer and induce AgNPs formation without additional reductants or stabilizers. The chemical and physicochemical properties of AgNPs coated CVCs were characterized by scanning electron microscopy, X-ray photoelectron spectroscopy, Raman spectroscopy, and water contact angle. The Staphylococcus aureus culture experiment was used to study the antibacterial properties. The cytocompatibility was assessed by water soluble tetrazolium salts (WST-1 assay, fluorescence staining, and scanning electron microscopy analysis. The results indicated that the CVCs surface was successfully coated with compact AgNPs. AgNPs were significantly well separated and spherical with a size of 30–50 nm. The density of AgNPs could be modulated by the concentration of silver nitrate solution. The antibacterial activity was dependent on the AgNPs dose. The high dose of AgNPs showed excellent antibacterial activity while associated with increased cytotoxicity. The appropriate density of AgNPs coated CVCs could exhibit improved biocompatibility and maintained evident sterilization effect. It is promising to design mussel-inspired silver releasing CVCs with both

  8. Concurrent use of pigtail and loop snare catheters for percutaneous retrieval of dislodged central venous port catheter.

    Science.gov (United States)

    Chuang, Ming-Tsung; Wu, Ding-Kwo; Chang, Cheng-Ang; Shih, Ming-Chen Paul; Ou-Yang, Fu; Chuang, Chien-Han; Tsai, Yi-Fan; Hsu, Jui-Sheng

    2011-11-01

    The purpose of this study was to report our experience of percutaneous retrieval of dislodged port catheters with concurrent use of pigtail and loop snare catheters. During a 5-year period at our institute (June 2005 to July 2010), a total of 23 dislodged port catheters were retrieved. The interval between port catheter implantation and dislodged catheter retrieval ranged from 43 days to 1,414 days (mean 586.7 days). The time of delayed retrieval ranged from 1 day to 45 days (mean 4.6 days). All dislodged catheters were retrieved with the concurrent use of pigtail and loop snare catheters via femoral venous route. The prevalence of port catheter dislodgement at our institute was 3.4%. All dislodged port catheters were removed successfully with pigtail and loop snare catheters together. No procedure-related complications were encountered, except for transient arrhythmia in two patients, which required no medication. In conclusion, the concurrent use of pigtail and loop snare catheters is a feasible and easy way for percutaneous retrieval of a dislodged central venous port catheter.

  9. Placing of tunneled central venous catheters prior to induction chemotherapy in children with acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Møller, Jens Kjølseth; Frydenberg, Morten;

    2010-01-01

    BACKGROUND: Tunneled central venous catheters (CVCs) are inevitable in children with acute lymphoid leukemia (ALL). The aim of this study was to evaluate the risk of CVC-related complications in children with ALL in relation to timing of catheter placement and type of catheter. PROCEDURE: All...... children hospitalized from January 2000 to March 2008 with newly diagnosed ALL and with double-lumen total implantable devices (TIDs) or tunneled external catheters (TEs) were included retrospectively. We only used data related to the patient's first catheter. RESULTS: We included 98 children; 35 received...... a TID and the remaining 63 received a TE. A total number of 29,566 catheter days and 93 catheter-associated blood stream infections (CABSI) was identified. We found a CABSI rate of 3.1/1,000 catheter days (5.4/1,000 catheter days for TEs and 1.4/1,000 catheter days for TIDs, incidence rate ratio (IRR) 3...

  10. Potential Misclassification of Urinary Tract-Related Bacteremia Upon Applying the 2015 Catheter-Associated Urinary Tract Infection Surveillance Definition From the National Healthcare Safety Network.

    Science.gov (United States)

    Greene, M Todd; Ratz, David; Meddings, Jennifer; Fakih, Mohamad G; Saint, Sanjay

    2016-04-01

    The Centers for Disease Control and Prevention recently updated the surveillance definition of catheter-associated urinary tract infection to include only urine culture bacteria of at least 1 × 10(5) colony-forming units/mL. Our findings suggest that the new surveillance definition may fail to capture clinically meaningful catheter-associated urinary tract infections.

  11. Risk of bloodstream infection in children admitted to paediatric intensive care units in England and Wales following emergency inter-hospital transfer.

    OpenAIRE

    Harron, K.; Mok, Q; Parslow, R.; Muller-Pebody, B; Gilbert, R.; Ramnarayan, P

    2014-01-01

    Purpose Adherence to full sterile procedures may be compromised when central venous catheters are inserted as part of emergency resuscitation and stabilisation, particularly outside the intensive care unit. Half of emergency admissions to paediatric intensive care units (PICU) in the UK occur after stabilisation at other hospitals. We determined whether bloodstream infection (BSI) occurred more frequently in children admitted to PICU after inter-hospital transfer compared to within-hospital a...

  12. 2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adult.

    Science.gov (United States)

    Capdevila, J A; Guembe, M; Barberán, J; de Alarcón, A; Bouza, E; Fariñas, M C; Gálvez, J; Goenaga, M A; Gutiérrez, F; Kestler, M; Llinares, P; Miró, J M; Montejo, M; Muñoz, P; Rodríguez-Creixems, M; Sousa, D; Cuenca, J; Mestres, C A

    2016-08-01

    The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. Short peripheral catheters have been found to be associated with the risk of nosocomial bacteremia resulting in morbidity and mortality. Staphyloccus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been elaborated by a panel of experts of the Spanish Society of Cardiovascular Infections in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy and Spanish Society of Thoracic-Cardiovascular Surgery and aims at define and establish the norm for management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance and registry, diagnosis and treatment of infection, indications for removal and stresses on continuous education as a driver for quality. Implementation of this norm will allow uniformity in usage thus minimizing the risk of infection and its complications. PMID:27580009

  13. Constructing Unit-Specific Empiric Treatment Guidelines for Catheter-Related and Primary Bacteremia by Determining the Likelihood of Inadequate Therapy

    OpenAIRE

    Davis, Megan E.; Anderson, Deverick J.; Sharpe, Michelle; Chen, Luke F.; Drew, Richard H

    2012-01-01

    This study aimed to determine the feasibility of using likelihood of inadequate therapy (LIT), a parameter calculated by using pathogen frequency and in vitro susceptibility for determination of appropriate empiric antibiotic therapy for primary bloodstream infections. Our study demonstrates that LIT may reveal differences in traditional antibiograms.

  14. [Suprapubic catheter insertion].

    Science.gov (United States)

    Neumann, Eva; Schwentner, Christian

    2016-01-01

    The suprapubic catheter enables a percutaneous drainage of urine. The insertion is made superior of the pubic bone through the abdominal wall into the bladder. It allows a permanent drainage of urine bypassing the urethra. The insertion of a suprapubic catheter requires knowledge and expertise. This paper summarizes the basic background and allows to follow the practical application step by step. PMID:26800072

  15. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T. [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey)

    2011-11-15

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  16. Genotypic variation and slime production among blood and catheter isolates of Candida parapsilosis.

    OpenAIRE

    Branchini, M L; Pfaller, M A; Rhine-Chalberg, J; Frempong, T; Isenberg, H D

    1994-01-01

    Candida parapsilosis is an important nosocomial pathogen that can proliferate in high concentrations of glucose and form biofilms on prosthetic materials. We investigated the genotypic diversity and slime production among 31 isolates of C. parapsilosis from individual patients with bloodstream or catheter infections. DNA subtyping was performed by using electrophoretic karyotyping plus restriction endonuclease analysis with BssHII followed by pulsed-field gel electrophoresis. Slime production...

  17. Risk factors of bloodstream infection-related death after liver transplantation%肝移植术后血流感染死亡的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    万齐全; 谢建飞; 叶少军; 刘忠忠; 仲福顺; 周建党; 叶啟发

    2016-01-01

    发生≥3次的血流感染(最多发生了6次).41.12% (44/107)发生血流感染的肝移植受者接受了不恰当的抗感染处理.原发感染部位:腹腔内、肺、尿道、血管内导管、部位不明分别为40、39、3、1、24例.微生物感染类型:革兰氏阳性菌、革兰氏阴性菌、真菌、混合感染分别为28、24、4、51例.102例为院内感染.186株血液标本细菌培养结果显示:84株为革兰氏阳性菌是其主要的致病菌,其中又以肠球菌(31株)及金黄色葡萄球菌(23株)为优势菌株.血流感染病死率为37.38% (40/107),其中因感染性休克死亡35例.(2)影响肝移植受者术后血流感染相关死亡的危险因素分析指标:单因素分析结果显示:受者的性别、供肝来源、感染时体温、病原微生物类型、血清Cr水平、血清Alb水平、外周血WBC、外周血PLT、感染性休克是肝移植术后血流感染死亡的危险因素(x2=5.801,5.920,13.047,12.776,11.366,7.976,25.173,9.289,51.905,P<0.05).多因素分析结果表明:血清Alb水平<30 mg/L和感染性休克是肝移植术后血流感染相关死亡的独立危险因素(OR=5.839,44.983,95%可信区间:1.145~29.767,12.606~160.514,P <0.05).结论 肝移植术后易发生血流感染,血清Alb水平<30mg/L和感染性休克是肝移植术后血流感染相关死亡的独立危险因素.%Objective To investigate the risk factors of bloodstream infection-related death after liver transplantation.Methods The retrospective case-control study was adopted.The clinical data of the 107 patients with bloodstream infection from 365 liver transplantation patients who were admitted to the Third Xiangya Hospital of Central South University (220 patients) and South Central Hospital Affiliated to Wuhan University (145 patients) from January 1,2002 to December 31,2015 were collected.The patients received modified piggyback liver transplantation.The second or third generation celphalosporin or carbapenems antibiotics

  18. PICC导管相关性感染的危险因素分析%Analysis on risk factors of PICC catheter related infections

    Institute of Scientific and Technical Information of China (English)

    王玉

    2014-01-01

    Obj ective:To probe into the risk factors of PICC catheter re-lated infections and improve the clinical medical security.Methods:A to-tal of 353 PICC patients with complete data were collected and they were divided into infection group (30 cases)and not infection group (323 ca-ses)according to whether catheter related infections occurred or not. Single factor analysis was used to investigate differences in risk factors of catheter related infections,and further Logistic regression analysis was used to investigate the independent risk factor of catheter related infec-tions.Results:Two groups of single factor analysis showed that patients in infection group had old age and long tube time,the ratio of diabetes history,application hormone,puncture≥2 or more times,guided by ultra-sound and operator experience<50 times were higher than that in non infection group and all differences were statistical significance (all P<0.05). The albumin level of infection group was lower than that in non infec-tion group,and the difference was statistical significance (P<0.05 ). Multi factor analysis of two groups data showed that the age,tube time, diabetes history,application of hormone,puncture≥2 or more times,op-erators’experience<50 times in infection group were higher than those in non infection group (P< 0.05).Conclusion:Old age,long tube time, diabetes history,application of hormone,puncture≥2 or more times and operators’experience<50 times were the independent risk factors of catheter related infections.%[目的]探讨经外周静脉置入中心静脉导管(PICC)相关性感染的危险因素,以利提高临床医疗安全性。[方法]纳入资料完整的PICC导管置入病人353例,以是否发生导管相关性感染为判断标准分为感染组30例和非感染组323例。采用单因素分析两组间导管相关性感染的危险因素的差异,并进一步通过Logistic回归分析影响导管相关性感染发生的独立危险因素。[结果]两组

  19. Impact of a modified Broviac maintenance care bundle on bloodstream infections in paediatric cancer patients

    Directory of Open Access Journals (Sweden)

    Furtwängler, Rhoikos

    2015-11-01

    Full Text Available Background: During intensive chemotherapy, bloodstream infection (BSI represents an important complication in paediatric cancer patients. Most patients carry a long-term central venous access device (CVAD. Improved maintenance care of these vascular catheters may decrease the risk of BSI.Methods: Intervention study (adapted CVAD prevention protocol with two observation periods (P1: 09-2009 until 05-2011; P2: 09-2011 until 05-2013; prospective surveillance of all laboratory confirmed BSIs. In P2, ready to use sterile NaCl 0.9% syringes were used for CVAD flushing and octenidine/isopropanol for the disinfection of catheter hubs and 3-way stopcocks. Results: During P1, 84 patients were included versus 81 patients during P2. There were no significant differences between the two patient populations in terms of median age, gender, underlying malignancy or disease status (first illness or relapse. Nearly all CVADs were Broviac catheters. The median duration from implantation to removal of the CVAD was 192 days (Inter-quartile-range (IQR; 110–288 days in P1 and 191 days (IQR; 103–270 days in P2. 28 BSI were diagnosed in 22 patients in P1 (26% of all patients experienced at least one BSI and 15 BSI in 12 patients in P2 (15% of all patients. The corresponding results for incidence density (ID were 0.44 (CI95 0.29–0.62 for P1 vs. 0.34 (0.19–0.53 BSI per 100 inpatient days for P2 and for incidence rate (IR 7.76 (5.16–10.86 in P1 vs. 4.75 (2.66–7.43 BSI per 1,000 inpatient CVAD utilization days. In P1, 9 BSI were caused by CoNS vs. only 2 in P2 (IR 2.49; CI95 0.17–4.17 vs. 0.63; CI95 0.08–1.72. In P1 two BSI (7% lead to early removal of the device. During P2 one CVAD was prematurely removed due to a Broviac-related BSI (6.7%.Conclusion: The preventive protocol investigated in this study led to a reduction of BSI in paediatric cancer patients. This result was clinically relevant but – due to insufficient power in a single centre observation

  20. Radiographic signs of non-venous placement of intended central venous catheters in children

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Erin C. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Taylor, George A. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2016-02-15

    Central venous catheters (CVCs) are commonly used in children, and inadvertent arterial or extravascular cannulation is rare but has potentially serious complications. To identify the radiographic signs of arterial placement of CVCs. We retrospectively reviewed seven cases of arterially malpositioned CVCs on chest radiograph. These cases were identified through departmental quality-assurance mechanisms and external consultation. Comparison of arterial cases was made with 127 age-matched chest radiographs with CVCs in normal, expected venous location. On each anteroposterior (AP) radiograph we measured the distance of the catheter tip from the right lateral border of the thoracic spine, and the angle of the vertical portion of the catheter relative to the midline. On each lateral radiograph we measured the angle of the vertical portion of each catheter relative to the anterior border of the thoracic spine. When bilateral subclavian catheters were present, the catheter tips were described as crossed, overlapping or uncrossed. On AP radiographs, arterially placed CVCs were more curved to the left, with catheter tip positions located farther to the left of midline than normal venous CVCs. When bilateral, properly placed venous catheters were present, all catheters crossed at the level of the superior vena cava (SVC). When one of the bilateral catheters was in arterial position, neither of the catheters crossed or the inter-catheter crossover distance was exaggerated. On lateral radiographs, there was a marked anterior angulation of the vertical portion of the catheter (mean angle 37 ± 15 standard deviation [SD] in arterial catheters versus 5.9 ± 8.3 SD in normally placed venous catheters). Useful radiographic signs suggestive of unintentional arterial misplacement of vascular catheters include leftward curvature of the vertical portion of the catheter, left-side catheter tip position, lack of catheter crossover on the frontal radiograph, as well as exaggerated

  1. Auditing urinary catheter care.

    Science.gov (United States)

    Dailly, Sue

    Urinary catheters are the main cause of hospital-acquired urinary tract infections among inpatients. Healthcare staff can reduce the risk of patients developing an infection by ensuring they give evidence-based care and by removing the catheter as soon as it is no longer necessary. An audit conducted in a Hampshire hospital demonstrated there was poor documented evidence that best practice was being carried out. Therefore a urinary catheter assessment and monitoring tool was designed to promote best practice and produce clear evidence that care had been provided. PMID:22375340

  2. Advanced Imaging Catheter: Final Project Report

    Energy Technology Data Exchange (ETDEWEB)

    Krulevitch, P; Colston, B; DaSilva, L; Hilken, D; Kluiwstra, J U; Lee, A P; London, R; Miles, R; Schumann, D; Seward, K; Wang, A

    2001-07-20

    Minimally invasive surgery (MIS) is an approach whereby procedures conventionally performed with large and potentially traumatic incisions are replaced by several tiny incisions through which specialized instruments are inserted. Early MIS, often called laparoscopic surgery, used video cameras and laparoscopes to visualize and control the medical devices, which were typically cutting or stapling tools. More recently, catheter-based procedures have become a fast growing sector of all surgeries. In these procedures, small incisions are made into one of the main arteries (e.g. femoral artery in the thigh), and a long thin hollow tube is inserted and positioned near the target area. The key advantage of this technique is that recovery time can be reduced from months to a matter of days. In the United States, over 700,000 catheter procedures are performed annually representing a market of over $350 million. Further growth in this area will require significant improvements in the current catheter technology. In order to effectively navigate a catheter through the tortuous vessels of the body, two capabilities must exist: imaging and positioning. In most cases, catheter procedures rely on radiography for visualization and manual manipulation for positioning of the device. Radiography provides two-dimensional, global images of the vasculature and cannot be used continuously due to radiation exposure to both the patient and physician. Intravascular ultrasound devices are available for continuous local imaging at the catheter tip, but these devices cannot be used simultaneously with therapeutic devices. Catheters are highly compliant devices, and manipulating the catheter is similar to pushing on a string. Often, a guide wire is used to help position the catheter, but this procedure has its own set of problems. Three characteristics are used to describe catheter maneuverability: (1) pushability -- the amount of linear displacement of the distal end (inside body) relative to

  3. Hemocultivos simultáneos y diagnóstico de sepsis relacionada a catéter Simultaneous haemocultures and diagnosis of catheter-related sepsis

    Directory of Open Access Journals (Sweden)

    G. González-Ávila

    2004-10-01

    Full Text Available Objetivo: determinar el valor diagnóstico de hemocultivos simultáneos. Antecedentes: El criterio clínico no es suficiente para establecer el diagnóstico de infección relacionada a catéter y en retiro por sospecha o el recambio rutinario no son prácticas recomendadas. Sujetos: Se evalúan 164 catéteres empleados para nutrición endovenosa colocados en 127 pacientes con cáncer, a quienes se les tomó una muestra simultánea de sangre a través del catéter y una vena periférica cuando existía sospecha de infección o bien cada 7 a 10 días de permanencia del catéter. Intervenciones: Se calculó la sensibilidad, especificidad y valores predictivos de los hemocultivos como método diagnóstico. El cultivo de punta constituyó el estándar de oro. Resultados: En presencia de un hemocultivo transcatéter positivo con hemocultivo negativo se identificó una sensibilidad de 87,5% y una especificidad de 97,9%, en cambio la presencia de un hemocultivo transcatéter negativo y periférico positivo mostró una sensibilidad de 62,5%. Cuando ambos hemocultivos fueron positivos se identificó correctamente la infección en el 83,3% de los casos con una sensibilidad de 93,7% y una especificidad de 93,9%. La correlación diagnóstica obtenida para ambos hemocultivos positivos fue de 0,87 y de 0,83 cuando el hemocultivo transcatéter fue positivo y el periférico negativo. Conclusiones: La toma de hemocultivos simultáneos tiene un alto valor diagnóstico.Objetive: To determine the diagnosis value of simultaneous blood cultures. Background: The clinical criteria is not enough to establish catheter-related sepsis diagnosis and remotion or replacement of catheter are not necessary. Subjects: We evaluated 164 catheters used for total parenteral nutrition placement in 127 patients with cancer. Simultaneous blood samples -central and peripheral venous- were taken after seven at ten days of permanency or infection suspicion and compared with tip culture

  4. Causes of central venous catheter associated infections and prevention countermeasures%中心静脉导管相关性感染原因分析及预防对策

    Institute of Scientific and Technical Information of China (English)

    桂煜

    2011-01-01

    OBJECTIVE To understand the central venous catheter related infections and to propose preventive measures. METHODS From Apr 2008 to Mar 2010, the causes of 54 patients with deep catheter related infections were analyzed, and the definite preventive measures were taken in accordance with the causes. RESULTS Among 54 patients received the central venous catheterization, the infection of catheter export was found in 5 cases,accounting for 9.3%, 3 cases of catheter-related bloodstream infection, accounting for 5.6%, both of which were recovery after the corresponding disposals. CONCLUSIONS The risk factors of catheter related infections are the inserted time of the catheter,the sites, tle catheter types, the dressing and the nursing care of medical staff. To improve the training of the medical personnel, establish the preventive barrier to a maximum and strictly execute the aseptic manifestation is better propitious to prevent the occurrence of central venous catheter associated infection.%目的 了解中心静脉导管相关性感染的原因及应采取的预防措施.方法 分析医院2008年4月-2010年3月住院的54例深静脉留置管患者发生的导管相关性感染原因,并针对原因采取一定的预防措施.结果 54例行中心静脉置管术的患者中,置管出口部位感染5例,占9.3%;导管相关血流感染3例,占5.6%;经相应处理后均好转.结论 导管相关性感染的危险因素中重要是导管留置时间、插管部位、导管类型、敷料及医务人员操作护理;加强人员教育培训、最大限度的建立防护屏障、严格执行无菌操作等有利于更好的预防中心静脉导管相关性感染的发生.

  5. Haemolyzed samples: responsibility of short catheters.

    Science.gov (United States)

    Raisky, F; Gauthier, C; Marchal, A; Blum, D

    1994-01-01

    The haemolysis of blood samples is a source of error in the electrolytic and enzymatic determination in clinical biochemistry. This circumstance seems dependent on the material used for the venepuncture. In this study we compared three kinds of material in 350 patients who were sampled in the emergency department. This randomized study compared the haemolysis of blood samples collected with stainless steel needles and short catheters, either Teflon FEP (Cathlon Critikon) or polyurethane Vialon (Insyte Becton-Dickinson). Quantification of hemolysis was performed by assay of the optical density of plasma haemoglobin. Results were analysed, after verification of the randomization, by one-way analysis of variance by ranks. This study demonstrated a highly significant relation between occurrence of haemolysis and the sampling material, used according to its technical obligations. Haemolysis occurred frequently when short catheters were used in 42% and 55% of cases with the Teflon and Vialon catheters, respectively. Haemolysis was much less frequent with stainless steel needles (12%). This difference was even more marked for haemoglobin levels above 1.5 milligrams of plasma, where the incidence was 4.2%, 9% and 30%, respectively, for the stainless steel needles, the Teflon catheter and the Vialon catheter. This study induced our emergency department to take more blood samples with a needle, even if an infusion was to be given subsequently, or to take them using a Teflon catheter. PMID:7840428

  6. Dedicated radial ventriculography pigtail catheter

    Energy Technology Data Exchange (ETDEWEB)

    Vidovich, Mladen I., E-mail: miv@uic.edu

    2013-05-15

    A new dedicated cardiac ventriculography catheter was specifically designed for radial and upper arm arterial access approach. Two catheter configurations have been developed to facilitate retrograde crossing of the aortic valve and to conform to various subclavian, ascending aortic and left ventricular anatomies. The “short” dedicated radial ventriculography catheter is suited for horizontal ascending aortas, obese body habitus, short stature and small ventricular cavities. The “long” dedicated radial ventriculography catheter is suited for vertical ascending aortas, thin body habitus, tall stature and larger ventricular cavities. This new design allows for improved performance, faster and simpler insertion in the left ventricle which can reduce procedure time, radiation exposure and propensity for radial artery spasm due to excessive catheter manipulation. Two different catheter configurations allow for optimal catheter selection in a broad range of patient anatomies. The catheter is exceptionally stable during contrast power injection and provides equivalent cavity opacification to traditional femoral ventriculography catheter designs.

  7. Clinical and microbiological characteristics of bloodstream infections in a tertiary hospital in Maceió, Alagoas, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Tereza Freitas Tenório

    2010-04-01

    Full Text Available We observed the clinical and microbiological characteristics of several stages of bloodstream infections (BSI, as well as the mortality attributed to it in a tertiary hospital in the northeast of Brazil (in the city of Maceió, Alagoas. A prospective cohort of 143 patients who had at least one positive blood culture was enrolled in the study. Their clinical evolution was followed up for 30 days from October 2005 to December 2006. The relation among the qualitative variables was verified through Chi-square test. The significance level was 5%. The statistical package adopted was SPSS 15.0 for Windows. Up to the thirtieth day, 30.1% of the patients presented bacteremia and 69.9% developed sepsis.Among these, 20.3% developed severe sepsis and 10.5% septic shock. The mortality attributed to it was 37.8%. In bacteremia, sepsis, severe sepsis, and septic shock conditions, mortality rates were 9.3%, 50%, 65.5%, and 84.6%, respectively. Respiratory (32.2% and urinary (14% sources and the ones related to central venous catheter (14% were prevalent. In the wards 55.12% of the cases developed sepsis, whereas in the intensive care units, the rate was 87.69% (p < 0.05. Chronic renal failure, diabetes melitus, and neuropathy were present in 21.7%, 26.6%, and 29.4% of the cases, respectively. Coagulase-negative Staphylococcus (25.9%, Staphylococcus aureus (21%, and Klebsiella pneumoniae (14% were the most present microorganism in the sample. The high morbidity and mortality rates in this study are attributed to the lack of knowledge on BSI characteristics and on instituted protocols for detection and treatment in early stages.

  8. Surface electrical charge of bloodstream trypomastigotes of Trypanosoma cruzi strains.

    Science.gov (United States)

    de Sousa, M A

    1983-01-01

    Bloodstream trypomastigotes of some Trypanosoma cruzi strains were processed through DEAE-cellulose columns under standardized conditions. The results obtained suggest mainly that these strains present different surface charges, that there are subpopulations of bloodstream trypomastigotes as regards electrical charges and that the broad forms are less negative than the slender ones. PMID:6443631

  9. Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatment.

    Science.gov (United States)

    Zarkotou, O; Pournaras, S; Tselioti, P; Dragoumanos, V; Pitiriga, V; Ranellou, K; Prekates, A; Themeli-Digalaki, K; Tsakris, A

    2011-12-01

    Bloodstream infections (BSIs) caused by Klebsiella pneumoniae carbapenemases (KPC)-producing K. pneumoniae (KPC-KP) are associated with high mortality rates. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with BSIs caused by molecularly confirmed KPC-KP. All consecutive patients with KPC-KP BSIs between May 2008 and May 2010 were included in the study and followed-up until their discharge or death. Potential risk factors for infection mortality were examined by a case-control study. Case-patients were those who died from the BSI and control-patients those who survived. Appropriate antimicrobial therapy was defined as treatment with in vitro active antimicrobials for at least 48 h. A total of 53 patients were identified. Overall mortality was 52.8% and infection mortality was 34%. Appropriate antimicrobial therapy was administered to 35 patients; mortality due to infection occurred in 20%. All 20 patients that received combination schemes had favourable infection outcome; in contrast, seven of 15 patients given appropriate monotherapy died (p 0.001). In univariate analysis, risk factors for mortality were age (p catheter-related bacteraemia (p 0.04), prior surgery (p 0.014) and other therapeutic interventions (p 0.015) were significantly associated with survival. Independent predictors of mortality were age, APACHE II score at infection onset and inappropriate antimicrobial treatment. Among them, appropriate treatment is the only modifiable independent predictor of infection outcome.

  10. Limiting the Number of Lumens in Peripherally Inserted Central Catheters to Improve Outcomes and Reduce Cost: A Simulation Study.

    Science.gov (United States)

    Ratz, David; Hofer, Timothy; Flanders, Scott A; Saint, Sanjay; Chopra, Vineet

    2016-07-01

    BACKGROUND The number of peripherally inserted central catheter (PICC) lumens is associated with thrombotic and infectious complications. Because multilumen PICCs are not necessary in all patients, policies that limit their use may improve safety and cost. OBJECTIVE To design a simulation-based analysis to estimate outcomes and cost associated with a policy that encourages single-lumen PICC use. METHODS Model inputs, including risk of complications and costs associated with single- and multilumen PICCs, were obtained from available literature and a multihospital collaborative quality improvement project. Cost savings and reduction in central line-associated bloodstream infection and deep vein thrombosis events from institution of a single-lumen PICC default policy were reported. RESULTS According to our model, a hospital that places 1,000 PICCs per year (25% of which are single-lumen and 75% multilumen) experiences annual PICC-related maintenance and complication costs of $1,228,598 (95% CI, $1,053,175-$1,430,958). In such facilities, every 5% increase in single-lumen PICC use would prevent 0.5 PICC-related central line-associated bloodstream infections and 0.5 PICC-related deep vein thrombosis events, while saving $23,500. Moving from 25% to 50% single-lumen PICC utilization would result in total savings of $119,283 (95% CI, $74,030-$184,170) per year. Regardless of baseline prevalence, a single-lumen default PICC policy would be associated with approximately 10% cost savings. Findings remained robust in multiway sensitivity analyses. CONCLUSION Hospital policies that limit the number of PICC lumens may enhance patient safety and reduce healthcare costs. Studies measuring intended and unintended consequences of this approach, followed by rapid adoption, appear necessary. Infect Control Hosp Epidemiol 2016;37:811-817. PMID:27033138

  11. Catheter-related thrombosis in children with intestinal failure and long-term parenteral nutrition: How to treat and to prevent?

    NARCIS (Netherlands)

    C.H. van Ommen; M.M. Tabbers

    2010-01-01

    Survival of children with chronic intestinal failure has increased as result of administration of home parenteral nutrition. Crucial for the successful management of home parenteral nutrition is the availability of an adequate central venous access. Venous access can be fraught by episodes of cathet

  12. Central venous catheters and bloodstream infections during induction therapy for acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Bergmann, K.; Hasle, H.; Asdahl, P.;

    2015-01-01

    Introduction: Rehabilitation was introduced back in 1950-60, and has been accepted as part of comprehensive care aimed at patients with cardiac diseases for more than 20 years. There is well established evidence that rehabilitation improves quality of life, and physical and psychological functional...

  13. Bloodstream infections in patients with solid tumors.

    Science.gov (United States)

    Gudiol, Carlota; Aguado, José María; Carratalà, Jordi

    2016-04-01

    Little information is currently available regarding bloodstream infection (BSI) in patients with solid tumors who, for a variety of reasons, are particularly predisposed to develop this condition. In this review we focus on the incidence, epidemiology, clinical features, etiology, antimicrobial resistance, and outcomes of BSI of adult cancer patients with solid tumors. Most episodes of BSI occur in non-neutropenic patients, in whom the site of primary or metastatic tumor often serves as the portal of entry. The urinary tract and the abdomen are the most frequent sources of infection, and cholangitis is the most common recurrent source of BSI. Gram-negative bacilli are becoming the leading cause of BSI in patients with solid tumors, and the rate of multidrug resistance is increasingly being recognized. The case-fatality rate in patients with solid tumors and BSI is high, especially among those with comorbidities, advanced neoplasms, corticosteroid therapy, and shock at presentation.

  14. Outcome of tunneled infusion catheters inserted via the right internal jugular vein

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sung Wook; Do, Young Soo; Choo, Sung Wook; Yoo, Wi Kang; Choo, In Wook [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jae Hyung [Sanggye Paik Hospital, Inje University, Seoul (Korea, Republic of)

    2003-03-01

    To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheter were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted, namely the one case of thrombophlebitis. Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein.

  15. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2010-08-15

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  16. Analysis on the related factors of nosocomial urinary tract infection in elderly inpatients with indwelling catheter%老年患者留置尿管致院内泌尿系感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    杨君; 朱跃平

    2010-01-01

    目的 分析老年患者住院期间留置尿管发生泌尿系感染的相关因素,了解留置尿管老年患者泌尿系感染状况,为预防和控制泌尿系感染提供依据.方法 通过查阅病历、护理记录、尿常规和尿培养等化验报告与科室院内感染小组成员填写的医院获得性感染资料相结合的方法,对某院老年科2008年2月至2010年2月留置尿管老年患者(年龄≥60岁)的泌尿系感染状况进行分析.结果 本组224例留置尿管患者中发生泌尿系感染者82例,占36.5%.留置尿管的老年患者发生泌尿系感染情况与其年龄、性别、留置尿管的时间、尿管的护理措施等因素有关.结论 严格掌握老年患者留置尿管指征,尽量减少老年患者的置管率,缩短置管时间,积极治疗原发病,针对不同感染情况加强管道护理是降低院内泌尿系感染的有效措施.%Objective To explore the current status and related factors of nosocomial urinary tract infection in elderly inpatients with indwelling catheter so as to provide basis for prevention and control of urinary tract infection. Methods Medical records, nursing records, urine routine and urine culture of elderly patients aged 60 or above in a geriatric department from February 2008 to February 2010 were combined with data recorded by nosocomial infection supervisors to analyze the status of urinary tract infection caused by indwelling catheter. Results The rate of urinary tract infection in the 224 objects was 36.5% (82 cases). Factors related to urinary tract infection in elderly inpatients with indwelling catheter were age, gender, days of indwelling catheter use and its nursing care methods. Conclusions Nosocomial urinary tract infection rate can be effectively decreased by restrictedly controlling the use indication of indwelling catheter among elderly patients to minimize their use of such catheter, shortening the days of urinary catheter use, focusing on the control of primary

  17. The analysis of the catheter related infections after endoscopic nanobilly drainage%鼻胆管引流术后的导管相关性感染分析

    Institute of Scientific and Technical Information of China (English)

    曹友红; 王小平; 孔文涛; 文卫

    2015-01-01

    Objective To analysis of the catheter related infections after endoscopic nano-billy drainage(ENBD) based on endoscopic retrograde cholangiopancreatography (ERCP). To study risk factors and preventive strategies of the catheter related infections afte ENBD. Methods The clinical data of 218 cases with ERCP in our hospital were collected from August 2011 to August 2014, which were analyzed retrospectively about infection rate, the corresponding source of infection and bacterial culture results. Results The infection rate of the catheter related infections after ENBD was 7.3%. The source of infection was gastrointestinal tract infection, catheter jam and bile duct. Infection bacterial mainly were klebsiella pneumoniae, E. coli, pseudomonas aeruginosa, enterococcus, staphylococcus aureus and acinetobacter baum-annii. Conclusion The infection rate of the catheter related infections after ENBD is low. The route of infection is retroinfection or blood. Staphylococcus is the main strain of gram-positive bacterias.%目的:了解在经内镜下逆行胰胆管造影术(ERCP)后行鼻胆管引流术(ENBD)的导管感染情况,研究鼻胆管导管感染危险因素及预防策略。方法回顾性分析2011年8月至2014年8月我院收治的218例行ERCP术后放置鼻胆管患者的导管感染率、相应的感染源及感染途径、感染细菌培养结果。结果 ERCP手术放置鼻胆管导管感染率为7.3%,感染源有胃肠道、导管堵塞及胆管自身因素;感染细菌培养结果主要为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、肠球菌及金黄色葡萄球菌、鲍曼不动杆菌。结论逆行胰胆管造影术后鼻胆管引流术后发生鼻胆管导管感染的概率低(7.3%),感染途径主要为胆肠逆行感染及经血、细菌感染以革兰阴性菌为主。

  18. Using QCC to Reduce Peritoneal Dialysis Catheter Related Complications%运用品管圈降低腹膜透析患者导管并发症分析

    Institute of Scientific and Technical Information of China (English)

    惠菊芬; 薛菲; 李红仙; 施敏敏; 王颖

    2014-01-01

    目的:探讨品管圈对提高腹膜透析(简称:腹透)患者透析管维护质量、降低导管相关并发症发生率的作用。方法按品管圈理论进行现状把握、计划拟定、目标设定、要因分析、对策拟定、实施检讨、效果确认、标准化。结果导管堵塞,移位,管周渗漏,相关感染等发生率均下降,且前后差异具有统计学意义(P<0.05)。结论品管圈可以提高透析管维护质量,降低透析管相关并发症发生率;具有主动管理的优点,能够更好地促进临床实际问题的解决,促进透析管维护管理制度、标准化操作流程的建立和完善。%Objective To explore the effect of application of Quality Control Circle(QCC)to improve the quality of maintaining catheter in peritoneal dialysis patients and reduce the rate of catheter related compilation. Methods according to the QCC theory to master states, formulate plans, set goals, analysis, make decisions, re-view implementation confirm the effect and standardize procedure.Results The rates of catheter occlusion, drift, leakage, infection were lower in QCC group thou in non-QCC group( P<0.05) .Conclusions using the QCC to protect and manage the dialysis catheter is good for improving the quality of dialysis tube and reducing the incidence of catheter related compilations.It has the advantage of managing actively, and is a benefit to resolve some denial problems.It is able to contribute to the establishment and improvement of peritoneal dialysis standard operating pro-cedure.

  19. Bloodstream Infections with Mycobacterium tuberculosis among HIV patients

    Centers for Disease Control (CDC) Podcasts

    2010-09-23

    This podcast looks at bloodstream infections with Mycobacterium tuberculosis and other pathogens among outpatients infected with HIV in Southeast Asia. CDC health scientist Kimberly McCarthy discusses the study and why bloodstream infections occur in HIV-infected populations.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/23/2010.

  20. Surface electrical charge of bloodstream trypomastigotes of Trypanosoma cruzi strains

    OpenAIRE

    Maria Auxiliadora de Sousa

    1983-01-01

    Bloodstream trypomastigotes of some Trypanosoma cruzi strains were processed through DEAE-cellulose columns under standardized conditions. The results obtained suggest mainly that these strains present different surface charges, that there are subpopulations of bloodstream trypomastigotes as regards electrical charges and that the broad forms are less negative than the slender ones.Tripomastigotas sanguíneos de algumas cepas de Trypanosoma cruzi foram processadas em colunas de DEAE-celulose s...

  1. Pacientes assintomáticos apresentam infecção relacionada ao cateter venoso utilizado para terapia nutricional parenteral Asymptomatic patients present infection related to the central venous catheter used for total parenteral nutrition

    Directory of Open Access Journals (Sweden)

    Juliana Deh Carvalho Machado

    2009-12-01

    Full Text Available OBJETIVO: Avaliar a freqüência de infecção relacionada ao cateter venoso central em pacientes submetidos a terapia nutricional parenteral. MÉTODOS: Foram analisados os cateteres venosos centrais de pacientes em terapia nutricional parenteral que tiveram a indicação de retirada do cateter venoso central por infecção, alta hospitalar, ou trombose. Os pacientes com infecção foram denominados de Grupo 1 e os demais de Grupo 2. RESULTADOS: Não houve diferença estatisticamente significante quanto ao estado nutricional dos 18 pacientes analisados. Foram analisados 28 cateteres e destes 68% estavam infectados, sendo 72% do Grupo 1 e 28% do Grupo 2 (assintomáticos. No Grupo 1, houve infecção sistêmica em 70% dos casos, já no Grupo 2 a hemocultura foi positiva em 17% dos casos. A colonização por Staphylococcus sp. ocorreu em 48% dos casos, seguida de Candida sp. (21%, Enterococcus faecalis (16%, Pseudomonas aerurginosa (10% e Proteus sp.(5%. CONCLUSÃO: A contaminação de cateter venoso central utilizado para terapia nutricional parenteral é freqüente. Mesmo pacientes assintomáticos recebendo nutrição parenteral têm uma incidência maior de infecção por Candida sp. Portanto é necessária a criação de barreiras que impeçam a colonização destes cateteres venosos centrais, a fim de diminuir a morbimortalidade de pacientes dependentes deste tipo de terapia.OBJECTIVE: The aim of this study was to evaluate the frequency of central venous catheter-related infections in hospitalized patients receiving total parenteral nutrition. METHODS: Central venous catheters were analyzed immediately after removal due to infection, hospital discharge or thrombosis. The patients with catheter-related infection were named Group 1 and the other patients were named Group 2. RESULTS: Eighteen patients were studied. There was no statistically significant difference in nutritional status between the two groups. A total of 28 catheters were analyzed

  2. Bacteriemia relacionada a catéter por Ochrobactrum anthropi Catheter-associated bacteremia caused by Ochrobactrum anthropi

    Directory of Open Access Journals (Sweden)

    Rolando Soloaga

    2009-12-01

    perspiration and sensorium deterioration. He had type 2 diabetes and antecedent of cerebrovascular accident. A double-lumen dialysis catheter was present due to chronic renal insufficiency. An episode of catheter-related bloodstream infection was documented by using Bact-Alert Blood Culture System and Differential-Time-to-Positivity Method for central venous catheter versus peripheral blood cultures (>120 min. Once removed, it was confirmed through Maki semi quantitative technique (>15 FCU. The microorganism was identified by API 20NE and Vitek 1 as Ochrobactrum anthropi.

  3. CLABSI Conversations: Lessons From Peer-to-Peer Assessments to Reduce Central Line-Associated Bloodstream Infections.

    Science.gov (United States)

    Pham, Julius Cuong; Goeschel, Christine A; Berenholtz, Sean M; Demski, Renee; Lubomski, Lisa H; Rosen, Michael A; Sawyer, Melinda D; Thompson, David A; Trexler, Polly; Weaver, Sallie J; Weeks, Kristina R; Pronovost, Peter J

    2016-01-01

    A national collaborative helped many hospitals dramatically reduce central line-associated bloodstream infections (CLABSIs), but some hospitals struggled to reduce infection rates. This article describes the development of a peer-to-peer assessment process (CLABSI Conversations) and the practical, actionable practices we discovered that helped intensive care unit teams achieve a CLABSI rate of less than 1 infection per 1000 catheter-days for at least 1 year. CLABSI Conversations was designed as a learning-oriented process, in which a team of peers visited hospitals to surface barriers to infection prevention and to share best practices and insights from successful intensive care units. Common practices led to 10 recommendations: executive and board leaders communicate the goal of zero CLABSI throughout the hospital; senior and unit-level leaders hold themselves accountable for CLABSI rates; unit physicians and nurse leaders own the problem; clinical leaders and infection preventionists build infection prevention training and simulation programs; infection preventionists participate in unit-based CLABSI reduction efforts; hospital managers make compliance with best practices easy; clinical leaders standardize the hospital's catheter insertion and maintenance practices and empower nurses to stop any potentially harmful acts; unit leaders and infection preventionists investigate CLABSIs to identify root causes; and unit nurses and staff audit catheter maintenance policies and practices. PMID:27031355

  4. When Prostate Cancer Circulates in the Bloodstream

    Directory of Open Access Journals (Sweden)

    Virginie Vlaeminck-Guillem

    2015-10-01

    Full Text Available Management of patients with prostate cancer is currently based on imperfect clinical, biological, radiological and pathological evaluation. Prostate cancer aggressiveness, including metastatic potential, remains difficult to accurately estimate. In an attempt to better adapt therapeutics to an individual (personalized medicine, reliable evaluation of the intrinsic molecular biology of the tumor is warranted, and particularly for all tumor sites (primary tumors and secondary sites at any time of the disease progression. As a consequence of their natural tendency to grow (passive invasion or as a consequence of an active blood vessel invasion by metastase-initiating cells, tumors shed various materials into the bloodstream. Major efforts have been recently made to develop powerful and accurate methods able to detect, quantify and/or analyze all these circulating tumor materials: circulating tumors cells, disseminating tumor cells, extracellular vesicles (including exosomes, nucleic acids, etc. The aim of this review is to summarize current knowledge about these circulating tumor materials and their applications in translational research.

  5. New antibiotic agents for bloodstream infections.

    Science.gov (United States)

    Vergidis, Paschalis I; Falagas, Matthew E

    2008-11-01

    Infections due to multidrug-resistant pathogens have shown a dramatic worldwide increase in prevalence. Bloodstream infections (BSIs) represent an important cause of morbidity and mortality in hospitalised patients. Research in the field led to the introduction of several novel antibiotic agents in the fight against bacterial pathogens. New antibiotics used against Gram-positive bacteria, mainly meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, include daptomycin, linezolid, quinupristin/dalfopristin and semisynthetic lipoglycopeptides. Among the Gram-negative bacteria, extended-spectrum beta-lactamase-producing Enterobacteriaceae as well as highly resistant Pseudomonas and Acinetobacter isolates are of particular concern. Doripenem is a recently approved carbapenem. Polymyxins are reconsidered as valuable therapeutic options for Gram-negative infections. Tigecycline, a glycylcycline, and ceftobiprole, a novel cephalosporin under investigation, have activity both against Gram-positive and Gram-negative organisms. In addition to the above agents, alternative treatment approaches that require further investigation have also been introduced into clinical practice. These include antibiotic lock therapy and continuous intravenous administration of antibiotics. In this article, we review the above treatment options for BSIs based on current clinical evidence. Comparative trials specifically focusing on patients with bacteraemia were generally not performed; however, a proportion of patients from the reported studies did have bacteraemia. PMID:18723329

  6. Efficacy of preventing hemodialysis catheter infections with citrate lock.

    Science.gov (United States)

    Silva, Jorge; Antunes, Jorge; Carvalho, Telmo; Ponce, Pedro

    2012-10-01

    Prevalent use of tunneled dialysis catheters can reach 30%. Infection remains the most serious catheter-related problem. Catheter locks are increasingly used for prevention, but are not yet recommended either by the Food and Drug Association or European Medicines Agency, on the basis of increasing bacterial resistance or lock toxicity. The aim was to test safety and effectiveness of citrate. A prospective, interventional study was conducted to assess the safety and efficacy of a 30% citrate lock in preventing catheter-related bacteremia (CRB). A total of 157 prevalent tunneled catheters were locked with citrate and prospectively followed during a 1-year period. The primary endpoint was first CRB diagnosed according to two of the diagnostic criteria for Catheter Infection of Centers for Disease Control and Prevention (CDC), namely definite and probable infection. The CDC criterion of possible but not proved infection was not considered. This citrate lock cohort (n = 157) had 10 episodes of CRB. We observed 0.49 CRB episodes/1000 patient-days and the mean infection-free catheter day was 130.6 ± 100.9. No clinically relevant adverse events were observed. No proved tunnel or exit site infection was observed and no patients died because of CRB. Catheter obstruction episodes were reported on 69 occasions out of 14 catheters. These results were compared with an historical cohort from a previous study of catheter locking with low-dose gentamicin and did not show significant difference in efficacy. Citrate lock is effective in preventing CRB. No toxicity was observed. The use of citrate lock may have advantages over antibiotic locks: no reported bacterial resistance, lower industrial cost, and less manipulation. PMID:22515732

  7. ICU 血液滤过患者导管相关性感染的调查研究%Investigation on the infection of patients with catheter-related ICU hemofiltration

    Institute of Scientific and Technical Information of China (English)

    李向娟; 韩慧芬; 杨淑霞

    2013-01-01

    Objective to analyse the ICU hemofiltration in patients with catheter related infections of pathogenic types ,causes ,and prevention and treatment measures .Methods our hospital ICU hemofiltration in patients with catheter related infection of pathogenic types of 15 patients ,medical staff hands ,surfaces and environmental equipment monitoring Results were retrospectively analyzed .Results the blood vessel related infection pathogens to staphylococcus aureus ,hemolytic staphylococci ,e .coli ,spore's fixed bacteria is given priority to ,followed by klebsiella pneumoniae ,candida ,pseudomonas aeruginosa .Conclusion medical staff hand hygiene ,the correct catheter nursing measures and the object surface ,the environmental pollution is the main factor of catheter related infections occur ,hand contamina-tion is the main medium ,thus strengthening the training of medical staff hand hygiene ,strict aseptic operation ,maintain the cleanness of environmental health is the basis and key to prevent and control infection effectively .%目的:分析IC U 血液滤过患者导管相关性感染的病原菌类型,发生的原因,以及预防、治疗措施。方法对我院IC U 血液滤过患者发生导管相关性感染的15例患者的病原菌类型、医务人员手、物体表面及环境设备监测结果进行回顾性分析。结果发生血管相关性感染的病原菌以金黄色葡萄球菌、溶血葡萄球菌、大肠埃希菌、孢氏不动菌为主,其次是肺炎克雷伯菌、念珠菌、绿脓杆菌。结论医务人员手卫生、正确的导管护理措施以及物体表面、环境污染是发生导管相关性感染的主要因素,手污染是主要传播媒介,因此加强医务人员手卫生的培训,严格无菌操作,保持环境卫生的清洁是有效预防和控制感染的基础和关键。

  8. Use of an alteplase algorithm for the management of hemodialysis catheter dysfunction.

    Science.gov (United States)

    Abdelmoneim, Ahmed S; Miller, Lisa M; Armstrong, Sean; Sood, Manish M; Wazny, Lori; Chateau, Dan; Vercaigne, Lavern M

    2012-04-01

    Hemodialysis (HD) catheter dysfunction compromises HD adequacy and increases the cost of patient care. Repeated administration of alteplase in HD catheters typically produces only short-term benefits. The purpose of this study was to design, implement, and evaluate the efficacy of an experimental alteplase algorithm to manage HD catheter dysfunction. This was a two-part prospective nonrandomized study. Baseline data of alteplase use and catheter exchange were collected during part 1 of the study. Part 2 consisted of the alteplase algorithm implementation and repeat collection of catheter data. Rates of alteplase use and catheter exchange per 1000 catheter-days were the primary and secondary outcomes of the study. One hundred and seventy-two catheters in 131 patients were followed prospectively during the course of the study. The adjusted relative rate (RR) of alteplase use showed no significant difference between both parts of the study, adjusted RR: 1.10, 95% confidence interval (CI) (0.73-1.65). Similarly, catheter exchange rates were not significantly different over the duration of the study (1.12 vs. 1.03 per 1000 catheter-days). However, waiting time for catheter exchange increased from 20.36 ± 14 days in part 1 to 38.42 ± 28 days in part 2 (P < 0.05). The alteplase algorithm did not significantly reduce alteplase use. This may be partially explained by repeated use of alteplase in part 2, due to longer waiting times for catheter exchange procedures. PMID:22098698

  9. 重症监护病房呼吸机相关肺炎患者血流感染病原菌分布及耐药性分析%The distribution and drug resistance of pathogenic bacteria related to bloodstream infection in patients with ventilator-associated pneumonia at intensive care unit

    Institute of Scientific and Technical Information of China (English)

    陈聪

    2015-01-01

    Objective To analyze the distributions and drug resistance of pathogenic bacteria related to bloodstream infection in patients with ventilator-associated pneumonia ( VAP) at intensive care unit ( ICU) in order to provide the information for reasonable use of antibacterial agents and guide the control and prevention of hospital infection.Methods The pathogenic bacterial identification and drug sensitive test of bacteria were carried out by using an automatic microbial analysis system (VITEK2 COMPACT).WHO-NET5.6 software was used for statistical analysis.Results There were 194 cases with bloodstream infection in 275 patients.The main pathogens were gram negative bacteria,accounting for 50.52%,followed by gram positive bacteria (39.18%) and fungi (10.30%).In gram-negative bacilli,Klebsiella pneumoniae and Escherichia coli were still the main pathogens causing bloodstream infections and highly sensitive to imipenem,meropenem and amikacin.In gram-positive cocci mainly were Staphylococcus epidermidis and Staphylo-coccus aureus and highly sensitive to vancomycin,linezolid and teicoplanin.Conclusion Pathogenic bacteria and multiple drug resist-ant bacteria are detected by ICU.The distribution of pathogenic bacteria and drug resistance of VAP in ICU patients are mastered which is of great significance for rational use of antibiotics.%目的:探讨重症监护病房( ICU)呼吸机相关肺炎( ventilator-associated pneumo-nia,VAP)患者血流感染病原菌分布及耐药情况,为指导医院感染的预防控制和临床合理使用抗生素提供依据。方法使用全自动微生物分析系统( VITEK2 COMPACT)对我院ICU 275例VAP患者的血液标本进行细菌鉴定和药敏试验,运用WHONET5.6软件对微生物检测结果进行统计分析。结果275例VAP患者中有194例发生血流感染,病原菌主要以革兰阴性菌为主,占50.52%;其次为革兰阳性菌(39.18%)和真菌(10.30%)。在革兰阴性杆菌中,

  10. Feasibility and outcome of proximal catheter ileostomy - A pilot study

    Directory of Open Access Journals (Sweden)

    Maulana M Ansari

    2011-01-01

    Full Text Available Background/Aim: Loop ileostomy has high complication rates and causes much patient inconvenience. This study was carried out to evaluate the feasibility and outcome of a proximal catheter ileostomy in place of loop ileostomy in patients treated by intestinal repair and/or resection-anastomosis. Design: Prospective study. Setting: J. N. Medical College Hospital, Aligarh Muslim University, Aligarh, India. Patients and Methods: From November 2006 to November 2009, in all patients treated surgically by primary repair and/or resection-anastomosis of small and/or large bowel, we constructed a catheter ileostomy when a defunctioning proximal protective loop ileostomy was considered advisable. Catheter ileostomy was constructed in the fashion of catheter jejunostomy, with postoperative saline irrigation. Results: Catheter ileostomy was performed in 20 patients in the 3-year period. The mean age of the subjects was 28.6 years and the male: female ratio was 1.86:1. Four patients died of septicemia and multiple organ failure unrelated to catheter ileostomy in the immediate postoperative period. Catheter ileostomy started functioning within 48 hours of the operation, and twice-daily irrigation was found sufficient in 81.25% of the surviving patients. Only one patient developed peritubal leak with mild skin excoriation that cleared within 5 days. Another patient with Koch′s abdomen underwent conversion to loop colostomy on re-exploration for postoperative adhesive obstruction. There was no instance of intestinal leak. Ileostomy wounds closed spontaneously within 7-14 days of catheter removal, and none required formal closure. Hospital stay ranged from 12-35 days (mean: 23 days. Conclusions: Catheter ileostomy is effective in protecting intestinal anastomosis/repair; there is minimal morbidity and no catheter-related leak/mortality, and we recommend the procedure.

  11. Risk factors for peripherally inserted central catheter-related infections in tumor patients and preventive countermeasures%肿瘤患者PICC导管相关性感染的危险因素及预防对策

    Institute of Scientific and Technical Information of China (English)

    单佩佩

    2011-01-01

    OBJECTIVE To explore the risk factors and countermeasures for PICC and catheter-related infections. METHODS A total of 340 cases of patients PICC clinical information were retrospectively analyzed, compared with patients CRI group and group of patients without the CRI infection in gender, age, education level, and the course, chemotherapy drugs, high nutrition with disease, share hormone, operator experience, parts, catheter lien intubation time of differences. RESULTS The infection rate of CRI was 11. 76% , and the single factor test eight variables related with the CRI (P<0. 05), logistic regression analysis indicated that the independent risk factors were in turn, operation experience for less, high nutrition chemotherapy drugs application, catheter lien time was long and older. CONCLUSION PICC is with a high incidence of CRI, through improving the puncture skills and success rate, applying tall nutrition chemotherapy drugs should be strict aseptic operation timely blunt tube, shortening time and improving the indwelling catheter immunity, the CRI can be reduced.%目的 探讨肿瘤患者经外周静脉置人中心静脉导管(PICC)的导管相关性感染(CRI)危险因素及预防对策.方法 回顾性分析340例PICC患者临床资料,比较CRI组与无CRI感染组患者在性别、年龄、病程、应用化疗、高营养药物、激素、基础疾病、操作人员经验、插管部位、导管留置时间等方面的差异.结果 CRI发生率为11.76%,单因素检验8个变量与CRI相关,logistic回归分析筛选出独立危险因素,依次为操作经验少、高营养、化疗药物应用、导管留置时间长、高龄.结论PICC合并CRI的发生率较高,通过提高穿刺技巧和成功率、应用高营养、化疗药物需严格无菌操作及时冲管、缩短导管留置时间、提高机体免疫力,减少CRI发生.

  12. Comparison of relative pressures calculated from PC-MRI and SPIV with catheter-based pressure measurements in a stenotic phantom model

    Science.gov (United States)

    Khodarahmi, Iman; Shakeri, Mostafa; Kotys-Traughber, Melanie; Sharp, Michael K.; Amini, Amir A.

    2012-03-01

    This paper describes an experimental system for validation of an approach to non-invasive determination of pressure gradients in stenotic flows as encountered in peripheral arterial disease. Pressure gradient across a Gaussian-shaped 87% area stenosis phantom was estimated by solving the pressure Poisson equation (PPE) for a steady flow mimicking the blood flow through the human iliac artery. The velocity field needed to solve the pressure equation was obtained using Phase-Contrast MRI (PC-MRI) and Stereoscopic Particle Image Velocimetry (SPIV). Steady flow rate of 46.9 ml/s was used, which corresponds to a Reynolds number of 188 and 595 at the inlet and stenosis throat, respectively (in the range of mean Reynolds number encountered, in-vivo). Results of PC-MRI and SPIV have been compared to the pressures measured directly by a pressure catheter transducer. The reconstructed pressure drop along the centerline overestimates the catheter reference pressure drop by 8.5% and 10.5% for PC_MRI and SPIV methods, respectively.

  13. 肿瘤患者中心静脉导管真菌感染的相关因素分析%Related factors for central venous catheter-related fungal infections in tumor patients

    Institute of Scientific and Technical Information of China (English)

    祖璎玲; 周健; 赵霞; 张小琴; 张龑莉; 房佰俊; 魏旭东; 宋永平

    2013-01-01

    OBJECTIVE To explore the incidence, etiology, and risk factors of central venous catheter (CVC)-related fungal infections in tumor patients so as to propose the effective prevention measures. METHODS The related factors for infections in 200 tumor patients who underwent CVC from Jan to Oct, 2011 were reviewed retrospectively. RESULTS The incidence of CVC-related fungal infections was 15. 0%. There were 26 cases with single CVC-related infections and 4 cases with fungemia. Candida parapsilosis, Candida tropicalis, Candida ruffle monilia , Candida albicans, and Candida glabrata accounted for 53. 3% , 16. 7% > 13. 3%, 10. 0% and 6. 7% , respectively. The gender, age, types of tumor, and surgery were negatively correlated with the incidence of CVC-related infections, the difference in the infection rates between the different sites of catheterization was statistically significant (P<0. 05), the difference in the catheterization duration between the patients with CVC-related infections was statistically significant(P<0. 05) , totally 26 cases with infections were cured after extuba-tion of CVC, 3 of 4 patients with fungemia were cured after the antifungal treatment, and 1 case died of the mixed pulmonary Candida infections. CONCLUSION Candida parapsilosis is the predominant pathogen causing CVC-related fungal infections in the tumor patients. Timely extubation of CVC can effectively prevent catheter-related blood stream infections.%目的 探讨肿瘤患者中心静脉导管(CVC)真菌感染的分布与发生率,分析其相关因素,提出有效的预防改进措施.方法 回顾性分析2011年1-10月医院留置CVC的200例肿瘤患者的感染情况及相关因素.结果 CVC相关性真菌感染发生率为15.0%,其中26例单纯CVC感染(CVC-RI),4例合并真菌血症,其中近平滑假丝酵母菌、热带假丝酵母菌、皱褶假丝酵母菌、白色假丝酵母菌及光滑假丝酵母菌分别占53.3%、16.7%、13.3%、10.0%及6.7%;CVC感染发

  14. Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal

    Science.gov (United States)

    Urbanetto, Janete de Souza; Peixoto, Cibelle Grassmann; May, Tássia Amanda

    2016-01-01

    ABSTRACT Objective: to investigate the incidence of phlebitis and its association with risk factors when using peripheral IV catheters (PIC) and following their removal - (post-infusion phlebitis) in hospitalized adults. Method: a cohort study of 171 patients using PIC, totaling 361 punctures. Sociodemographic variables and variables associated with the catheter were collected. Descriptive and analytical statistical analyses were performed. Results: average patient age was 56.96 and 51.5% of the sample population was male. The incidence of phlebitis was 1.25% while using PIC, and 1.38% post-infusion. The incidence of phlebitis while using PIC was associated with the length of time the catheter remained in place, whereas post-infusion phlebitis was associated with puncture in the forearm. Ceftriaxone, Clarithromycin and Oxacillin are associated with post-infusion phlebitis. Conclusions: this study made it possible to investigate the association between risk factors and phlebitis during catheter use and following its removal. The frequency of post-infusion phlebitis was larger than the incidence of phlebitis with the catheter in place, with Phlebitis Grade III and II being the most frequently found in each of these situations, respectively. Aspects related to post-infusion phlebitis can be explained, given the limited number of studies addressing this theme from this perspective. PMID:27508916

  15. Biofilm formation is a risk factor for mortality in patients with Candida albicans bloodstream infection—Scotland, 2012–2013

    Science.gov (United States)

    Rajendran, R.; Sherry, L.; Nile, C.J.; Sherriff, A.; Johnson, E.M.; Hanson, M.F.; Williams, C.; Munro, C.A.; Jones, B.J.; Ramage, G.

    2016-01-01

    Bloodstream infections caused by Candida species remain a significant cause of morbidity and mortality in hospitalized patients. Biofilm formation by Candida species is an important virulence factor for disease pathogenesis. A prospective analysis of patients with Candida bloodstream infection (n = 217) in Scotland (2012–2013) was performed to assess the risk factors associated with patient mortality, in particular the impact of biofilm formation. Candida bloodstream isolates (n = 280) and clinical records for 157 patients were collected through 11 different health boards across Scotland. Biofilm formation by clinical isolates was assessed in vitro with standard biomass assays. The role of biofilm phenotype on treatment efficacy was also evaluated in vitro by treating preformed biofilms with fixed concentrations of different classes of antifungal. Available mortality data for 134 patients showed that the 30-day candidaemia case mortality rate was 41%, with predisposing factors including patient age and catheter removal. Multivariate Cox regression survival analysis for 42 patients showed a significantly higher mortality rate for Candida albicans infection than for Candida glabrata infection. Biofilm-forming ability was significantly associated with C. albicans mortality (34 patients). Finally, in vitro antifungal sensitivity testing showed that low biofilm formers and high biofilm formers were differentially affected by azoles and echinocandins, but not by polyenes. This study provides further evidence that the biofilm phenotype represents a significant clinical entity, and that isolates with this phenotype differentially respond to antifungal therapy in vitro. Collectively, these findings show that greater clinical understanding is required with respect to Candida biofilm infections, and the implications of isolate heterogeneity. PMID:26432192

  16. The changing epidemiology of Staphylococcus aureus bloodstream infection

    DEFF Research Database (Denmark)

    Galbraith, J.C.; Valiquette, G.; Kennedy, K.J.;

    2013-01-01

    Clin Microbiol Infect ABSTRACT: Although the epidemiology of Staphylococcus aureus bloodstream infection (BSI) has been changing, international comparisons are lacking. We sought to determine the incidence of S. aureus BSI and assess trends over time and by region. Population-based surveillance...... episodes of S. aureus BSI were identified. The overall annual incidence rate for S. aureus BSI was 26.1 per 100 000 population, and those for methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) were 24.2 and 1.9 per 100 000, respectively. Although the overall incidence...... of community-onset MSSA BSI (15.0 per 100 000) was relatively similar across regions, the incidence rates of hospital-onset MSSA (9.2 per 100 000), community-onset MRSA (1.0 per 100 000) and hospital-onset MRSA (0.8 per 100 000) BSI varied substantially. Whereas the overall incidence of S. aureus BSI did...

  17. Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Trelha Gauna

    2013-08-01

    Full Text Available Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3% patients started dialysis due to urgency, 37 (62.7% had BSI, and 12 (20% died. Hyperemia at the catheter insertion site (64.9% was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases, non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes, and Candida species (6. Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units.

  18. Analysis of integrated ICU catheter associated nosocomial infection and related factors%综合性ICU导管相关性医院感染及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    范红莉

    2016-01-01

    Objective:To explore the integrated ICU catheter associated nosocomial infection and related factors.Methods:320 patients with integrated ICU catheter associated nosocomial infection were selected.The clinical data were retrospectively analyzed.Results:The positive rate of blood flow infection,pulmonary infection and urinary tract infection was 22.81%,51.56% and 25.63% respectively,and the positive rate of pulmonary infection was the highest(P0.05).Conclusion:Pulmonary infection was the most in integrated ICU catheter associated nosocomial infection,and gram negative bacteria were the main pathogens.Catheter associated nosocomial infection may not be an independent risk factor for mortality.%目的:探讨综合性ICU导管相关医院感染和相关因素。方法:收治综合性ICU导管相关性医院感染患者320例,回顾性分析临床资料。结果:血流感染、肺部感染及尿路感染阳性检出率分别为22.81%、51.56%及25.63%,其中,肺部感染阳性率最高(P<0.01)。革兰阴性菌、革兰阳性菌及假丝酵母菌构成比分别为67.81%、16.88%及15.31%,其中,革兰阴性菌构成比最高(P<0.01)。血流感染、肺部感染及尿路感染患者中死亡率分别为16.44%、15.76%及13.41%(P>0.05)。结论:ICU导管相关性医院感染以肺部感染为主,革兰阴性菌为主要病原菌。导管相关性医院感染可能并非影响死亡率的独立危险因素。

  19. Epidemiological investigation of catheter related infections in neonatal intensive car unit (NICU)%NICU 导管相关性感染的流行病原学调查

    Institute of Scientific and Technical Information of China (English)

    王礼周; 户风莉; 谭秀兰; 陈佳楠; 吴夏萍

    2016-01-01

    OBJECTIVE To investigate the distribution of pathogenic bacteria of catheter related infections in the hospital NICU,so as to provide theoretical guidance and basis for clinical treatment.METHODS A total of 1051 cases of children admitted to hospital NICU from Jun.2014 to Jun.2015 were under retrospectively analysis.The catheter-related infection rate and pathogenic bacteria distribution were analyzed.SPSS 16.0 was used for statistic analysis.RESULTS There were 102 cases of nosocomial infections in 1051 cases of newborns,and the infection rate was 9.71%,among which 19 cases had catheter-related blood stream infection (CRBSI)and 9 cases had vent-ilator-associated pneumonia (VAP);CRBSI and VAP incidence rates decreased with the increasing birth weight of newborns,and the difference was significant (P <0.05).A total of 28 strains of pathogenic bacteria were isolated from the 28 cases of newborns,mainly gram-negative bacteria,totally 23 strains,accounting for 82.14%. CONCLUSION Most of the catheter-related infections happens because of intravenous nutrition to the children and mechanical ventilation,and the risk factor associated with infections is birth weight.The main pathogens related to catheter are Klebsiella,Pseudomonas aeruginosa and Staphylococcus,which should be given attention in clinic.%目的:探讨医院新生儿重症监护病房(NICU)中导管相关性感染病原菌分布情况,为临床治疗提供理论指导依据。方法回顾性分析2014年6月-2015年6月在医院 NICU 收治1051例新生儿,分析导管相关的感染率、病原菌的分布情况,数据采用 SPSS 16.0软件进行统计分析。结果1051例新生儿发生医院感染102例,感染率为9.71%,其中发生导管相关性血流感染(CRBSI)19例,发生呼吸机相关性肺炎(VAP)9例;CRBSI 和 VAP发生率随着新生儿出生时体质量的增加而降低,差异有统计学意义(P <0.05);28例新生儿共检出28株病原菌,

  20. 综合重症监护病房肠杆菌科细菌致血流感染发生的危险因素%Risk factors of bloodstream infections caused by enterobacteriaceae and related prognostic factors in general intensive care unit

    Institute of Scientific and Technical Information of China (English)

    孙伏喜; 冯旰珠; 高天明; 张扬; 赵水娣

    2014-01-01

    目的 探讨综合监护病房医院获得性肠杆菌科细菌血流感染(BSI)的危险因素.方法回顾性分析南京医科大学第二附属医院重症医学科综合监护病房2007年1月至2012年12月间南京医科大学第二附属医院重症医学科获得性肠杆菌科及非肠杆菌科细菌BSI患者的临床资料,分析肠杆菌科细菌BSI发生的危险因素,并以是否存活作为预后判定的终点指标,对肠杆菌科细菌BSI分别进行单因素及多因素Logistic回归分析,探究影响其存活的相关因素.结果 在96例医院获得性血流感染患者中35例为肠杆菌科细菌BSI,35例肠杆菌科细菌BSI患者中15例死亡,病死率42.9%;就肠杆菌科与非肠杆菌科细菌BSI患者的基础及临床特征对比后发现,影响肠杆菌科细菌BSI发生的危险因素包括急性胰腺炎、接受腹部手术及使用制酸剂(17.1%比4.9%,31.4%比16.4%,77.1%比45.9%;P<0.05 或0.01).对肠杆菌科细菌BSI患者生存组和死亡组各项特征的单因素分析及多因素Logistic回归分析发现,对肠杆菌科细菌BSI患者存活的影响因素包括患者年龄、APACHEⅡ评分、气管插管或切开及ESBL阳性(P<0.05).结论 在入住综合监护病房的患者中,急性胰腺炎、接受腹部手术及使用制酸剂的患者更易罹患肠杆菌科细菌BSI;而一旦发生细菌BSI,患者的年龄、APACHEⅡ评分、气管插管或切开及ESBLs阳性是影响其预后的重要因素.%Objective To explore the risk factors and its related prognostic factors of hospital-acquired bloodstream infections caused by enterobacteriaceae in general intensive care unit(GICU). Methods The clinical data of hospital-acquired bloodstream infections caused by enterobacteriaceae in general intensive care unit from January 2007 to December 2012 were retrospectively analyzed to determine the risk factors and explore the related prognostic factors of bloodstream infections by mono-factor and Logistic regression

  1. Usefulness of multifunctional gastrointestinal coil catheter for colorectal stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae-Hyung; Shin, Ji Hoon; Kim, Jin Hyoung; Lim, Jin-Oh; Kim, Kyung Rae [Asan Medical Center, Radiology and Research Institute of Radiology, Seoul (Korea); Song, Ho-Young [Asan Medical Center - Radiology, Songpa-gu, Seoul (Korea); Park, In Kook [Dongguk University, Life Science, Seoul (Korea); Choi, Eugene K. [Weill Medical College of Cornell University, New York, NY (United States)

    2008-11-15

    The purpose of this study was to evaluate the usefulness of a multifunctional gastrointestinal coil catheter for stent placement in 98 patients with colorectal strictures. The catheter was used in 98 consecutive patients for stent placement in the rectum (n = 24), recto-sigmoid (n = 13), sigmoid (n = 38), descending (n = 6), transverse (n = 11), splenic flexure (n = 3), hepatic flexure (n = 2), and ascending (n = 1) colon. The catheter was made of a stainless steel coil (1.3 mm in inner diameter), a 0.4-mm nitinol wire, a polyolefin tube, and a hemostasis valve. Usefulness of the catheter was evaluated depending on whether the catheter could pass a stricture over a guide wire and whether measurement of the stricture length was possible. The passage of the catheter over a guide wire beyond the stricture was technically successful and well tolerated in 93 (94.9%) of 98 patients. In the failed five patients, it was not possible to negotiate the guide wire due to presence of nearly complete small bowel obstruction. The average length of stricture was 6.15 cm (range, 3 cm to 20 cm) in patients with the colorectal stricture. There were no procedure-related complications. In conclusion, the multifunctional coil catheter seems to be useful in colorectal stent placement. (orig.)

  2. Percutaneous catheter drainage of intraabdominal abscesses and fluid

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kwon, Tae Hee; Yoo, Hyung Sik; Suh, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Young Ho [Cheil General Hospital, Seoul (Korea, Republic of)

    1986-10-15

    Percutaneous catheter drainage has been reported to be an effective method in the management of selected patients with abscess and fluid collection. Its high success rate and relatively low complications make the procedure an alternative to surgery in the individual cases. During past two years percutaneous catheter drainage in 25 patients with intraabdominal abscesses and fluid collection was performed at the Department of Radiology, Yonsei University College of medicine. Here the technique and author's results were summarized. 1. The total 25 patients who had percutaneous catheter drainage are 10 liver abscesses, 3 subphrenic, one subhepatic, 4 renal and perirenal, 2 pelvic, one psoas, one anterior pararenal fluid from acute pancreatitis, one pancreas pseudocyst and 2 malignant tumor necrosis. 2. The modified Seldinger technique used for all cases of abscess and fluid drainage under guidance of ultrasound scan. The used catheters were 10F. Pigtail and 14F. Malecot (Cook c/o) catheters. 3. The abscesses and fluid of 17 patients among 25 were cured by the percutaneous catheter drainage and 4 patients were clinically improved. The catheter drainage was failed in 2 patients and 3 complication were developed. 4. The success rate of this procedure was 91.3%, failure rate was 8.7% and complication rate was 12%.

  3. Genotypic analysis of Acinetobacter bloodstream infection isolates in a Turkish university hospital.

    NARCIS (Netherlands)

    Alp, E.; Esel, D.; Yildiz, O.; Voss, A.; Melchers, W.J.G.; Doganay, M.

    2006-01-01

    Acinetobacter baumannii is a significant pathogen of bloodstream infections in hospital patients that frequently causes single clone outbreaks. We aimed to evaluate the genetic relatedness and antimicrobial susceptibility of Acinetobacter spp. bloodstream isolates, in order to obtain insight into th

  4. Risk factors for central venous catheter-related infections in pediatric intensive care Fatores de risco para as infecções relacionadas ao caracter venoso central em terapia intensiva pediátrica

    Directory of Open Access Journals (Sweden)

    Ricardo Vilela

    2007-01-01

    Full Text Available OBJECTIVES: To identify risk factors for short-term percutaneously inserted central venous catheter-related infections in children and to evaluate the accuracy of a mortality score in predicting the risk of infection. METHOD: After reviewing the charts of patients who developed catheter-related infection in a university hospital's pediatric intensive care unit, we conducted a case-controlled study with 51 pairs. Variables related to patients and to catheter insertion and use were analyzed. Risk factors were defined by logistic regression analysis. The accuracy of the Pediatric Risk of Mortality score to discriminate the risk for infection was tested using the Receiver Operating Characteristic curve. RESULTS: Infection was associated with respiratory failure, patient's length of stay, duration of tracheal intubation, insertion of catheter in the intensive care unit and parenteral nutrition. Insertion site (femoral or internal jugular was unimportant. Multivariate logistic regression analysis identified the following variables. Risk factors included more than one catheter placement (p=0.014 and duration of catheter use (p=0.0013, and protective factors included concomitant antibiotic use (p=0.0005 and an intermittent infusion regimen followed by heparin filling compared to continuous infusion without heparin (p=0.0002. Pediatric Risk of Mortality did not discriminate the risk of infection. CONCLUSIONS: Central parenteral nutrition and central venous catheters should be withdrawn as soon as possible. Femoral vein catheterization carries a risk of infection similar to internal jugular catheterization. The Pediatric Risk of Mortality score should not be used to predict the risk of central catheter-related infections.OBJETIVOS: Identificar fatores de risco para as infecções relacionadas a cateter venoso central de curta permanência, inserido por punção, em crianças e avaliar a eficiência de um escore de mortalidade pediátrica em prever o risco

  5. Mortality in enterococcal bloodstream infections increases with inappropriate antimicrobial therapy

    DEFF Research Database (Denmark)

    Suppli, M.; Aabenhus, R.; Harboe, Z.B.;

    2010-01-01

    Enterococcus species are common in nosocomial bloodstream infections and their incidence is rising. Although well recognized in several serious bacterial infections, the influence of appropriate antimicrobial therapy in enterococcal bacteraemia has not been fully settled. The aim of the study.......7-10), thrombocytopenia (3.9, 1.6-9.3), chronic liver failure (3.3, 1.1-10) and age >/=60 years (2.2, 0.99-5.0). Antibiotics not appropriately covering enterococci are frequently administered empirically in suspected bloodstream infections. Inappropriate antibiotic therapy was an independent risk factor for mortality...

  6. Constitute and antifungal susceptibility of Candida spp . causing blood-stream infection%血流感染假丝酵母菌菌种构成及其药物敏感性

    Institute of Scientific and Technical Information of China (English)

    徐鸣皋; 丁进亚; 徐娟; 孙洁

    2016-01-01

    Objective To analyze the constitute and antifungal susceptibility of Candida spp . causing bloodstream infection in a hospital,so as to provide evidence for the prevention and treatment of bloodstream infection caused by Candida spp .Methods Candida spp . isolated from blood specimens of clinical patients in a hospital between 2009 and 2013 were analyzed retrospectively,the high risk factors for Candida bloodstream infection were analyzed. Results A total of 42 isolates of Candida spp . were isolated from blood specimens of 42 patients between 2009 and 2013,the major was Candida parapsilosis (C.parapsilosis ,n =20,47.62%),followed by C.albicans (n =16, 38.10%),C.tropicalis (n=4,9.52%),and C.glabrata(n=2,4.76%).Candida spp .were mainly distributed in emergency intensive care unit(n=11),departments of urologic surgery (n=9)and cardiothoracic surgery(n=8). The venous catheters of 37 patients(88.10%)were isolated the same Candida spp . as blood culture,the average time from indwelling venous catheters to positive culture of blood and catheters were 31 .47 and 33.18 days respec-tively;the percentage of positive culture for blood and catheters both increased with the prolongation of catheteriza-tion (both P < 0.001 ).Susceptibility rates of Candida spp . to fluconazole and voriconazole were 75.00% -100.00%,to amphotericin B were all 100.00%,to itraconazole varied significantly with different species (0 -87.50%).Conclusion The major Candida strains causing bloodstream infection in this hospital is C.parapsilosis , and is related to the use of intravenous catheters,susceptibility rates to fluconazole,amphotericin B,and voricon-azole are all high.%目的:分析某院假丝酵母菌血流感染菌种构成及其对抗真菌药物的敏感性,为临床预防和治疗假丝酵母菌血流感染提供依据。方法回顾性分析2009—2013年该院临床科室送检血标本中检出的假丝酵母菌,并对假丝酵母菌血流感染的高

  7. Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatment.

    Science.gov (United States)

    Zarkotou, O; Pournaras, S; Tselioti, P; Dragoumanos, V; Pitiriga, V; Ranellou, K; Prekates, A; Themeli-Digalaki, K; Tsakris, A

    2011-12-01

    Bloodstream infections (BSIs) caused by Klebsiella pneumoniae carbapenemases (KPC)-producing K. pneumoniae (KPC-KP) are associated with high mortality rates. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with BSIs caused by molecularly confirmed KPC-KP. All consecutive patients with KPC-KP BSIs between May 2008 and May 2010 were included in the study and followed-up until their discharge or death. Potential risk factors for infection mortality were examined by a case-control study. Case-patients were those who died from the BSI and control-patients those who survived. Appropriate antimicrobial therapy was defined as treatment with in vitro active antimicrobials for at least 48 h. A total of 53 patients were identified. Overall mortality was 52.8% and infection mortality was 34%. Appropriate antimicrobial therapy was administered to 35 patients; mortality due to infection occurred in 20%. All 20 patients that received combination schemes had favourable infection outcome; in contrast, seven of 15 patients given appropriate monotherapy died (p 0.001). In univariate analysis, risk factors for mortality were age (p infection onset (p appropriate antimicrobial treatment (p 0.003), combinations of active antimicrobials (p 0.001), catheter-related bacteraemia (p 0.04), prior surgery (p 0.014) and other therapeutic interventions (p 0.015) were significantly associated with survival. Independent predictors of mortality were age, APACHE II score at infection onset and inappropriate antimicrobial treatment. Among them, appropriate treatment is the only modifiable independent predictor of infection outcome. PMID:21595793

  8. 金黄色葡萄球菌血流感染的临床特征分析%Clinical features of bloodstream infection caused by staphylococcus aureus

    Institute of Scientific and Technical Information of China (English)

    路明; 姚婉贞; 王筱宏; 刘振英

    2011-01-01

    OBJECTIVE To study the clinical characteristics and antimicrobial resistance of bloodstream infections caused by Staphylococcus aureus (SAU). METHODS Patients with bloodstream infections of SAU in our hospital from 2004 to 2008 were retrospectively reviewed. RESULTS All 28 patients had fever and 60. 7% with rigor. 18 cases had metastatic infection and lung was the most common metastasizing site. 85.7% of the patients had variety of vulnerable factors. 39% complicated by septic shock and the total mortality rate was 32.0%. 6 episodes were community acquired and 50. 0% of the primary infection site were from skin or soft tissues. All the six community-acquired SAU isolates were methicillin sensitive S. aureus (MSSA). The other 22 episodes were nosocomial infections, 45. 5% were related with central venous catheters, and 72. 0% of the SAU isolates were methicillin resistant S. aureus (MRSA). All the SAU isolates acquired from community and hospital were resistant to penicillin. CONCLUSION High fever with rigor and metastatic infection are common features of SAU bloodstream infection. MRSA isolates increased gradually with high mortality rate.%目的 了解金黄色葡萄球菌血流感染的临床特征及细菌耐药情况.方法 回顾分析医院2004-2008年由金黄色葡萄球菌所致血流感染患者的临床和微生物学资料.结果 共28例患者入选,均有发热,60.7%伴寒颤,18例有迁徙灶,肺受累最常见;85.7%的患者存在易感因素,39.0%合并感染性休克,死亡率32.0%;社区感染6例,多以皮肤为原发感染灶(50.0%),均为甲氧西林敏感金黄色葡萄球菌;医院内感染22例,多与中心静脉导管相关(45.5%),72.0%为耐甲氧西林金黄色葡萄球菌(MRSA);社区和医院内感染金黄色葡萄球菌株对青霉素100.0%耐药.结论 金黄色葡萄球菌血流感染多有高热、寒颤伴有迁徙灶,MRSA逐渐增多,导致很高的死亡率.

  9. Neonatal bloodstream infections in a pediatric hospital in Vietnam

    DEFF Research Database (Denmark)

    Kruse, Alexandra Yasmin; Thieu Chuong, D.H.; Phuong, C.N.;

    2013-01-01

    Septicemia and bloodstream infections (BSIs) are major causes of neonatal morbidity and mortality in developing countries. We prospectively recorded all positive blood cultures (BSI) among neonates admitted consecutively to a tertiary pediatric hospital in Vietnam during a 12-month period. Among...

  10. Prevention of nosocomial bloodstream infections in preterm infants

    NARCIS (Netherlands)

    K. Helder MScN (Onno)

    2013-01-01

    textabstractProtecting patients from harm is the overarching theme of the studies presented here. More precisely, this thesis places a focus on the prevention of nosocomial or hospitalacquired bloodstream infections in preterm infants, thus saving them from further harm. A nosocomial infection is an

  11. Analysis of risk factors for swan-ganz intravascular catheter-related infections%CCU患者漂浮导管相关性血流感染的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    谢强丽; 赵初环; 冯霞飞; 李文玉; 郑再星; 吴圣杰

    2016-01-01

    目的 分析心脏重症患者漂浮导管相关性血流感染(CRBSI)的危险因素.方法 连续收集2013年1月—2014年12月入住温州医科大学附属第一医院心脏重症监护室的768例行漂浮导管检查心脏重症患者,患者出现感染征兆时、疑是导管相关性感染或置管时间超过7天拔除导管时均进行导管血培养和尖端5 cm细菌培养.结果 768例患者目标监测3050个导管日,发生导管血流感染23例,CRBSI的千导管日感染发生率为7.5‰,感染率约为3.0%.培养结果 前5位的致病菌是金黄色葡萄球菌、溶血性葡萄球菌、表皮葡萄球菌、白色念珠菌、肺炎克氏菌.患者性别、年龄、是否有糖尿病以及置管期间合用抗生素与导管相关性感染无相关性(P>0.05),患者置管前全身皮肤是否充分清洁、导管留置时间长短与导管相关性感染具有相关性(P0. 05), but the skin of whole body clean or not before catheterization, the length of catheterization had correlation with catheter related infection ( P < 0. 05 ). Multivariate logistic regression analysis showed that the whole bode skin clean before catheterization was the protective factor for CRBSI, and long catheter indwelling time and combined antibiotic treatment during catheterization were the risk factors for CRBSI (P<0. 05). Conclusions The incidence of CRBSI in patients with severe heart disease is related to the catheter indwelling time, and skin clean before indwelling which are able to effectively reduce the incidence of CRBSI. Antibiotic treatment during catheterization is not beneficial for decreasing the incidence of CRBSI.

  12. Detection of mixed microbial biofilms on central venous catheters removed from Intensive care Unit Patients Detecção de biofilmes microbianos mistos em cateters venosos de pacientes de Unidades de Terapia Intensiva

    Directory of Open Access Journals (Sweden)

    Anisio Storti

    2005-09-01

    Full Text Available Central venous catheters from intensive care unit patients were subjected to microbiological methods (semiquantitative culture and scanning electron microscopy in order to assess microbial attachment and correlate it with blood cultures. During the period of the survey, 59 patients with inserted central venous catheters were studied. The type of catheter used was nontunneled, noncuffed, single lumen, made of polyurethane. Blood samples for cultures were collected at the moment of catheter removal. Data on the patient's age, gender, catheter insertion site, and duration of catheterization were also obtained. From 63 catheters tips analysed, 30 (47.6% showed microbial colonization. Infection proved to be more prevalent in 26 (41.3% patients with catheters inserted via subclavia vein than in 2 (3.2% inserted via the jugular vein. Infection was observed more frequently in catheters which were kept in place more than seven days. A. baumannii, Citrobacter freundii, E. aerogenes, P. aeruginosa and S. saprohyticus were isolated as causal agents of catheter-related bloodstream infections. The antimicrobial agent with greater in vitro activity against Gram-negative bacteria was imipenen and against Gram-positive were vancomycin, cefepime, penicillin, rifampin and tetracycline. The SEM analyses revealed biofilms on surfaces of all the catheters examined.Cateteres venosos centrais inseridos em pacientes internados em unidade de terapia intensiva foram avaliados por métodos microbiológicos (cultura semi-quantitativa e microscopia eletrônica de varredura a fim de detectar adesão microbiana e correlacionar com a cultura de sangue. Durante o período de estudo, foram avaliados 59 pacientes com cateter venoso central. A idade dos pacientes, sexo, sítio de inserção e tempo de permanência do cateter foram anotados. O cateter era de poliuretano não tunelizado e de único lúmen. O sangue para cultura foi coletado no momento da remoção do cateter. De 63

  13. Delayed bowel perforation following suprapubic catheter insertion

    OpenAIRE

    Mehta Ajay; Ahmed Shwan J; Rimington Peter

    2004-01-01

    Abstract Background Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion. Case presentation A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter. Conclusion Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with low...

  14. System evaluation of nursing interventions in preventing catheter-related infection after PVCs%外周静脉置管导管相关性感染护理措施预防效果的系统评价

    Institute of Scientific and Technical Information of China (English)

    李芸芸; 余雪梅; 刘明秀

    2016-01-01

    Objective To system evaluate the nursing interventions in preventing catheter -related infection after PVCs.Methods Firstly, all the RCTs, quasi-RCTs and case-control studies that related to the nursing interventions in preventing catheter-related infection after PVCs were searched from the database including Cochrane Library ( issue 12, 2015 ), JBI evidence-based nursing center library, MEDLINE, EMBASE, China biomedical literature database ( time limit from December 2005 to December 2015 ), supplemented by the internet retrieval .Two researchers selected studies according to the inclusive and exclusive criteria.Then, the eligible studies were quality evaluated using the Cochrane handbook and the data were descriptively analyzed .Results The eligible studies included a total of 4 605 patients and were mainly foreign literatures including 3 RCTs, 7 quasi-RCTs and 1 case-control studies.Conclusions The nursing interventions in preventing catheter-related infection should focus on 9 aspects such as catheter location , material, disinfection and fixation .%目的:系统评价减少外周静脉置管导管相关性感染发生率的相关护理措施。方法计算机检索Cochrane图书馆(2015年第12期)、JBI循证护理中心图书馆、MEDLINE、EMBASE、中国生物医学文献数据库( CBM )(检索时限均从2005年12月—2015年12月),辅以互联网络检索;收集所有讨论不同护理干预措施对导管相关性感染发生率影响的随机对照试验、半随机对照试验和病例对照研究;由2名研究员按照纳入和排除标准筛选文献并提取资料,参考Cochrane Handbook 的质量评价标准进行质量评价,对结果仅进行描述性分析。结果主要纳入外文文献,其中含3项随机对照试验、7项半随机对照试验、1项病例对照研究,共4605例患者。结论从置管部位、材质、消毒方式、固定方式等9个方面的护理措施可减少导管相关性感染的发生。

  15. Hydrodynamics of catheter biofilm formation

    CERN Document Server

    Sotolongo-Costa, Oscar; Rodriguez-Perez, Daniel; Martinez-Escobar, Sergio; Fernandez-Barbero, Antonio

    2009-01-01

    A hydrodynamic model is proposed to describe one of the most critical problems in intensive medical care units: the formation of biofilms inside central venous catheters. The incorporation of approximate solutions for the flow-limited diffusion equation leads to the conclusion that biofilms grow on the internal catheter wall due to the counter-stream diffusion of blood through a very thin layer close to the wall. This biological deposition is the first necessary step for the subsequent bacteria colonization.

  16. ICU导尿管相关性尿路感染发生因素与病原学分析%Risk factors and etiology of catheter-related urinary tract infections in patients in ICU

    Institute of Scientific and Technical Information of China (English)

    何群; 张冉; 王敏; 蔡继明; 徐少毅; 董叶丽

    2011-01-01

    目的 探讨医院ICU导尿管相关性尿路感染(CAUTIs)发生因素与病原学分析.方法采用回顾性调查分析医院2008、2009年ICU 87例导尿管相关性尿路感染病例.结果 革兰阴性病原菌占35.9%,以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌为主,分别为11.7%、7.6%、5.5%,革兰阳性菌占24.1%,以粪肠球菌、屎肠球菌、鹑鸡肠球菌为主,分别为4.1%、11.7%、5.5%,真菌占40.0%,以假丝酵母菌属为主;87例患者中,混合性感染36例;各种严重的基础疾病、意识障碍、长时间留置导尿、高效广谱抗菌药物长期或不合理应用、女性、老年均是ICU CAUTIs的主要因素.结论ICU CAUTIs发生与多种因素有关,缩短导尿管留置时间是降低CAUTIs发生率直接措施.%OBJECTIVE To study the risk factors and etiology of urinary catheter related infection of patients in our ICU. METHODS The clinical data of patients with catheter-associated urinary tract infections (CAUTIs) in our department were analyzed retrospectively from 2008 to 2009. RESULTS In ICU, the main risk factors of CAUTIs included severe basic diseases .unconsciousness, indwelling time, the broad spectrum antibiotics use, gender, age and so on. The main Gram-negative bacteria (35. 9%) were Escherichia coli (11. 7%), Pseudomonas aeruginosa (7. 6%) ,Klebsiella pneumoniae (5. 5%), while the main Gram-positive bacteria (24. 1%) included Enterococcus faecalis(24. 1%) ,E. faeciumC24. 1JK)) , E. Gallinarum(2i. 1%) , the main fungi was candida(40. 0%). Among the 87 cases, 36 cases were mixed-infection. CONCLUSION CAUTIs are mostly occurred in ICU, which are . Associated with many factors, to shorten the time for detaining the catheter is the direct measure to reduce the incidence of CAUTIs.

  17. Interventional radiologic placement of tunneled central venous catheters : results and complications in 557 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chan Kyo; Do, Young Soo; Paik, Chul H. [Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)] (and others)

    1999-05-01

    To evaluate prospectively the results of interventional radiologic placement of tunneled central venous catheters, and subsequent complications. Between April 1997 and April 1998, a total of 557 tunneled central venous catheters were percutaneously placed in 517 consecutive patients in an interventional radiology suite. The indications were chemotherapy in 533 cases, total parenteral nutrition in 23 and transfusion in one. Complications were evaluated prospectively by means of a chart review, chest radiography, central vein angiography and blood/catheter culture. The technical success rate for tunneled central venous catheter placement was 100% (557/557 cases). The duration of catheter placement ranged from 4 to 356 (mean, 112{+-}4.6) days; Hickman catheters were removed in 252 cases during follow-up. Early complications included 3 cases of pneumothorax(0.5%), 4 cases of local bleeding/hematoma(0.7%), 2 cases of primary malposition(0.4%), and 1 case of catheter leakage(0.2%). Late complications included 42 cases of catheter-related infection(7.5%), 40 cases of venous thrombosis (7.2%), 18 cases of migration (3.2%), 5 cases of catheter / pericatheter of occlusion(0.8%), and 1 case of pseudoaneurysm(0.2%). The infection rate and thrombosis rate per 1000 days were 1.57 and 1.50, respectively. The technical success rate of interventional radiologic placement of tunneled central venous catheters was high. In comparison to conventional surgical placement, it is a more reliable method and leads to fewer complications.

  18. Misplaced central venous catheters: applied anatomy and practical management.

    Science.gov (United States)

    Gibson, F; Bodenham, A

    2013-03-01

    Large numbers of central venous catheters (CVCs) are placed each year and misplacement occurs frequently. This review outlines the normal and abnormal anatomy of the central veins in relation to the placement of CVCs. An understanding of normal and variant anatomy enables identification of congenital and acquired abnormalities. Embryological variations such as a persistent left-sided superior vena cava are often diagnosed incidentally only after placement of a CVC, which is seen to take an abnormal course on X-ray. Acquired abnormalities such as stenosis or thrombosis of the central veins can be problematic and can present as a failure to pass a guidewire or catheter or complications after such attempts. Catheters can also be misplaced outside veins in a patient with otherwise normal anatomy with potentially disastrous consequences. We discuss the possible management options for these patients including the various imaging techniques used to verify correct or incorrect catheter placement and the limitations of each. If the course of a misplaced catheter can be correctly identified as not lying within a vulnerable structure then it can be safely removed. If the misplaced catheter is lying within or traversing large and incompressible arteries or veins, it should not be removed before consideration of what is likely to happen when it is removed. Advice and further imaging should be sought, typically in conjunction with interventional radiology or vascular surgery. With regard to misplaced CVCs, in the short term, a useful aide memoir is: 'if in doubt, don't take it out'.

  19. Central venous catheter related Infection and risk factors after cardiovascular surgery%心脏外科术后中心静脉导管相关感染致病菌及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    唐闽; 崔岭; 时东彦; 梁宜武; 马千里; 王宪德

    2008-01-01

    目的 研究心脏外科术后中心静脉导管相关感染(CRI)、导管相关性菌血症(CRB)的发生率和菌群分布状况,以及CRI的危险因素,为临床科学管理中心静脉导管,降低CRI、CRB的发病率提供有益的参考.方法 自2005年1月至2005年12月共随机选取在心脏外科手术治疗的300例患者留置的中心静脉导管进行尖端细菌培养,同时进行血培养.结果 300例中35例(11.7%)发生CBI,CBB 5例(1.7%).病原菌菌群分布:革兰阳性球菌占54.3%,革兰阴性杆菌占34.3%.真菌占11.4%.前5位致病菌分别为:表皮葡萄球茵、金黄色葡萄球菌、肺炎克雷白杆菌、铜绿假单胞杆茵、白色念珠菌.CRl、CRB的危险因素包括:原发疾病种类、穿刺置管部位、中心静脉导管留置时间等.中心静脉导管留置时间>6d,感染率明显增加.结论 CBI、CBB是留置中心静脉导管最严重的并发症,旱期诊断、及时合理应用抗生素对降低病死率具有重要的意义.%Objective To investigate the pathogen culturing of the catheter related infection(CRI),cathe-ter related bloodstram infection(CRB)and risk factors after central venous catheter(CVC)of cardiovascular surgery in order to provide the beneficial reference.Methods From Jan 2005 to Dec 2005,a total of 300 cases central ve-nous cathers were determined,and the cusp of the catheters was determined by bacteria cultivation,and blood bacte-ria cultivation.Results The infection happened in 35 of 300 patients with inserted central venous catheter.The cusps of CRI rate was 11.7%.CRB rate was 1.7%.54.3%pathogens were gram-positive cocci,34.3% were gram-negative bacilli,11.4% were fungi.The most common strain were Staphylococcus epidermis,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginose,and Candiadia albicans.The infection rate increased obviously when the dwelling time>6 d.Conclusion CRI and CRB are the most severe complication of CVC,and it is important to cut down the death

  20. Interventional radiological imaging and treatment of port catheter dysfunctions; Angiografische Diagnostik und interventionelle Therapie von Portdysfunktionen

    Energy Technology Data Exchange (ETDEWEB)

    Kausche, S.; Nagel, S.N.; Teichgraeber, Ulf [Charite Universitaetsmedizin Berlin (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2011-03-15

    To evaluate the impact of interventional radiological imaging and treatment of central venous port catheter complications. Materials and Methods: In this retrospective analysis 429 port catheter dysfunctions were evaluated in 393 port catheter systems for a total of 389 patients over a period of 10 years. The study included 193 (49.1 %) patients with radiologically implanted port catheter systems and 200 (50.9 %) referred patients with surgically implanted port systems. Port catheter dysfunctions were subdivided into early and late complications as well as into non-thrombotic and thrombotic events. After administration of contrast medium, the port system was visualized using digital subtraction angiography. Data were retrospectively collected from the in-house databases and then analyzed descriptively. Results: 429 contrast media injections via port catheters were performed in 393 port catheter systems. There were 359 (83.7 %) late complications and 70 (16.3 %) early complications. In 299 (69.7 %) cases thrombotic events occurred and 130 (30.3 %) non-thrombotic events were recorded. The most common reason for contrast media injection via port catheter system was port catheter-related thrombosis in 269 (62.7 %) cases. 70 (16.3 %) catheter migrations and 30 (7.0 %) fibrin sheath formations were detected. 18 (4.2 %) port needle malfunctions could be resolved through needle exchange. All 15 (3.5 %) catheter disconnections had to be revised in all cases. Also six port explantations were performed in 6 (1.4 %) catheter fractures. Conclusion: The possibilities of angiographic imaging and interventional radiological correction of port catheter dysfunctions must be exploited fully in order to avoid premature port explantation. (orig.)

  1. ICU深静脉导管感染的病原菌分布和耐药性分析%Investigation of distribution and drug resistance of pathogenic bacteria causing deep venous catheter related infection in ICU

    Institute of Scientific and Technical Information of China (English)

    李静; 周利霞; 范秋生

    2012-01-01

    Objective To investigate the characteristics of distribution and drug resistance of pathogenic bacteria causing deep venous catheter related infection in ICU.Methods From January 2006 to August 2010,the culture and drug sensitivity test results of 342 deep venous catheter tip from ICU were analyzed retrospectively. Results Among the results of 342 catheter tip cultures,101 strains( 29. 5% )of pathogenic bacteria were detected. The proportion of G+ bacteria,enterobacteria ceae,non-fermentation G- bacteria and fungi was 29 strains( 28.7% ),25 strains( 24. 8% ),33 strains( 32. 6% )and 14 strains ( 13.9% )respectively. The six most common pathogenic bacteria were pseudomonas aeruginosa 20 strains( 19.8% ), Klebsiella pneumonia 12 strains( 11.9% ),Staphylococcus aureus 10 strains( 9. 9% ), Staphylococcus epidermis 8 strains( 7. 9% ),En-terococcus faecium 7 strains( 6. 9% ) and Saccharomyces albicans 7 strains( 6. 9% ). 8 strains( 80. 0% )of Staphylococcus aureus were MRSA,7 strains( 63. 6% )of coagulase negative Staphylococci were MRCNS and 14 strains( 56. 0% )of Enterobacte-riaceae were ESBLs. Most isolated strains were multiple drug resistant. Conclusion The most common pathogens cultured from the deep venous catheter tip in ICU were highly resistant to antibiotics. The clinical micro-organisms laboratory should report the results of bacterial culture and drug susceptibility quickly and accurately for reasonable use of antibiotic drugs in clinical treatment.%目的 探讨ICU深静脉导管感染的病原菌分布和细菌耐药性特征.方法 对2006年1月-2010年8月ICU送检的342例次深静脉导管标本的细菌培养和药敏试验结果进行分析.结果 342份标本中共检出病原菌101株(29.5%):革兰阳性球菌、肠杆菌科、非发酵革兰阴性杆菌和真菌分别为29株(28.7%)、25株(24.8%)、33株(32.6%)和14株(13.9%).病原菌分离率前6位依次为铜绿假单胞菌20株(19.8%)、肺炎克雷伯菌12株(11.9%)

  2. Knowledge of nursing students about central venous catheters

    Directory of Open Access Journals (Sweden)

    Mlinar Suzana

    2012-01-01

    Full Text Available Background/Aim. Central venous catheters (CVC are at the crucial importance, particulary in the intensive therapy units. In order to handle a CVC safely, nursing students need to acquire theoretical and practical knowledge during the course of their studies. The aim of the study was to establish theoretical knowledge of nursing students about the procedures of nurses in placing and removing a central venous catheter (CVC, dressing the catheter entry point, the reasons for measuring central venous pressure (CVP, possible complications and risk factors for developing infections related to CVC. Methods. The questionnaire developed specifically for this cross-sectionl study was handed out to 87 full-time students and 57 part-time students. Results. The results show that all the surveyed nursing students know why chest radiography is carried out when inserting a catheter, have relatively good knowledge of CVC insertion points, procedures carried out in case of a suspected catheter sepsis and complications and risk factors for the development of infections related to CVC. However, the study show that the majority of students have insufficient knowledge of the procedures accompanying insertion of a catheter, signs that indicate correct functioning of CVC, frequency of flushing a catheter when it is not in use and the reasons for introducing an implanted CVC. Conclusion. Based on the results of the study it can be concluded that the second-year nursing students have insufficient knowledge of CVC. In order to correctly and safely handle a CVC, good theoretical knowledge and relevant practical experience are needed. The authors therefore believe that, in future, the classes should be organized in smaller groups with step-by-step demonstrations of individual procedures in handling a CVC, and the students encouraged to learn as actively as possible.

  3. Adverse events related to the use of peripheral intravenous catheters in children according to dressing regimens Eventos adversos relacionados al uso de catéteres intravenosos periféricos en niños según los tipos de curativos Eventos adversos relacionados ao uso de cateteres intravenosos periféricos em crianças de acordo com tipos de curativos

    OpenAIRE

    Ariane Ferreira Machado; Mavilde da Luz Gonçalves Pedreira; Massae Noda Chaud

    2008-01-01

    A randomized, controlled study was implemented to verify reasons to release and adverse events related to the use of peripheral intravenous catheters in children, according to the dressing regimens The sample was set at 150 peripheral intravenous catheters, randomly assigned to three groups: sterile gauze dressings, sterilized transparent film dressings, and non sterile hypoallergenic adhesive tape. The data was collected after consent had been obtained by the Ethics Committee, including chil...

  4. Surface electrical charge of bloodstream trypomastigotes of Trypanosoma cruzi strains

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora de Sousa

    1983-12-01

    Full Text Available Bloodstream trypomastigotes of some Trypanosoma cruzi strains were processed through DEAE-cellulose columns under standardized conditions. The results obtained suggest mainly that these strains present different surface charges, that there are subpopulations of bloodstream trypomastigotes as regards electrical charges and that the broad forms are less negative than the slender ones.Tripomastigotas sanguíneos de algumas cepas de Trypanosoma cruzi foram processadas em colunas de DEAE-celulose sob condições padronizadas. Os resultados obtidos sugerem principalmente que estas cepas possuem cargas superficiais diferentes, que em relação a este aspecto existem subpopulações de tripomastigotas e que as formas largas são menos negativas do que as finas.

  5. Comparison of serum procalcitonin in respiratory infections and bloodstream infections

    OpenAIRE

    Zhu, Yanhui; Yuan, Yulin; Huang, Huayi

    2015-01-01

    Purpose: This study observed the relationship between procalcitonin (PCT) and results of sputum culture, the relationship between PCT and results of blood culture to evaluate and compare the value of PCT in respiratory and bloodstream infections. Methods: We analyzed 1616 patients in which PCT and sputum culture were concurrently ordered and analyzed, and 1096 patients in which PCT and blood culture were concurrently ordered and analyzed from January 2014 to May 2015. PCT concentrations were ...

  6. Candida bracarensis Bloodstream Infection in an Immunocompromised Patient ▿

    OpenAIRE

    Warren, Thomas A.; McTaggart, Lisa; Richardson, Susan E.; Zhang, Sean X.

    2010-01-01

    Candida bracarensis is a recently described Candida species which is phenotypically similar to Candida glabrata. A case of C. bracarensis bloodstream infection in a bone marrow transplant patient is described and confirms this organism as an opportunistic human pathogen. The organism can be distinguished from C. glabrata by its white color on CHROMagar and by DNA sequence analysis using D1/D2 and internal transcribed spacer (ITS) primers.

  7. Molecular Detection of Bloodstream Pathogens in Critical Illness

    OpenAIRE

    Al_griw, Huda Hm

    2012-01-01

    Background: Critically ill patients are at particular risk of developing bloodstream infection. Such infections are associated with the development of sepsis, leading to a marked increase in mortality rate. Early detection of the causative organism and appropriate antibiotic treatment are therefore critical for optimum outcome of patients with nosocomial infection. Current infection diagnosis is based on standard blood culture techniques. However, microbiological culture has a number of limi...

  8. Clonal relationships among bloodstream isolates of Escherichia coli.

    OpenAIRE

    Maslow, J.N.; Whittam, T S; Gilks, C F; Wilson, R A; Mulligan, M E; Adams, K S; Arbeit, R D

    1995-01-01

    The clonal relationships among 187 bloodstream isolates of Escherichia coli from 179 patients at Boston, Mass., Long Beach, Calif., and Nairobi, Kenya, were determined by multilocus enzyme electrophoresis (MLEE), analysis of polymorphisms associated with the ribosomal operon (ribotyping), and serotyping. MLEE based on 20 enzymes resolved 101 electrophoretic types (ETs), forming five clusters; ribotyping resolved 56 distinct patterns concordant with the analysis by MLEE. The isolates at each s...

  9. Bacteriological Profile of Epidural Catheters

    Directory of Open Access Journals (Sweden)

    B. M. Sahay, Sanjot Dahake, D. K Mendiratta*,Vijayshree Deotale*,B. Premendran, P.S.Dhande, Pratibha Narang*

    2010-01-01

    Full Text Available The bacteriological profile of epidural catheters was studied in 88 patients. Skin swabs before catheterizationand before removal of catheter with their controls were cultured in TSB Medium. The catheter hub, theportion at the skin puncture site and at the tip were cultured in TSB Medium. The 1cm of the catheter bitjust before the tip was cultured in TGB medium for anaerobes.Both, the skin controls swabs and theanaerobic culture, were negative. From the remaining, 56 positive cultures were obtained. Staphylococcusepidermidis was the predominant organism in 52% followed by staphylococcus aureus 25%. The remaining23% was shared by Acinetobacter, Pseudomonas, Klebsiella, and E. coli. All the positive cultures fromskin prior to epidural catheterization had turned sterile by 48 hours, indicating continued bactericidal actionof the disinfectant. The likely source of positive skin cultures at 48 hours is hair follicles.The catheter tipculture was positive in 9 specimen, none of which resulted in the formation of epidural abscess. In 3 casesthe cultures of skin puncture site and the tip were identical indicating tracking-in of the organisms.

  10. Central venous catheters in hemodialysis: To accept recommendations or to stick to own experience

    Directory of Open Access Journals (Sweden)

    Stolić Radojica

    2008-01-01

    Full Text Available Backgraund/Aim. Hemodialysis catheter, as an integral part of hemodialysis, is a catheter placed into the jugular, subclavian and femoral vein. The most common catheter-related complications are infections and thrombosis. The aim of the study was to analyze the prevalence of complications associated with differently inserted central-vein catheters for hemodialysis. Methods. The study was organized as a prospective examination during the period from December 2003 to November 2006, and included all patients who needed an active depuration by hemodialysis, hospitalized at the Clinical Center Kragujevac. The subject of the study were 464 centralvein catheters inserted during the mentioned period and there were recorded all complications related to the placement and usage of catheters. Results. The largest percent of inserted catheters was into the femoral vein − 403 (86.8%, significantly less into the jugular vein − 42 (9.2%, while into the subclavian vein there were placed only 19 catheters (4%. The average of femoral catheter functioning was 17 catheter days, in jugular catheters it was 17.3 days while the subclavian catheters had an average rate of functioning of 25.9 catheter days; there was found a statistically significant difference regarding the duration of functioning (p = 0.03. By microbe colonization of smear culture of the skin at the catheter insertion site, in clinically present suspicion of catheter infection, there was obtained a positive finding in 5.5% of catheters placed into the femoral vein and 7.1% of catheters instilled into the jugular vein, of which Staphylococcus aureus was the most important bacterial type, without statistically significant difference (p = 0.51. Haemoculture, done when there was a suspicion of bacteriemia, was positive in 3.7% of the patients with femoral and 4.8% with jugular catheters; Staphylococcus aureus was the most common bacteria type, but there was no statistically significant difference (p

  11. Catheter-based photoacoustic endoscope

    Science.gov (United States)

    Yang, Joon-Mo; Li, Chiye; Chen, Ruimin; Zhou, Qifa; Shung, K. Kirk; Wang, Lihong V.

    2014-06-01

    We report a flexible shaft-based mechanical scanning photoacoustic endoscopy (PAE) system that can be potentially used for imaging the human gastrointestinal tract via the instrument channel of a clinical video endoscope. The development of such a catheter endoscope has been an important challenge to realize the technique's benefits in clinical settings. We successfully implemented a prototype PAE system that has a 3.2-mm diameter and 2.5-m long catheter section. As the instrument's flexible shaft and scanning tip are fully encapsulated in a plastic catheter, it easily fits within the 3.7-mm diameter instrument channel of a clinical video endoscope. Here, we demonstrate the intra-instrument channel workability and in vivo animal imaging capability of the PAE system.

  12. Clinical analysis of multidrug resistant patients with catheter-related blood stream infection%多重耐药致导管相关性血流感染调查分析

    Institute of Scientific and Technical Information of China (English)

    陈萍; 刘丁; 方清永; 王政; 王豪; 成谣; 南玲; 黄庆玲

    2013-01-01

    目的 探讨多重耐药的导管相关性血流感染(catheter-related blood stream infection,CRBSI)发病情况,为制定和采取预防控制措施提供依据.方法 对2011年1月-2012年2月住院患者中多重耐药的导管相关性血流感染病例进行统计分析.结果 导管相关性血流感染发生率4.1%,其多重耐药感染发生率3.0%,主要为革兰阴性菌为91.4%,凝固酶阴性葡萄球菌、肺炎克雷伯菌、肠球菌、鲍曼不动杆菌、大肠埃希菌、耐甲氧西林金黄色葡萄球菌分别在多重耐药中占33.2%、13.6%、10.5%、10.1%、9.3%、6.4%.结论 多重耐药菌对常用抗菌药物几乎全部耐药,重视病原菌监测,对控制多重耐药的导管相关性血流感染及临床合理应用抗菌药物有指导意义.%Objective To investigate the characteristic for catheter-related blood stream infection caused by multidrug resistant bacteria and provide evidence for prevention and controlling measure of MDRB. Methods The statistical analysis of distribution and resistance of multidrug resistant bacteria from characteristic for catheter-related blood stream infection from January 2011 to February 2012 were retrospected. Results Incidence of nosocomial infection in patients with CRBSI was 4.1%. The CRBSI rate among the multidrug resistant bacteria was 3.0% , Most of the pathogens of CRBSI are Gram-negative bacteria for 91.4%, the rates of coagulase negative Staphylococcus, Klebsiella pneumoniae, Enterococcus species, Acinetobacter baunammii complex, Escherichia coli and Staphylococcus aureus in multidrug resistant bacteria were 33.2%, 13.6%, 10.5%, 10.1%, 9.3% and 6.4% respectively. Conclusions The major multiple drug-resistant bacteria are resistant to common-used antimicrobial drugs. Attaching importance to pathogen and drug sensitivity inspection can guide controlling multidrug resistant bacteria of CRBSI and rational using clinical antibiotics.

  13. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Oh, Joo Hyeong; Yoon, Yub; Lee, Tae Won; Ihm, Chun Gyoo [Kyunghee University Hospital, seoul (Korea, Republic of)

    2001-01-01

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416{+-}45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency.

  14. KREX2 is not essential for either procyclic or bloodstream form Trypanosoma brucei.

    Directory of Open Access Journals (Sweden)

    Jason Carnes

    Full Text Available BACKGROUND: Most mitochondrial mRNAs in Trypanosoma brucei require RNA editing for maturation and translation. The edited RNAs primarily encode proteins of the oxidative phosphorylation system. These parasites undergo extensive changes in energy metabolism between the insect and bloodstream stages which are mirrored by alterations in RNA editing. Two U-specific exonucleases, KREX1 and KREX2, are both present in protein complexes (editosomes that catalyze RNA editing but the relative roles of each protein are not known. METHODOLOGY/PRINCIPAL FINDINGS: The requirement for KREX2 for RNA editing in vivo was assessed in both procyclic (insect and bloodstream form parasites by methods that use homologous recombination for gene elimination. These studies resulted in null mutant cells in which both alleles were eliminated. The viability of these cells demonstrates that KREX2 is not essential in either life cycle stage, despite certain defects in RNA editing in vivo. Furthermore, editosomes isolated from KREX2 null cells require KREX1 for in vitro U-specific exonuclease activity. CONCLUSIONS: KREX2 is a U-specific exonuclease that is dispensable for RNA editing in vivo in T. brucei BFs and PFs. This result suggests that the U deletion activity, which is required for RNA editing, is primarily mediated in vivo by KREX1 which is normally found associated with only one type of editosome. The retention of the KREX2 gene implies a non-essential role or a role that is essential in other life cycle stages or conditions.

  15. 21 CFR 882.4100 - Ventricular catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventricular catheter. 882.4100 Section 882.4100...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4100 Ventricular catheter. (a) Identification. A ventricular catheter is a device used to gain access to the cavities of the brain for...

  16. Distribution and drug resistance of pathogens causing catheter-related urinary tract infections%导尿管相关性尿路感染的病原菌分布及耐药性

    Institute of Scientific and Technical Information of China (English)

    刘丽; 吴皖; 陈丹; 鲁艳

    2012-01-01

    目的 了解导尿管相关性尿路感染病原菌的分布及耐药性,为临床医师诊断与治疗提供参考依据.方法 166株导尿管相关性尿路感染病原菌的培养鉴定按照《全国临床检验操作规程》进行;药敏试验采用K-B法.结果 166株尿路感染病原菌以大肠埃希菌的检出居首位,占39.8%,铜绿假单胞菌居第2位,占13.9%,金黄色葡萄球菌为第3位,占13.3%;所有病原菌对常用抗菌药物均产生了不同程度的耐药性.结论 临床医师必须按照药敏试验的结果合理使用抗菌药物,才能遏制细菌耐药性快速增长的不良趋势.%OBJECTIVE To analyze the distribution and antimicrobial resistance of the pathogens causing catheter-related urinary tract infections, so as to offer reference for clinical diagnosis and treatment. METHODS Referring to National Guide to Clinical Laboratory Procedures, totally 166 isolates of pathogenic bacteria causing catheter-related urinary tract infections were cultured and identified ; the drug susceptibility testing was carried out by using K-B methods. RESULTS Among 166 strains of pathogenic bacteria, Escherichia coli (39. 8%) ranked the first, followed by Pseudomonas aeruginosa (13. 9%) and Staphylococcus aureus (13. 3%). All of pathogenic bacteria have developed drug resistance to commonly used antibiotics at varied degrees. CONCLUSION The clinicians should reasonably use antibiotics based on the results of drug susceptibility testing so as to restrain the increasing tendency of bacterial resistance.

  17. 1例导管相关性尿路感染的药学监护与体会%Pharmaceutical care for one patient with catheter-related urinary tract infections

    Institute of Scientific and Technical Information of China (English)

    王琳; 杜小波

    2015-01-01

    Objective By participating in a series of prescribing plan given to patients who have urinary infection related to catheter , this paper aimed to discuss the working mode of taking part in clinical drug treatment to improve the rational use of clinical medi‐cine .Methods The treatment process of a respiratory ICU patient who has urinary infection related to catheter was monitored and specific prescription plan was put forward .Results The participation of the clinical pharmacists in the work of prescribing has im‐proved the effect of drug treatment effect ,reduced the adverse reactions ,secured the safety of drugs and won the clinical recogni‐tion .Conclusion By taking part in the individual clinical drug treatment ,the pharmacist can gradually be a part of the medical team and play their role in clinical pharmacy practice .%目的:通过临床药师参与1例导管相关性尿路感染患者个体化给药方案的设计,探讨临床药师参与临床药物治疗工作模式。方法对呼吸IC U 1例导管相关性尿路感染患者的治疗过程进行监护,并设计个体化给药方案。结果临床药师参与临床个体化给药方案设计工作,提高了患者的药物治疗效果,减少了不良反应,使药师的工作得到临床认可。结论药师通过个体化给药方案设计,参与临床药物治疗,可逐步融入医疗团队,发挥临床药师的作用。

  18. Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Edivane Pedrolo

    2014-10-01

    Full Text Available OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters.METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing or control (gauze and micro porous tape groups.RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170; local reactions to the dressing (p-value = 0.3774; and dressing fixation (p-value = 0.2739.CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.

  19. Cytometric Catheter for Neurosurgical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Evans III, Boyd Mccutchen [ORNL; Allison, Stephen W [ORNL; Fillmore, Helen [ORNL; Broaddus, William C [ORNL; Dyer, Rachel L [ORNL; Gillies, George [ORNL

    2010-01-01

    Implantation of neural progenitor cells into the central nervous system has attracted strong interest for treatment of a variety of pathologies. For example, the replacement of dopamine-producing (DA) neural cells in the brain appears promising for the treatment of patients affected by Parkinson's disease. Previous studies of cell-replacement strategies have shown that less than 90% of implanted cells survive longer than 24 - 48 hours following the implantation procedure. However, it is unknown if these cells were viable upon delivery, or if they were affected by other factors such as brain pathology or an immune response. An instrumented cell-delivery catheter has been developed to assist in answering these questions by facilitating quantification and monitoring of the viability of the cells delivered. The catheter uses a fiber optic probe to perform flourescence-based cytometric measurments on cells exiting the port at the catheter tip. The current implementation of this design is on a 3.2 mm diameter catheter with 245 micrometer diameter optical fibers. Results of fluorescence testing data are presented and show that the device can characterize the quantity of cell densities ranging from 60,000 cells/ml to 600,000 cells/ml with a coefficient of determination of 0.93.

  20. Transhepatic venous catheters for hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed El Gharib

    2014-06-01

    Conclusion: Based on our findings, transhepatic hemodialysis catheters have proven to achieve good long-term functionality. A high level of maintenance is required to preserve patency, although this approach provides remarkably durable access for patients who have otherwise exhausted access options.

  1. Clinical analysis of 74 cases of bloodstream infections caused by multidrug-resist-ant Acinetobacter%多重耐药不动杆菌属血流感染74例临床分析

    Institute of Scientific and Technical Information of China (English)

    邹颖; 徐晓刚; 郭庆兰; 李光辉

    2014-01-01

    Objective To study the clinical characteristics,antimicrobial restistance of bloodstream infections (bacteremia) caused by multidrug-resistant Acinetobacter and analyze the outcomes of antibacterial therapy.Methods The clinical data were reviewed retrospectively for 74 patients with bloodstream infection caused by multidrug-resistant Acinetobacter who were trea-ted in HuaShan hospital from January 2005 to December 2011 .Results During the 6-year period,74 patients were diagnosed with multidrug-resistant Acinetobacter bacteremia,73 of which were nosocomial infections.The remaining one was community-acquired. Primary bloodstream infection accounted for 51 .4% (38/74),and secondary infection 48.6% (36/74), mainly secondary to pulmonary infections (23.0%,17/74). Solid tumor was the most common underlying disease (24.3%,18/74).Prior corticosteroid therapy,indwelling deep venous catheter,surgery and invasive procedures were predisposing factors of bacteremia. Acinetobacter-related bloodstream infections were associated with higher white blood cell count,increased neutrophil percentage,higher APACHE II score and lower serum albumin level.The bloodstream infection was caused by Acinetobacter baumannii in 65 pa-tients,Acinetobacter lwoffi in 7 patients,both Acinetobacter baumannii and Acinetobacter junii in one patient.The all-cause mortality rate was 27.0% (20/74).In vitro susceptibility testing showed that 20.0% (15/75 )of the Acinetobacter isolates were resistant to cefoperazone-sulbactam,which was the lowest among all the antibiotics tested.About 40.0% to 42.7% of the isolates were resistant to carbapenems.The outcome was related to the antimicrobial restistance.Carbapenem non-suscepti-ble Acinetobacter was associated with poorer outcome compared with carbapenem-susceptible Acinetobacter (mortality 46.9%vs 11 .9%,P <0.05 ).Cefoperazone-sulbactam non-susceptible Acinetobacter was also associated with poorer outcome com-pared with cefoperazone-sulbactam susceptible

  2. Ethanol causes protein precipitation--new safety issues for catheter locking techniques.

    Directory of Open Access Journals (Sweden)

    Gernot Schilcher

    Full Text Available OBJECTIVE: The ethanol lock technique has shown great potential to eradicate organisms in biofilms and to treat or prevent central venous catheter related infections. Following instillation of ethanol lock solution, however, the inherent density gradient between blood and ethanol causes gravity induced seepage of ethanol out of the catheter and blood influx into the catheter. Plasma proteins so are exposed to highly concentrated ethanol, which is a classic agent for protein precipitation. We aimed to investigate the precipitating effect of ethanol locks on plasma proteins as a possible cause for reported catheter occlusions. METHODS: Plasma samples were exposed in-vitro to ethanol (concentrations ranging from 7 to 70 v/v% and heparin lock solutions. In catheter studies designed to mimic different in-vivo situations, the catheter tip was placed in a plasma reservoir and the material contained within the catheter was analyzed after ethanol lock instillation. The samples underwent standardized investigation for protein precipitation. RESULTS: Protein precipitation was observed in plasma samples containing ethanol solutions above a concentration of 28%, as well as in material retrieved from vertically positioned femoral catheters and jugular (subclavian catheters simulating recumbent or head down tilt body positions. Precipitates could not be re-dissolved by dilution with plasma, urokinase or alteplase. Plasma samples containing heparin lock solutions showed no signs of precipitation. CONCLUSIONS: Our in-vitro results demonstrate that ethanol locks may be associated with plasma protein precipitation in central venous catheters. This phenomenon could be related to occlusion of vascular access devices locked with ethanol, as has been reported. Concerns should be raised regarding possible complications upon injection or spontaneous gravity induced leakage of such irreversibly precipitated protein particles into the systemic circulation. We suggest

  3. Eventos adversos e motivos de descarte relacionados ao reuso de produtos médicos hospitalares em angioplastia coronária Adverse events and reasons for discard related to the reuse of cardiac catheters in percutaneous transluminal coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Margarete Ártico Batista

    2006-09-01

    Full Text Available OBJETIVO: Descrever os eventos adversos ocorridos durante e após angioplastia coronária (ATC, possivelmente relacionados ao reuso de produtos médico-hospitalares, além de quantificar e identificar os motivos de descarte em relação ao primeiro uso e ao reuso. MÉTODO: Foram estudados 60 pacientes, sendo que 29 (48,3% apresentavam angina instável, 27 (45% IAM e quatro (6,7% outros diagnósticos. Durante o procedimento e na permanência na Unidade Intensiva Coronariana, atentou-se à possibilidade de ocorrência dos eventos adversos febre, hipertensão, hipotensão, calafrios, sudorese, sangramento, náuseas e vômitos. Foram avaliados sete produtos médico-hospitalares: introdutor, cateter-guia, fio-guia 0.35, fio-guia 0.014, cateter- balão para angioplastia, seringa com manômetro para insuflar balão (indeflator e torneira de três vias (manifold. No total de produtos (76 de primeiro uso e 410 reprocessados, verificou-se se houve descarte e se isto ocorreu antes ou durante o procedimento e quais os motivos para tanto. Utilizou-se o teste Qui Quadrado, admitindo-se erro alfa de 5%. RESULTADOS: Vinte e seis pacientes apresentaram eventos adversos. A hipotensão foi o evento mais prevalente e ocorreu em 11(18,3% casos. Não houve, porém, significância estatística entre o evento adverso hipotensão e reuso ou não dos produtos médico-hospitalares. Por não estarem íntegros, foram descartados três produtos de primeiro uso e 55 produtos dos reutilizados. CONCLUSÃO: Os eventos adversos apresentados pelos pacientes submetidos à angioplastia não estão associados ao reuso dos produtos médico-hospitalares. A integridade e funcionalidade foram os motivos principais de descarte.OBJECTIVE: To describe the adverse effects that occur during and after percutaneous transluminal coronary angioplasty (PTCA possibly related to the reuse of medical equipment. An additional objective is to quantify and identify the reasons of discard in respect to

  4. 留置尿管患者尿路感染的相关因素及预防对策%Related factors for urinary tract infections in patients with indwelling catheter and preventive countermeasures

    Institute of Scientific and Technical Information of China (English)

    苗桂萍; 王娟; 朱欢

    2012-01-01

    目的 分析留置尿管患者尿路感染的相关因素,并探讨预防对策,以降低尿路感染发生率.方法 运用回顾性调查方法对23例留置尿管发生尿路感染患者进行原因分析;观察不同留置尿管时间尿路感染的发生率.结果 随着留置尿管时间的增加,发生尿路感染例数显著增加,留置尿管10、20、30、>30 d患者发生尿路感染分别占8.70%、17.39%、30.43%、43.48% ;23例感染患者中有16例行尿培养检查,送检率为69.57%,培养结果均为阳性,分离出的病原菌以革兰阴性杆菌为主,占52.17%,其中主要为大肠埃希菌、肺炎克雷伯菌,分别占30.43%、21.74%,革兰阳性球菌占26.09%,以屎肠球菌为主,占17.39%,除此之外真菌感染增加,以白色假丝酵母菌为主,占21.74%.结论 留置尿管时间、集尿系统密闭性不良等原因是造成尿路感染的主要危险因素,针对各种危险因素,采取有效的预防措施,可降低尿路感染的发生.%OBJECTIVE To analyze the related factors for urinary tract infection due to indwelling urinary catheter and discuss the preventive countermeasures.so as to reduce the incidence of urinary tract infection.METHODS The causes of urinary tract infections in 23 cases with indwelling urinary catheter were retrospectively analyzed, the incidence of urinary tract infections of different catheterization durations was investigated.RESULTS The urinary tract infections significantly increased as the catheter indwelling duration increased.For the duration of 10ds, 20ds, 30ds, >30 ds, the morbidity were 8.70%, 17.39% , 30.43%, 43.48% respectively, 16 of 23 cases were enrolled in urine culture, the submitted rate was 69.57%.Gram-negative bacilli were the predominant pathogens, accounting for 52.17%, E.coli and PAE were the major pathogens, accounting for 30.43% and 21.74%, respectively; Gram-positive bacilli accounted for 26.09%, among which Enterococcus feces was 17.39%.In

  5. Delayed bowel perforation following suprapubic catheter insertion

    Directory of Open Access Journals (Sweden)

    Mehta Ajay

    2004-12-01

    Full Text Available Abstract Background Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion. Case presentation A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter. Conclusion Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with lower abdominal scar. The risk may be reduced with the use of ultrasound scan guidance.

  6. Improving our ability to diagnose infections associated with central venous catheters: value of Gram's staining and culture of entry site swabs.

    OpenAIRE

    McGeer, A.; Righter, J

    1987-01-01

    We prospectively studied 45 central venous catheters to determine whether Gram's staining and culture of skin swabs from the entry site could be used to predict catheter-related infection. Data were collected from insertion site swabs, intracutaneous and intravascular catheter segments, and blood cultures. Surveillance site cultures at the time of dressing changes showed that bacterial growth, once established, persisted until removal of the catheter but that the time of onset of infection wa...

  7. Causes of central venous catheter-related infections after cardiac surgery and intervention measures%心脏术后中心静脉导管感染的原因分析及干预措施的研究

    Institute of Scientific and Technical Information of China (English)

    郭舒婕; 王晓敏; 张瑜; 张艳丽

    2012-01-01

    OBJECTIVE To analyze the causes of central venous catheter-related infections after the cardiac surgery and to explore the intervention countermeasures. METHODS A total of 100 patients who underwent cardiac surgery were selected, and all the patients underwent the central venous catheterization. RESULTS Of the 100 patients investigated, the central venous catheter-related infections occurred in 22 patients with the infection rate of 22. 0% , including 6 cases of Staphylococcus epidermidis infections, 5 cases of S. aureus infections, 4 cases of Klebsiella pneumoniae infections, 3 cases of Enterococcus faecalis infections, 1 case of Acinetobacter baumannii infection, 1 case of Enterobacter cloacae infection, 1 case of Candida albicans infection, and 1 case of Pseudomonas aeruginosa infection. The infections disappeared after being given appropriate antibiotics on the basis of drug susceptibility testing. The incidence rate of the central venous catheter-related infections in the patients with less than 50 years of age was 12. 5%, and 26. 5% of the patients with more than 50 years, the difference was statistically significant (P<0. 05). The infection rate of the patients without complications was 9. 1 % , and 28. 3% of the patients with complications, the difference was statistically significant (P<0. 05). The infection rate of the patients with the subclavian vein as puncture site was 17. 8%. and 21. 8% of the patients with internal jugular vein as the puncture site, the difference was not statistically significant. The infection rate of the patients with the joints and sealing solution optimized was 17. 6%, the conventional 37. 5%, the difference was statistically significantP<0. 05). The infection rate of the patients with dual-chamber was 21. 4% , 27. 3% of the patients with three-cavity, the difference was not statistically significant. The infection rate of the patients with the catheterization duration less than 7 days was 9. 1% , 20. 1% of the patient with the

  8. Nursing care for patients carrying indwelling catheter in target vessel for continuous chemotherapy

    International Nuclear Information System (INIS)

    Objective: To reduce the occurrence of undesirable catheter-related events in patients with indwelling catheter during the course of continuous chemotherapy. Methods: (1)To enhance the propaganda,education and guidance to patients. (2) To standardize the nursing care operations. (3) To establish the reasonable care rules and procedures. (4) The nurses should take the daily nursing care,observations and recording work seriously. Results: Through the analysis of a variety of problems occurred in patients with indwelling catheter during the course of continuous chemotherapy the nursing care experience was summed up. Conclusion: Proper and effective care can reduce the occurrence of undesirable catheter-related events in patients with indwelling catheter during the course of continuous chemotherapy. (authors)

  9. Imaging of the complications of peripherally inserted central venous catheters

    Energy Technology Data Exchange (ETDEWEB)

    Amerasekera, S.S.H. [Department of Radiology, Good Hope Hospital, Sutton Coldfield, Birmingham (United Kingdom)], E-mail: steve.amerasekera@nhs.net; Jones, C.M.; Patel, R.; Cleasby, M.J. [Department of Radiology, Good Hope Hospital, Sutton Coldfield, Birmingham (United Kingdom)

    2009-08-15

    Peripherally inserted central catheters (PICC) are widely used to provide central venous access, often in chronically ill patients with long-term intravenous access requirements. There are a number of significant complications related to both insertion and maintenance of PICC lines, including catheter malposition, migration, venous thrombosis, and line fracture. The incidence of these complications is likely to rise as the number of patients undergoing intravenous outpatient therapy increases, with a corresponding rise in radiologist input. This paper provides an overview of the relevant peripheral and central venous anatomy, including anatomical variations, and outlines the complications of PICC lines. Imaging examples demonstrate the range of radiological findings seen in these complications.

  10. Safety and Complications of Double-Lumen Tunnelled Cuffed Central Venous Dialysis Catheters

    Science.gov (United States)

    Hamid, Rana S.; Kakaria, Anupam K.; Khan, Saif A.; Mohammed, Saja; Al-Sukaiti, Rashid; Al-Riyami, Dawood; Al-Mula Abed, Yasser W.

    2015-01-01

    Objectives: This study aimed to assess the technical success, safety and immediate and delayed complications of double-lumen tunnelled cuffed central venous catheters (TVCs) at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman. Methods: This retrospective study took place between January 2012 and October 2013. The clinical records and radiological data of all patients who underwent ultrasound- and fluoroscopy-guided TVC placement at SQUH during the study period were reviewed. Demographic data and information regarding catheter placement, technical success and peri- and post-procedure complications (such as catheter-related infections or thrombosis) were collected. Results: A total of 204 TVCs were placed in 161 patients. Of these, 68 were female (42.2%) and 93 were male (57.8%). The mean age of the patients was 54.4 ± 17.3 years. The most common reason for catheter placement was the initiation of dialysis (63.4%). A total of 203 procedures were technically successful (99.5%). The right internal jugular vein was the most common site of catheter placement (74.9%). Mild haemorrhage which resolved spontaneously occurred in 11 cases (5.4%). No other complications were observed. Subsequent follow-up data was available for 132 catheters (65.0%); of these, thrombosis-related catheter malfunction was observed in 22 cases (16.7%) and catheter-related infection in 29 cases (22.0%). Conclusion: Radiological-guided placement of tunnelled haemodialysis catheters can be performed safely with excellent technical success. The success rate of catheter insertion at SQUH was favourable in comparison with other studies reported in the literature. PMID:26629377

  11. Recommendations for the use of long-term central venous catheter (CVC) in children with hemato-oncological disorders: management of CVC-related occlusion and CVC-related thrombosis. On behalf of the coagulation defects working group and the supportive therapy working group of the Italian Association of Pediatric Hematology and Oncology (AIEOP).

    Science.gov (United States)

    Giordano, Paola; Saracco, Paola; Grassi, Massimo; Luciani, Matteo; Banov, Laura; Carraro, Francesca; Crocoli, Alessandro; Cesaro, Simone; Zanazzo, Giulio Andrea; Molinari, Angelo Claudio

    2015-11-01

    Central venous catheters (CVC), used for the management of children with hemato-oncological disorders, are burdened by a significant incidence of mechanical, infective, or thrombotic complications. These complications favor an increasing risk in prolongation of hospitalization, extra costs of care, and sometimes severe life-threatening events. No guidelines for the management of CVC-related occlusion and CVC-related thrombosis are available for children. To this aim, members of the coagulation defects working group and the supportive therapy working group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) reviewed the pediatric and adult literature to propose the first recommendations for the management of CVC-related occlusion and CVC-related thrombosis in children with hemato-oncological disorders.

  12. Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections.

    Science.gov (United States)

    Bordeau, Valérie; Cady, Anne; Revest, Matthieu; Rostan, Octavie; Sassi, Mohamed; Tattevin, Pierre; Donnio, Pierre-Yves; Felden, Brice

    2016-09-01

    Staphylococcus aureus is a commensal bacterium and pathogen. Identifying biomarkers for the transition from colonization to disease caused by this organism would be useful. Several S. aureus small RNAs (sRNAs) regulate virulence. We investigated presence and expression of 8 sRNAs in 83 S. aureus strains from 42 patients with sepsis or septic shock and 41 asymptomatic colonized carriers. Small pathogenicity island sRNAs sprB and sprC were clade specific. Six sRNAs had variable expression not correlated with clinical status. Expression of RNAIII was lower in strains from septic shock patients than in strains from colonized patients. When RNAIII was associated with expression of sprD, colonizing strains could be discriminated from strains in patients with bloodstream infections, including patients with sepsis and septic shock. Isolates associated with colonization might have sRNAs with target expression different from those of disease isolates. Monitoring expression of RNAIII and sprD could help determine severity of bloodstream infections. PMID:27224202

  13. 3D/2D Registration of Mapping Catheter Images for Arrhythmia Interventional Assistance

    CERN Document Server

    Fallavollita, Pascal

    2009-01-01

    Radiofrequency (RF) catheter ablation has transformed treatment for tachyarrhythmias and has become first-line therapy for some tachycardias. The precise localization of the arrhythmogenic site and the positioning of the RF catheter over that site are problematic: they can impair the efficiency of the procedure and are time consuming (several hours). Electroanatomic mapping technologies are available that enable the display of the cardiac chambers and the relative position of ablation lesions. However, these are expensive and use custom-made catheters. The proposed methodology makes use of standard catheters and inexpensive technology in order to create a 3D volume of the heart chamber affected by the arrhythmia. Further, we propose a novel method that uses a priori 3D information of the mapping catheter in order to estimate the 3D locations of multiple electrodes across single view C-arm images. The monoplane algorithm is tested for feasibility on computer simulations and initial canine data.

  14. 3D/2D Registration of Mapping Catheter Images for Arrhythmia Interventional Assistance

    Directory of Open Access Journals (Sweden)

    Pascal Fallavollita

    2009-09-01

    Full Text Available Radiofrequency (RF catheter ablation has transformed treatment for tachyarrhythmias and has become first-line therapy for some tachycardias. The precise localization of the arrhythmogenic site and the positioning of the RF catheter over that site are problematic: they can impair the efficiency of the procedure and are time consuming (several hours. Electroanatomic mapping technologies are available that enable the display of the cardiac chambers and the relative position of ablation lesions. However, these are expensive and use custom-made catheters. The proposed methodology makes use of standard catheters and inexpensive technology in order to create a 3D volume of the heart chamber affected by the arrhythmia. Further, we propose a novel method that uses a priori 3D information of the mapping catheter in order to estimate the 3D locations of multiple electrodes across single view C-arm images. The monoplane algorithm is tested for feasibility on computer simulations and initial canine data.

  15. Drawing on Accounts of Long-Term Urinary Catheter Use: Design for the "Seemingly Mundane".

    Science.gov (United States)

    Chapple, Alison; Prinjha, Suman; Feneley, Roger; Ziebland, Sue

    2016-01-01

    The design of the Foley catheter has not changed since 1937. Scientists interested in medical technology tend to focus on state-of-the-art designs for newsworthy specialties rather than the more mundane technologies of daily life. We interviewed 36 people living with a long-term urinary catheter in the United Kingdom, who described limitations of the current catheter design, including infections and complications and consequences for social life and relationships, and their perceptions of whose responsibility it was to improve the design. All took steps to hide the urine bag, but the need to use a catheter and urine bag had, for some, a very detrimental effect on social life and relationships. People living with long-term catheters are relatively isolated at home and dealing with many different underlying health problems, undermining opportunities to speak with a collective patient voice. Qualitative health researchers could act as a conduit to help stimulate new designs. PMID:25646001

  16. The technical development of steerable catheter robot in performing interventional vascular surgery

    International Nuclear Information System (INIS)

    Minimally invasive surgery is one of the primary means for the treatment of vascular diseases. The catheter is one of the main operating tools. As the vascular system is quite complicated and tiny, it is usually very difficult for the operator to accurately and bare-handily accomplish the whole intravascular procedure. Therefore, with the rapid development of minimally invasive surgeries the practical study related to the clinical employment of steerable catheter robot has attracted the researchers' attention. This paper aims to describe the emergence and development history of steerable catheter robot and also to introduce the main achievements as well as the up-to-date progress in the researches relevant to steerable catheter robot that the have been obtained by research workers all over the world so far. The prospects for the future development of steerable catheter robot are briefly discussed. (authors)

  17. Transhepatic venous catheters for hemodialysis

    OpenAIRE

    Mohamed El Gharib; Gamal Niazi; Waleed Hetta; Yahya Makkeyah

    2014-01-01

    Purpose: To describe our experience with the technique of transhepatic venous access for hemodialysis and to evaluate its functionality and complications. Patients and methods: From March 2012 till October 2012, 23 patients with age ranging from 12 to 71 years old having end-stage renal disease (ESRD) were included in our study and were subjected to transhepatic venous catheter insertion. In 21 patients there were not any remaining patent peripheral venous accesses. In 2 patients there wer...

  18. Comparison of Step Tip Type and Split Tip Type Hemodialysis Catheter: HemoGlide Versus the HemoSplit

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University, Daejeon (Korea, Republic of)

    2009-08-15

    To evaluate the results and complications of the step tip type and split tip type tunneled hemodialysis catheters. Between March 2008 and December 2008, a total of 147 tunneled hemodialysis catheters of step tip (n=89) and split tip (n=58) type were placed in 126 patients to perform hemodialysis. We evaluated the number of catheterization days, as well as complications with respect to catheter tip types. A tunneled hemodialysis catheter was placed successfully in all cases. The duration of catheterization ranged from 7 to 180 days (mean 68, total catheter days: 10,504 days). A significantly higher complication rate was observed in the step tip type (n=23) as compared to the split tip type (n=4) (p=0.004), especially due to catheter dysfunction and catheter laceration. Five cases of catheter-related infection (3.4%, 0.48/1000 catheter days) were observed. Placement of the tunneled hemodialysis catheter of step tip type and spit tip type were performed safely. However, the split tip type is more useful because of the greater rate of complication in step tip type

  19. Surveillance of bloodstream infections in pediatric cancer centers – what have we learned and how do we move on?

    Directory of Open Access Journals (Sweden)

    Simon, Arne

    2016-05-01

    Full Text Available Pediatric patients receiving conventional chemotherapy for malignant disease face an increased risk of bloodstream infection (BSI. Since BSI may represent an acute life-threatening event in patients with profound immunosuppression, and show further negative impact on quality of life and anticancer treatment, the prevention of BSI is of paramount importance to improve and guarantee patients’ safety during intensive treatment. The great majority of all pediatric cancer patients (about 85% have a long-term central venous access catheter in use (type Broviac or Port; CVAD. Referring to the current surveillance definitions a significant proportion of all BSI in pediatric patients with febrile neutropenia is categorized as CVAD- BSI. This state of the art review summarizes the epidemiology and the distinct pathogen profile of BSI in pediatric cancer patients from the perspective of infection surveillance. Problems in executing the current surveillance definition in this patient population are discussed and a new concept for the surveillance of BSI in pediatric cancer patients is outlined.

  20. POLYCLONAL OUTBREAK OF BLOODSTREAM INFECTIONS CAUSED BY Burkholderia cepacia COMPLEX IN HEMATOLOGY AND BONE MARROW TRANSPLANT OUTPATIENT UNITS

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    Icaro Boszczowski

    2014-01-01

    Full Text Available Aim: The objective was to describe an outbreak of bloodstream infections by Burkholderia cepacia complex (Bcc in bone marrow transplant and hematology outpatients. Methods: On February 15, 2008 a Bcc outbreak was suspected. 24 cases were identified. Demographic and clinical data were evaluated. Environment and healthcare workers' (HCW hands were cultured. Species were determined and typed. Reinforcement of hand hygiene, central venous catheter (CVC care, infusion therapy, and maintenance of laminar flow cabinet were undertaken. 16 different HCWs had cared for the CVCs. Multi-dose heparin and saline were prepared on counter common to both units. Findings: 14 patients had B. multivorans (one patient had also B. cenopacia, six non-multivorans Bcc and one did not belong to Bcc. Clone A B. multivorans occurred in 12 patients (from Hematology; in 10 their CVC had been used on February 11/12. Environmental and HCW cultures were negative. All patients were treated with meropenem, and ceftazidime lock-therapy. Eight patients (30% were hospitalized. No deaths occurred. After control measures (multidose vial for single patient; CVC lock with ceftazidime; cleaning of laminar flow cabinet; hand hygiene improvement; use of cabinet to store prepared medication, no new cases occurred. Conclusions: This polyclonal outbreak may be explained by a common source containing multiple species of Bcc, maybe the laminar flow cabinet common to both units. There may have been contamination by B. multivorans (clone A of multi-dose vials.

  1. Cateter venoso profundo recoberto com antibiótico para reduzir infecção: estudo piloto Antibiotic coated catheter to decrease infection: pilot study

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    Pedro Kurtz

    2008-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A bacteremia associada a cateter venoso central (CVC aumenta a morbidade e mortalidade hospitalar em pacientes internados em unidade de terapia intensiva (UTI. Os cateteres recobertos com rifampicina e minociclina (RM reduzem a freqüência de colonização e bacteremia. No entanto, resultados de estudos recentes questionaram o seu impacto clínico. O objetivo deste estudo foi comparar a incidência de colonização e bacteremia associada à CVC recobertos com RM e não recobertos numa coorte de pacientes admitidos em UTI. METODO: Estudo prospectivo, controlado em UTI mista clínico-cirúrgica. Os pacientes receberam um CVC recobertos com RM ou não recoberto. Após remoção do CVC, foi feita cultura de ponta do cateter e hemoculturas foram coletadas. Avaliou-se a freqüência de colonização e bacteremia. RESULTADOS: Cento e vinte CVC foram inseridos e 100 puderam ser avaliados, 49 no grupo não recobertos e 51 no grupo recoberto. As características clínicas foram similares nos 2 grupos. Dois casos de bacteremia associada ao cateter (BAC (3,9% ocorreram em pacientes que receberam CVC recobertos com RM comparado a 5 (10,2% casos de BAC no grupo não recobertos (p = 0,26. Seis (11,8% cateteres recobertos foram colonizados, comparados a 14 (28,6% no grupo não recoberto (p = 0,036. A análise de Kaplan-Meier não demonstrou diferença no risco de colonização ou BAC entre os dois grupos estudados. A taxa de BAC foi de 4,7 por 1000 cateteres-dia no grupo com CVC recobertos e 11,4 por 1000 cateteres-dia no grupo que recebeu cateteres não recobertos (p = 0,45. CONCLUSÕES: Neste estudo piloto, demonstrou-se menor freqüência de colonização em cateteres recobertos com RM, quando comparados a cateteres não recobertos. A freqüência de BAC não foi diferente entre os dois grupos.BACKGROUND AND OBJECTIVES: Nosocomial catheter related bloodstream infections (CR-BSI increase morbidity and mortality in critically ill

  2. Klebsiella variicola is a frequent cause of bloodstream infection in the stockholm area, and associated with higher mortality compared to K. pneumoniae.

    Science.gov (United States)

    Maatallah, Makaoui; Vading, Malin; Kabir, Muhammad Humaun; Bakhrouf, Amina; Kalin, Mats; Nauclér, Pontus; Brisse, Sylvain; Giske, Christian G

    2014-01-01

    Clinical isolates of Klebsiella pneumoniae are divided into three phylogroups and differ in their virulence factor contents. The aim of this study was to determine an association between phylogroup, virulence factors and mortality following bloodstream infection (BSI) caused by Klebsiella pneumoniae. Isolates from all adult patients with BSI caused by K. pneumoniae admitted to Karolinska University Hospital, Solna between 2007 and 2009 (n = 139) were included in the study. Phylogenetic analysis was performed based on multilocus sequence typing (MLST) data. Testing for mucoid phenotype, multiplex PCR determining serotypes K1, K2, K5, K20, K54 and K57, and testing for virulence factors connected to more severe disease in previous studies, was also performed. Data was retrieved from medical records including age, sex, comorbidity, central and urinary catheters, time to adequate treatment, hospital-acquired infection, and mortality, to identify risk factors. The primary end-point was 30- day mortality. The three K. pneumoniae phylogroups were represented: KpI (n = 96), KpII (corresponding to K. quasipneumoniae, n = 9) and KpIII (corresponding to K. variicola, n = 34). Phylogroups were not significantly different in baseline characteristics. Overall, the 30-day mortality was 24/139 (17.3%). Isolates belonging to KpIII were associated with the highest 30-day mortality (10/34 cases, 29.4%), whereas KpI isolates were associated with mortality in 13/96 cases (13.5%). This difference was significant both in univariate statistical analysis (P = 0.037) and in multivariate analysis adjusting for age and comorbidity (OR 3.03 (95% CI: 1.10-8.36). Only three of the isolates causing mortality within 30 days belonged to any of the virulent serotypes (K54, n = 1), had a mucoid phenotype (n = 1) and/or contained virulence genes (wcaG n = 1 and wcaG/allS n = 1). In conclusion, the results indicate higher mortality among patients infected with

  3. Klebsiella variicola is a frequent cause of bloodstream infection in the stockholm area, and associated with higher mortality compared to K. pneumoniae.

    Directory of Open Access Journals (Sweden)

    Makaoui Maatallah

    Full Text Available Clinical isolates of Klebsiella pneumoniae are divided into three phylogroups and differ in their virulence factor contents. The aim of this study was to determine an association between phylogroup, virulence factors and mortality following bloodstream infection (BSI caused by Klebsiella pneumoniae. Isolates from all adult patients with BSI caused by K. pneumoniae admitted to Karolinska University Hospital, Solna between 2007 and 2009 (n = 139 were included in the study. Phylogenetic analysis was performed based on multilocus sequence typing (MLST data. Testing for mucoid phenotype, multiplex PCR determining serotypes K1, K2, K5, K20, K54 and K57, and testing for virulence factors connected to more severe disease in previous studies, was also performed. Data was retrieved from medical records including age, sex, comorbidity, central and urinary catheters, time to adequate treatment, hospital-acquired infection, and mortality, to identify risk factors. The primary end-point was 30- day mortality. The three K. pneumoniae phylogroups were represented: KpI (n = 96, KpII (corresponding to K. quasipneumoniae, n = 9 and KpIII (corresponding to K. variicola, n = 34. Phylogroups were not significantly different in baseline characteristics. Overall, the 30-day mortality was 24/139 (17.3%. Isolates belonging to KpIII were associated with the highest 30-day mortality (10/34 cases, 29.4%, whereas KpI isolates were associated with mortality in 13/96 cases (13.5%. This difference was significant both in univariate statistical analysis (P = 0.037 and in multivariate analysis adjusting for age and comorbidity (OR 3.03 (95% CI: 1.10-8.36. Only three of the isolates causing mortality within 30 days belonged to any of the virulent serotypes (K54, n = 1, had a mucoid phenotype (n = 1 and/or contained virulence genes (wcaG n = 1 and wcaG/allS n = 1. In conclusion, the results indicate higher mortality among patients infected with

  4. 导尿管相关尿路感染目标性监测结果分析%The analysis of the surveillance results of catheter-related urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    骆安德

    2011-01-01

    目的:探讨开展导尿管相关尿路目标性监测是否降低尿路感染发生率,并分析其危险因素,为医院感染管理和控制提供科学的依据.方法:采用目标性监测方法,对2010年所有住院患者发生导尿管相关尿路感染情况进行调查.结果:926例留置尿管患者,发生尿路感染18例,感染率为1.94%,与去年相比感染率明显下降,监测发现感染与基础病、无菌操作、手卫生及导尿管留置时间有关;病原菌分布以大肠埃希菌为主,占20.00%,排在第1位,其次是金黄色葡萄球菌、粪肠球菌、白色念珠菌等.结论:通过目标性监测,发现了医院感染管理工作的各种问题和薄弱环节,通过针对性干预减少获得医院感染的危险因素,降低医院感染发生率.%Objective: To investigate the work of surveillance of catheter-related unnary tract on reducing the incidence rate of urinary tract infection. The analysis of risk factors of urinary tract infection were provided a timely scientific basis for the hospital infection management and control. Methods: The incidences of catheter-related urinary tract infection of all in-patients in 2010 were investigated objectively with monitoring method. Results: In 926 cases with detaining urine tube, 18 cases were infccled, the incidence was 1.94%, which dropped precipitously compared with last year. According to the surveillance resuhs. it was found that the infection rates were associated with basic disease, aseptic technique, hand hygiene and the lasting time of catheterization. The pathogen germs were large intestine Egypt primarily, which accounted for 20.00% as the first. The next was Staphylococcus aureus, Enteracoccus faecalis, Candida albicans and so on. Conclusion: The vast problems and weak link in the hospital infection management could be found by the objective surveillance method. Appropriate interference on reducing the risk factors of hospital infection, can effectively reduce the

  5. Flush Foley's catheter: The most easy way

    OpenAIRE

    Vijay P. Agrawal

    2013-01-01

    Introduction: Foley catheters are used for monitoring urine output in anesthetized patients, comatose patients, incontinent patients, acute urinary retention, paralysed patients, trauma patients, urethral surgeries, ureterectomy, kidney disease, before and after cesarean sections etc. When a Foley catheter becomes clogged, it can cause various complications. For which it is flushed or replaced.Objectives: To find a simple way to flush a Foleys catheter.Material & Methods: Patient was expl...

  6. A case of misplaced permacath dialysis catheter

    Directory of Open Access Journals (Sweden)

    Mohammed Arshad Ali

    2015-01-01

    Full Text Available Central venous placement using ultrasound has significantly reduced the complications associated with blind puncture. The central venous catheter can still get misplaced if it follows an anomalous route after appropriate puncture of desired vessel. We report a case of misplaced dialysis catheter into the accessory hemiazygos vein which resulted in a large hemothorax, and we recommend the routine use of a fluoroscope for placement of dialysis catheters so as to avoid serious complications.

  7. Impact of different catheter lock strategies on bacterial colonization of permanent central venous hemodialysis catheters.

    Science.gov (United States)

    Erb, Stefan; Widmer, Andreas F; Tschudin-Sutter, Sarah; Neff, Ursula; Fischer, Manuela; Dickenmann, Michael; Grosse, Philipp

    2013-12-01

    Thirty-nine hemodialysis patients with permanent central venous catheters were analyzed for bacterial catheter colonization comparing different catheter-lock strategies. The closed needleless Tego connector with sodium chloride lock solution was significantly more frequently colonized with bacteria than the standard catheter caps with antimicrobially active citrate lock solution (odds ratio, 0.22 [95% confidence interval, 0.07-0.71]; P = .011).

  8. 恶性肿瘤患者血流感染的危险因素分析%Risk factors for bloodstream infections in patients with malignant tumors

    Institute of Scientific and Technical Information of China (English)

    徐海燕; 王延风; 冯沙娜; 朱宇; 刘姗; 吴熙; 吴晓明; 于雷

    2016-01-01

    OBJECTIVE To explore the characteristics of bloodstream infections in patients with malignant tumors and analyze the risk factors so as to provide guidance for reasonable prevention and treatment of the bloodstream infections .METHODS A total of 150 malignant tumor patients who were positive for blood culture from Mar 2013 to Mar 2015 were recruited as the study objects ,then the univariate analysis and multivariate logistic regression a-nalysis were carried out ,and the statistical analysis of data was performed with the use of SPSS 16 .0 software . RESULTS Of 150 patients whose blood specimens were cultured positive for pathogens ,83 (52 .2% ) were positive for gram-negative bacteria ,55 (42 .8% ) were positive for gram-positive bacteria ,and 8 (5 .0% ) were positive for fungi.The Escherichiacoli,Staphylococcus epidermidis,and Klebsiella pneumoniae were the common species of pathogens .The univariate analysis indicated that the risk factors for the bloodstream infections included the neu-tropenia ,mechanical ventilation ,central venous catheter indwelling ,Charlson complication index ,and time of use of antibiotics no less than 7 days (P<0 .05);the multivariate logistic analysis showed that the intravenous cathe-ter indwelling and time of use of antibiotics no less than 7 days were the independent risk factors for the blood-stream infections .CONCLUSION It is an effective way to reduce the invasive operations and strictly control the time of use of antibiotics so as to reduce the incidence of the bloodstream infections .%目的 探讨恶性肿瘤患者发生血流感染的特点及其危险因素,为合理地预防和治疗血流感染提供临床依据.方法 选取医院2013年3月-2015年3月150例恶性肿瘤血培养阳性患者为研究对象,对其进行单因素分析及多因素logistic回归分析,筛选出与发生血流感染相关的危险因素,采用SPSS 16.0对数据进行统计分析.结果 150例血培养阳性患者共检出革兰阴性菌83

  9. Emerging commercial molecular tests for the diagnosis of bloodstream infection.

    Science.gov (United States)

    Mwaigwisya, Solomon; Assiri, Rasha Assad M; O'Grady, Justin

    2015-05-01

    Bloodstream infection (BSI) by microorganisms can lead to sepsis. This condition has a high mortality rate, which rises significantly with delays in initiation of appropriate antimicrobial treatment. Current culture methods for diagnosing BSI have long turnaround times and poor clinical sensitivity. While clinicians wait for culture diagnosis, patients are treated empirically, which can result in inappropriate treatment, undesirable side effects and contribute to drug resistance development. Molecular diagnostics assays that target pathogen DNA can identify pathogens and resistance markers within hours. Early diagnosis improves antibiotic stewardship and is associated with favorable clinical outcomes. Nonetheless, limitations of current molecular diagnostic methods are substantial. This article reviews recent commercially available molecular methods that use pathogen DNA to diagnose BSI, either by testing positive blood cultures or directly testing patient blood. We critically assess these tests and their application in clinical microbiology. A view of future directions in BSI diagnosis is also provided. PMID:25866124

  10. 医院获得性铜绿假单胞菌血流感染的临床分析%Clinical analysis of hospital-acquired bloodstream infections due to Pseudomonas aeruginosa

    Institute of Scientific and Technical Information of China (English)

    文亚坤; 曹萌; 邹琳; 俞森洋; 孙宝君

    2013-01-01

    bloodstream infections , 98. 0% of the patients had fever, 72. 5% with rigor, and 31. 4% with hematologic disease and low white blood cell counts and low neutrophilic granulocyte counts. Of the rest of the patients, there were 97. 1% of the patients with the white blood cell counts or/and the neutrophilic granulocyte counts elevated, 37. 3% with catheter-related bloodstream infections. There were 35. 3% of the patients complicated by septic shock, and the overall mortality rate was 29. 4%. The univariate analysis of the mortality-associated factors indicated that the mortality was correlated with the more than 70 years of age, diabetes mellitus, heart disease, pulmonary infection, blood ALB<30 g/L, blood HGB<90 g/L, invasive mechanical ventilation, hemodialysis, and the ICU stay. The logistic regression analysis indicated that the diabetes mellitus and blood HGB<90 g/L were related to the mortality. CONCLUSION The patients with hospital-acquired P. aeruginosa bloodstream infections are usually complicated by the fever, rigor, and the elevated white blood cell counts or/and neutrophilic granulocyte counts. The diabetes mellitus and blood HGB<90 g/L are the related factors for the mortality.

  11. Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study

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    Msangi Viola

    2007-05-01

    Full Text Available Abstract Background Bloodstream infection is a common cause of hospitalization, morbidity and death in children. The impact of antimicrobial resistance and HIV infection on outcome is not firmly established. Methods We assessed the incidence of bloodstream infection and risk factors for fatal outcome in a prospective cohort study of 1828 consecutive admissions of children aged zero to seven years with signs of systemic infection. Blood was obtained for culture, malaria microscopy, HIV antibody test and, when necessary, HIV PCR. We recorded data on clinical features, underlying diseases, antimicrobial drug use and patients' outcome. Results The incidence of laboratory-confirmed bloodstream infection was 13.9% (255/1828 of admissions, despite two thirds of the study population having received antimicrobial therapy prior to blood culture. The most frequent isolates were klebsiella, salmonellae, Escherichia coli, enterococci and Staphylococcus aureus. Furthermore, 21.6% had malaria and 16.8% HIV infection. One third (34.9% of the children with laboratory-confirmed bloodstream infection died. The mortality rate from Gram-negative bloodstream infection (43.5% was more than double that of malaria (20.2% and Gram-positive bloodstream infection (16.7%. Significant risk factors for death by logistic regression modeling were inappropriate treatment due to antimicrobial resistance, HIV infection, other underlying infectious diseases, malnutrition and bloodstream infection caused by Enterobacteriaceae, other Gram-negatives and candida. Conclusion Bloodstream infection was less common than malaria, but caused more deaths. The frequent use of antimicrobials prior to blood culture may have hampered the detection of organisms susceptible to commonly used antimicrobials, including pneumococci, and thus the study probably underestimates the incidence of bloodstream infection. The finding that antimicrobial resistance, HIV-infection and malnutrition predict fatal

  12. Real-time x-ray fluoroscopy-based catheter detection and tracking for cardiac electrophysiology interventions

    Energy Technology Data Exchange (ETDEWEB)

    Ma Yingliang; Housden, R. James; Razavi, Reza; Rhode, Kawal S. [Division of Imaging Sciences and Biomedical Engineering, King' s College London, London SE1 7EH (United Kingdom); Gogin, Nicolas; Cathier, Pascal [Medisys Research Group, Philips Healthcare, Paris 92156 (France); Gijsbers, Geert [Interventional X-ray, Philips Healthcare, Best 5680 DA (Netherlands); Cooklin, Michael; O' Neill, Mark; Gill, Jaswinder; Rinaldi, C. Aldo [Department of Cardiology, Guys and St. Thomas' Hospitals NHS Foundation Trust, London SE1 7EH (United Kingdom)

    2013-07-15

    Purpose: X-ray fluoroscopically guided cardiac electrophysiology (EP) procedures are commonly carried out to treat patients with arrhythmias. X-ray images have poor soft tissue contrast and, for this reason, overlay of a three-dimensional (3D) roadmap derived from preprocedural volumetric images can be used to add anatomical information. It is useful to know the position of the catheter electrodes relative to the cardiac anatomy, for example, to record ablation therapy locations during atrial fibrillation therapy. Also, the electrode positions of the coronary sinus (CS) catheter or lasso catheter can be used for road map motion correction.Methods: In this paper, the authors present a novel unified computational framework for image-based catheter detection and tracking without any user interaction. The proposed framework includes fast blob detection, shape-constrained searching and model-based detection. In addition, catheter tracking methods were designed based on the customized catheter models input from the detection method. Three real-time detection and tracking methods are derived from the computational framework to detect or track the three most common types of catheters in EP procedures: the ablation catheter, the CS catheter, and the lasso catheter. Since the proposed methods use the same blob detection method to extract key information from x-ray images, the ablation, CS, and lasso catheters can be detected and tracked simultaneously in real-time.Results: The catheter detection methods were tested on 105 different clinical fluoroscopy sequences taken from 31 clinical procedures. Two-dimensional (2D) detection errors of 0.50 {+-} 0.29, 0.92 {+-} 0.61, and 0.63 {+-} 0.45 mm as well as success rates of 99.4%, 97.2%, and 88.9% were achieved for the CS catheter, ablation catheter, and lasso catheter, respectively. With the tracking method, accuracies were increased to 0.45 {+-} 0.28, 0.64 {+-} 0.37, and 0.53 {+-} 0.38 mm and success rates increased to 100%, 99

  13. Real-time x-ray fluoroscopy-based catheter detection and tracking for cardiac electrophysiology interventions

    International Nuclear Information System (INIS)

    Purpose: X-ray fluoroscopically guided cardiac electrophysiology (EP) procedures are commonly carried out to treat patients with arrhythmias. X-ray images have poor soft tissue contrast and, for this reason, overlay of a three-dimensional (3D) roadmap derived from preprocedural volumetric images can be used to add anatomical information. It is useful to know the position of the catheter electrodes relative to the cardiac anatomy, for example, to record ablation therapy locations during atrial fibrillation therapy. Also, the electrode positions of the coronary sinus (CS) catheter or lasso catheter can be used for road map motion correction.Methods: In this paper, the authors present a novel unified computational framework for image-based catheter detection and tracking without any user interaction. The proposed framework includes fast blob detection, shape-constrained searching and model-based detection. In addition, catheter tracking methods were designed based on the customized catheter models input from the detection method. Three real-time detection and tracking methods are derived from the computational framework to detect or track the three most common types of catheters in EP procedures: the ablation catheter, the CS catheter, and the lasso catheter. Since the proposed methods use the same blob detection method to extract key information from x-ray images, the ablation, CS, and lasso catheters can be detected and tracked simultaneously in real-time.Results: The catheter detection methods were tested on 105 different clinical fluoroscopy sequences taken from 31 clinical procedures. Two-dimensional (2D) detection errors of 0.50 ± 0.29, 0.92 ± 0.61, and 0.63 ± 0.45 mm as well as success rates of 99.4%, 97.2%, and 88.9% were achieved for the CS catheter, ablation catheter, and lasso catheter, respectively. With the tracking method, accuracies were increased to 0.45 ± 0.28, 0.64 ± 0.37, and 0.53 ± 0.38 mm and success rates increased to 100%, 99.2%, and 96

  14. Laparoscopic versus open catheter placement in peritoneal dialysis patients: a systematic review and meta-analysis

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    Xie Haiying

    2012-07-01

    Full Text Available Abstract Background Peritoneal dialysis has been proven to be a safe and effective mode of renal replacement therapy for patients with end-stage renal disease. The usage of laparoscopic catheter placement technique was increased in recent years. But the advantages and disadvantages between the laparoscopic catheter placement technique and open laparotomy technique were still http://in controversy. The objective of this study is to access the operation-related data and complications of catheter placement for peritoneal dialysis (PD patients, Then to determine the better method for catheter insertion. Methods We performed a systematic review and meta-analysis on published studies identified by the databases PubMed, EMBASE, Highwire, and the Cochrane Library. Analysis was performed using the statistical software Review Manager Version 5.0. Results We assessed the operation-related data and complications of four randomized controlled trials (RCTs and ten observational studies. The available data showed that laparoscope prolonged the time for catheter insertion in PD patients, however, the two groups did not significantly differ in hospital stays, early and late complications, including infection, dialysate leaks, catheter migration, pericannular bleeding, blockage and hernia. Conclusions The data showed that Laparoscopic catheter placement had no superiority to open surgery. However, this treatment still needs to be confirmed in a large, multi-center, well-designed RCT.

  15. Investigation of central venous catheter-related infections in patients undergoing cardiac surgery%心脏术后患者中心静脉置管感染调查分析

    Institute of Scientific and Technical Information of China (English)

    马海英; 张志强; 段长虹; 李岩; 杨艳荣; 臧树志

    2013-01-01

    目的 对心脏术后患者行中心静脉置管(CVC)感染情况进行调查,为其临床的防治提供参考.方法 共纳入558例心外科行心脏手术的患者,所有患者根据病情均给予CVC,观察患者是否发生感染,并应用非条件logistic回归分析进行多因素分析.结果 558例行CVC患者中发生感染85例,感染率为15.3%;CVC尖端培养阳性28例,分离的16株病原菌中革兰阳性菌8株占50.0%,革兰阴性菌6株占37.5%,真菌2株占12.5%;85例感染患者中,65例为局部定植,12例为局部感染,8例为菌血症;单因素分析结果表明,感染患者年龄≥60岁、留置时间≥7d、导管管径≥16 G、导管管腔(多腔)、糖尿病史所占例数明显高于未发生感染患者,且感染患者白蛋白更低,差异有统计学意义(P<0.05);进一步行多因素分析结果表明,年龄≥60岁、留置时间≥7d、导管管腔(多腔)、糖尿病史及低白蛋白是CVC患者发生感染的独立危险因素(P<0.05).结论 年龄≥60岁、留置时间≥7d、导管管腔(多腔)、糖尿病史及低白蛋白是CVC患者发生感染的独立危险因素,对该类危险因素进行必要的干预具有重要的意义.%OBJECTIVE To investigate the status of the central venous catheter (CVC)-related infections in the patients undergoing cardiac surgery so as to provide reference for the clinical prevention and treatment. METHODS A total pf 558 patients who underwent the cardiac surgery were enrolled in the study, all patients were given the CVC according to the illness, the status of the infections was observed, and multivariate non-conditional logistic regression analysis was performed. RESULTS There were 85 of 558 CVC patients in whom the infections occurred. There were 28 cases with the culture of CVC positive. Of 16 strains of pathogens isolated, there were 8 (50.0%) strains of gram-positive bacteria, 6 (37. 5%) strains of gram-negative bacteria,and 2 (12. 5%) strains of fungi. Of

  16. Percutaneous placement of peritoneal port-catheter in oncologic patients

    International Nuclear Information System (INIS)

    The aim of this paper is to describe the technique of percutaneous ultrasound (US)-guided placement of a peritoneal port-catheter in an interventional radiological setting. Nineteen patients with peritoneal carcinomatosis were selected for intraperitoneal port-catheter placement in order to perform intracavitary receptor-immuno- or radio-immunotherapy with Ytrium-90. All the procedures were performed percutaneously under US and fluoro guidance; the insertion site for catheters was chosen according to abdominal conditions and US findings: all devices were implanted at the lower abdominal quadrants. All patients were followed up with CT and US according to the therapy protocol. The procedure was successfully completed in 15/19 patients, in 4 being contraindicated by peritoneal adhesions. No procedure-related complications and device occlusions during therapy were observed; one catheter displaced 7 months later the placement. In our experience, this procedure was feasible, reliable and easy to perform, allowing the correct administration of the planned intracavitary therapy. Peritoneal adhesions are the main limitation of peritoneal port placement. (orig.)

  17. Transradial arterial access catheter knots: how to stay out of trouble.

    Science.gov (United States)

    Kassimis, G; Channon, K M; Hahalis, G; Poulimenos, L; Manolis, A; Banning, A P; Krokidis, M

    2015-10-01

    Transradial access has nowadays become a standard of care for percutaneous coronary angiography and intervention. This approach has demonstrated significant reduction in bleeding rate, length of hospital stay, and improvement in clinical outcomes when compared to the traditional transfemoral approach. Due to its advantages this new access is also increasingly being used in non-coronary visceral or peripheral interventions. However, this novel approach may lead to severe catheter kinking and twisting and further manipulation may be required to unravel the catheter and avoid complication. Purpose of this technical review is to present the current techniques and trends in preventing and resolving issues related to radial access catheter kinks. PMID:26158289

  18. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis;

    2015-01-01

    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...

  19. Catheter ablation of parahisian premature ventricular complex.

    Science.gov (United States)

    Kim, Jun; Kim, Jeong Su; Park, Yong Hyun; Kim, June Hong; Chun, Kook Jin

    2011-12-01

    Catheter ablation is performed in selected patients with a symptomatic premature ventricular complex (PVC) or PVC-induced cardiomyopathy. Ablation of PVC from the His region has a high risk of inducing a complete atrioventricular block. Here we report successful catheter ablation of a parahisian PVC in a 63-year-old man.

  20. Soft thrombus formation in radiofrequency catheter ablation

    NARCIS (Netherlands)

    Demolin, JM; Eick, OJ; Munch, K; Koullick, E; Nakagawa, H; Wittkampf, FHM

    2002-01-01

    During RF catheter ablation, local temperature elevation can result in coagulum formation on the ablation electrode, resulting in impedance rise. A recent study has also demonstrated the formation of a so-called soft thrombus during experimental ablations. This deposit poorly adhered to the catheter

  1. Automated Pointing of Cardiac Imaging Catheters.

    Science.gov (United States)

    Loschak, Paul M; Brattain, Laura J; Howe, Robert D

    2013-12-31

    Intracardiac echocardiography (ICE) catheters enable high-quality ultrasound imaging within the heart, but their use in guiding procedures is limited due to the difficulty of manually pointing them at structures of interest. This paper presents the design and testing of a catheter steering model for robotic control of commercial ICE catheters. The four actuated degrees of freedom (4-DOF) are two catheter handle knobs to produce bi-directional bending in combination with rotation and translation of the handle. An extra degree of freedom in the system allows the imaging plane (dependent on orientation) to be directed at an object of interest. A closed form solution for forward and inverse kinematics enables control of the catheter tip position and the imaging plane orientation. The proposed algorithms were validated with a robotic test bed using electromagnetic sensor tracking of the catheter tip. The ability to automatically acquire imaging targets in the heart may improve the efficiency and effectiveness of intracardiac catheter interventions by allowing visualization of soft tissue structures that are not visible using standard fluoroscopic guidance. Although the system has been developed and tested for manipulating ICE catheters, the methods described here are applicable to any long thin tendon-driven tool (with single or bi-directional bending) requiring accurate tip position and orientation control.

  2. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  3. Correcting the dynamic response of a commercial esophageal balloon-catheter.

    Science.gov (United States)

    Cross, Troy J; Beck, Kenneth C; Johnson, Bruce D

    2016-08-01

    It is generally recommended that an esophageal balloon-catheter possess an adequate frequency response up to 15 Hz, such that parameters of respiratory mechanics may be quantified with precision. In our experience, however, we have observed that some commercially available systems do not display an ideal frequency response (Wiener deconvolution. These two numerical techniques were performed on a commercial balloon-catheter interfaced with 0, 1, and 2 lengths of extension tubing (90 cm each), referred to as configurations L0, L90, and L180, respectively. The frequency response of the balloon-catheter in these configurations was assessed by empirical transfer function analysis, and its "working" range was defined as the frequency beyond which more than 5% amplitude and/or phase distortion was observed. The working frequency range of the uncorrected balloon-catheter extended up to only 10 Hz for L0, and progressively worsened with additional tubing length (L90 = 3 Hz, L180 = 2 Hz). Although both numerical methods of correction adequately enhanced the working frequency range of the balloon-catheter to beyond 25 Hz for all length configurations (L0, L90, and L180), Wiener deconvolution consistently provided more accurate corrections. Our data indicate that Wiener deconvolution provides a superior correction of the balloon-catheter's dynamic response, and is relatively more robust to extensions in catheter tube length compared with the exponential correction method. PMID:27402558

  4. Unusual migration of pulmonary artery catheter

    Directory of Open Access Journals (Sweden)

    Sanjay Kuravinakop

    2007-01-01

    Full Text Available Pulmonary artery catheter is widely used in intensive care. Distal migration of the catheter is a know complication. Diagnosis of such a migration is made by both clinical criteria and radiographs. A 55 year old septic lady was admitted to the intensive care unit. Pulmonary artery catheter introduced for cardiac output monitoring migrated from right lung to left lung. Diagnosis was made following a chest radiograph the following day of insertion with the clinical criteria remaining unaltered. Migration of pulmonary artery catheter can occur not only distally but from one lung to another. Clinical criteria alone cannot rule out migration. Chest radiographs form an important part in monitoring the position of the pulmonary artery catheter.

  5. Central venous catheters: detection of catheter complications and therapeutical options; Zentralvenoese Katheter: Diagnostik von Komplikationen und therapeutische Optionen

    Energy Technology Data Exchange (ETDEWEB)

    Gebauer, B.; Beck, A. [Universitaetsmedizin Charite, Berlin (Germany). Klinik fuer Strahlenheilkunde; Wagner, H.J. [Vivantes-Kliniken, Friedrichshain und Am Urban, Berlin (Germany). Radiologie; Vivantes-Kliniken, Hellersdorf und Prenzlauer Berg (Germany). Radiologie

    2008-06-15

    For modern medicine central venous catheters play an important role for diagnostic and therapeutic options. Catheter implantation, complication detection and therapy of catheter complications are an increasing demand for the radiologist. The review article provides an overview of different catheter types, their indications, advantages and disadvantages. Catheter malpositions are usually detectable in conventional X-ray. Most malpositions are correctable using interventional-radiological techniques. In addition therapeutical options for thrombotic complications (venous thrombosis, catheter occlusion, fibrin sheath) are discussed. In case of an infectious catheter complication, usually a catheter extraction and re-implantation is necessary.

  6. Healthcare Burden, Risk Factors, and Outcomes of Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections after Stem Cell Transplantation.

    Science.gov (United States)

    Dandoy, Christopher E; Haslam, David; Lane, Adam; Jodele, Sonata; Demmel, Kathy; El-Bietar, Javier; Flesch, Laura; Myers, Kasiani C; Pate, Abigail; Rotz, Seth; Daniels, Paulina; Wallace, Gregory; Nelson, Adam; Waters, Heather; Connelly, Beverly; Davies, Stella M

    2016-09-01

    Mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) lead to significant morbidity, mortality, and healthcare resource utilization in hematopoietic stem cell transplant (HSCT) patients. Determination of the healthcare burden of MBI-LCBIs and identification of patients at risk of MBI-LCBIs will allow researchers to identify strategies to reduce MBI-LCBI rates. The objective of our study was to describe the incidence, risk factors, timing, and outcomes of MBI-LCBIs in hematopoietic stem cell transplant patients. We performed a retrospective analysis of 374 patients who underwent HSCT at a large free-standing academic children's hospital to determine the incidence, risk factors, and outcomes of patients that developed a bloodstream infection (BSI) including MBI-LCBI, central line-associated BSI (CLABSI), or secondary BSI in the first year after HSCT. Outcome measures included nonrelapse mortality (NRM), central venous catheter removal within 7 days of positive culture, shock, admission to the pediatric intensive care unit (PICU) within 48 hours of positive culture, and death within 10 days of positive culture. One hundred seventy BSIs were diagnosed in 100 patients (27%): 80 (47%) MBI-LCBIs, 68 (40%) CLABSIs, and 22 (13%) secondary infections. MBI-LCBIs were diagnosed at a significantly higher rate in allogeneic HSCT patients (18% versus 7%, P = .007). Reduced-intensity conditioning (OR, 1.96; P = .015) and transplant-associated thrombotic microangiopathy (OR, 2.94; P = .0004) were associated with MBI-LCBI. Nearly 50% of all patients with a BSI developed septic shock, 10% died within 10 days of positive culture, and nearly 25% were transferred to the PICU. One-year NRM was significantly increased in patients with 1 (34%) and more than 1 (56%) BSIs in the first year post-HSCT compared with those who did not develop BSIs (14%) (P ≤ .0001). There was increased 1-year NRM in patients with at least 1 MBI-LCBI (OR, 1.94; P

  7. The Role of Atrial Fibrillation Catheter Ablation in Patients with Congestive Heart Failure: “Burning”for a Cure

    OpenAIRE

    Dimpi Patel; Mohammed Khan

    2011-01-01

    Atrial Fibrillation (AF) and congestive heart failure (CHF) often co-exist. Catheter ablation is increasingly used to cure AF related to CHF.Clinical evidence supports the feasibil- ity of catheter ablation as a treatment option in drug refractory AF patients with CHF.Investiga- tors have reported an improvement in ejection fraction, quality of life, and functional capacity

  8. Risk factors for bloodstream infections in 66 patients in ICU%ICU 66例血流感染患者危险因素分析

    Institute of Scientific and Technical Information of China (English)

    姚彬; 习慧明

    2012-01-01

    OBJECTIVE To investigate the risk factors for bloodstream infections in the intensive care unit (ICU), to analyze the distribution of pathogens and their drug resistance so as to provide basis for the prevention and treatment of bloodstream infections and reduce the incidence of bloodstream infections and the mortality. METHODS Totally 66 patients with bloodstream infections were investigated retrospectively in the ICU of Beijing Haidian Hospital between 2009 and 2011, the risk factors for bloodstream infections, the distribution of pathogens, and the drug resistance characteristics were analyzed. RESULTS A total of 70 strains of pathogens were isolated from 66 patients with bloodstream infections, including 32 (45. 7%) strains of gram-negative bacteria,28 (40. 0%) strains of gram-positive bacteria, and 10 (14.3%) strains of fungi; the main pathogens causing bloodstream infections were coagulase-negative Staphylococci (25. 7%), Acinetobacter baumannii (12.9%), Yeast (12. 9%), Burkholderia cepacia (10.0%), Enterococcus feces (8.6%), and Escherichia coli (8. 6%). Those patients with the bloodstream infections had poor prognosis and the mortality rate was high, up to 69. 23%. The chronic underlying disease, low immunity, invasive operation,and the abuse of antibiotics were risk factors of bloodstream infections. CONCLUSION The distribution of the gram-negative bacteria is as basically same as the gram-positive bacteria in the pathogens causing blood stream infections in the ICU during the three years. A. baumannii is the main species of gram-negative bacteria, and coagulase-negative Staphylococci was the predominant species of gram-positive bacteria. The strict aseptic operation, careful nursing of catheter, intensifying the blood culture, and reasonable use of antibiotics are the effective measures to prevent and treat the bloodstream infections.%目的 了解重症监护病房(ICU)血流感染的危险因素、病原菌分布特点及其耐药性,为更好地预防

  9. 老年患者导管相关性感染病原菌分布及药敏分析%Pathogenic bacteria causing catheter-related infections in senile patients and drug susceptibility

    Institute of Scientific and Technical Information of China (English)

    周玉; 李晓霞; 龚美亮; 徐雅萍; 周和平

    2012-01-01

    目的 研究老年患者导管相关性感染(CRI)的病原菌分布及药物敏感性.方法 回顾性分析486例老年患者导管培养结果,对确诊病例阳性结果的菌群分布和主要病原菌的药物敏感性进行分析.结果 81例患者确诊为CRI,其中近平滑假丝酵母菌、表皮葡萄球菌、鲍氏不动杆菌在病原菌中分离率分别为21.4%、15.5%、11,9%;表皮葡萄球菌中92.3%为耐甲氧西林表皮葡萄球菌(MRSE);鲍氏不动杆菌均为泛耐药株.结论 老年患者CRI的主要病原菌为真菌、表皮葡萄球菌、鲍氏不动杆菌,且对多种抗菌药物耐药.%OBJECTIVE To study the distribution and drug susceptibility of ptthogens causing catheter-related infections (CRI) in senile patients. METHODS A retrospective analysis of the cultured specimens from 486 senile patients with catheterization was performed. The distribution of pathogens in positive diagnosed cases and the drug susceptibility of the main pathogens were analyzed. RESULTS There were 81 patients diagnosed with CRI. The detection rates of Candida parapsilosis , Staphylococcus epidermidis , and Acinetobacter baumanii were 21. 4%, 15.5% and 11. 9%, respectively; 92. 3% of S. Epidermidis were methicillin-resistant. All of A. Baumanii isolates were pan-drug resistant strains. CONCLUSION The major pathogens causing CRI in senile patients are fungi, S. Epidermidis,and A. Baumanii, which are multidrug-resistant.

  10. Application and effect of FOCUS-PDCA methodology on the control of catheter-related blood stream infection%FOCUS-PDCA 方法学在控制 CRBSI 过程中的应用及效果

    Institute of Scientific and Technical Information of China (English)

    封卫征; 朱金京

    2014-01-01

    Objective To evaluate the effect of FOCUS-PDCA program(find,organize,clarify,understand,se-lect,plan,do,check,act )on the prevention and control of catheter-related blood stream infection (CRBSI)in an intensive care unit(ICU).Methods Process of central venous catheterization and nursing care were analyzed by u-sing FOCUS-PDCA program,and the causes for CRBSI were found out ;a continuous quality improvement (CQI) team was established to provide training for ICU nurses,and the process was improved and supervised,virtuous cir-cle was created.Results Incidence of CRBSI decreased from 8.29‰ before FOCUS-PDCA intervention(January-December,2010)to 3.20‰ after FOCUS-PDCA intervention(January 2011 -December 2012),the difference was significant (χ2 =14.6,P <0.001).Conclusion FOCUS-PDCA program is effective for controlling the incidence of CRBSI.%目的:探讨运用 FOCUS-PDCA 程序预防控制重症监护室(ICU)导管相关血流感染(CRBSI)的效果。方法运用 FOCUS-PDCA 程序分析中心静脉置管以及护理操作流程中的各个环节,明确 CRBSI 发生的具体原因;成立持续质量控制(CQI)小组并对 ICU 护士进行培训,对操作流程进行改进和监督,形成良性循环。结果运用 FOCUS-PDCA 程序干预前(2010年1-12月),ICU 的 CRBSI 发病率为8.29‰;经干预后(2011年1月-2012年12月),CRBSI 的发病率降至3.20‰,差异具有统计学意义(χ2=14.6,P <0.001)。结论运用 FOCUS-PDCA程序控制 CRBSI 的发病率是有效的。

  11. Timing of positive blood samples does not differentiate pathogens causing healthcare-associated from community-acquired bloodstream infections in children in England: a linked retrospective cohort study

    OpenAIRE

    Henderson, K. L.; MÜLLER-PEBODY, B.; WADE, A.; Sharland, M.; MINAJI, M.; Johnson, A P; Gilbert, R.

    2014-01-01

    SUMMARY Paediatricians recognize that using the time-dependent community-acquired vs. hospital-acquired bloodstream infection (BSI) dichotomy to guide empirical treatment no longer distinguishes between causative pathogens due to the emergence of healthcare-associated BSIs. However, paediatric epidemiological evidence of the aetiology of BSIs in relation to hospital admission in England is lacking. For 12 common BSI-causing pathogens in England, timing of laboratory reports of positive paedia...

  12. Clinical investigation of catheter-related infections in two central venous cathers%两种中心静脉导管相关性感染的临床观察

    Institute of Scientific and Technical Information of China (English)

    高立平

    2012-01-01

    目的 评价抗感染中心静脉导管在减少重症监护病房(ICU)患者导管相关性感染(CRI)中的作用.方法 将248例在ICU留置中心静脉导管的患者随机分成普通中心静脉导管组(对照组120例)和抗感染中心静脉导管组(抗感染组128例),观察两组CRI的发生率和病原菌分布情况.结果 抗感染组的CRI发生率明显低于对照组(6.3%vs14.2%),差异有统计学意义(P<0.05).CRI的病原菌为金黄色葡萄球菌、鲍曼不动杆菌、阴沟肠杆菌、肠球菌、肺炎克雷伯菌和白色念珠菌,但两组患者CRI病原菌分布比较,差异无统计学意义(P>0.05).结论 抗感染中心静脉导管可明显降低ICU患者CRI的发生率.%Objective To evaluate the effect of reducing intravenous catheter-ralated infection (CRT) using antiseptic impregnated central venous catheter in patients in intensive care unit (ICU). Methods 248 patients treated in ICU who needed intravascular catheterization were randomly divided into the control group (120 cases, treated with ordinary central venous catheter) and the antiseptic group (128 cases, treated with antiseptic impregnated central venous catheter). The incidence of CRI and pathogenic distribution were observed. Results The incidence of CRI in the antiseptic group was significantly lower than that of the control group (6.3% vs 14.2%, P<0.05). The pathogens of CRI were Staphytococcus aureus, Acmetabactor baumarwiii, E. Cloacae, entemcoccus, Klebsiella pneumonias and Candida albicans. Pathogenic distribution between the two groups showed no statistically significant difference (PX).O5). Conclusion Antiseptic impregnated central venous catheter can obviously reduce the incidence of CRI in patients in ICU.

  13. Assessment of right liver graft perfusion effectiveness between one and two-catheter infusion methods

    OpenAIRE

    Jung, Bo-Hyun; Hwang, Shin; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan; Kim, Ki-Hun; Ahn, Chul-Soo; Moon, Deok-Bog; Park, Gil-Chun; Kang, Sung-Hwa; Yoon, Young-In; Lee, Sung-Gyu

    2014-01-01

    Backgrounds/Aims Conventional graft perfusion method using one small-caliber catheter takes a relatively long time for right liver graft perfusion, thus some modification is needed. In this study, we intended to assess the effectiveness of right liver graft perfusion methods through comparison of different infusion catheters. Methods The study consisted of two parts including one bench experiment to obtain data of hydraulic infusion and one clinical trial of 40 cases on graft perfusion with o...

  14. Bloodstream Infections in a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Mehmet Sah Ižpek

    2014-12-01

    Full Text Available Aim: To determine the pattern of bloodstream infections (BSIs and antimicrobial susceptibility of pathogens in a neonatal intensive care unit (NICU.Material and Method: Positive hemoculture of neonates diagnosed with nosocomial sepsis from March 2011 to March 2014 in the NICU of Diyarbakir Maternity and Children%u2019s Hospital, in the southeastern region of Anatolia, Turkey, were retrospectively reviewed. Results: A total of 148 pathogens were isolated in 142 neonates. The most common microorganisms isolated were Klebsiella pneumoniae (40.5% and Acinetobacter baumannii (29.7% which was a result of a hospital outbreak. Multi-drug resistant (MDR strains accounted for 20.0% of K. pneumoniae isolates and 93.2% of A. baumannii isolates. The sepsis-attributable mortality rate was higher in cases infected with MDR strains than in cases infected without MDR strains or Candida spp (24% vs. 9.7%, p=0.032. Discussion: In our unit, BSIs were more often caused by Gram negative bacteria. BSIs caused by MDR strains were associated with a higher rate of sepsis-attributable mortality.

  15. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan

    2011-01-01

    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  16. The Impact of Radiofrequency Catheter Ablation on Coagulation Function and the Preventive Effect of Heparin in Related Patients%射频消融术对凝血功能的影响及肝素的干预作用

    Institute of Scientific and Technical Information of China (English)

    吴再涛; 李玲; 单其俊

    2013-01-01

    目的:了解射频消融(Radiofrequency catheter ablation,RFCA)术对患者凝血功能的影响及肝素的干预作用.方法:连续入选接受RFCA治疗的快速性心律失常患者31例,根据手术不同路径分为经右心导管组16例,经左心导管组15例.经左心导管组术中经血管鞘注射肝素钠50 U/kg,经右心导管组未注射肝素钠.分别于术前及术后20 h抽取静脉血测定血浆D-二聚体水平,采用自身对照的方法进行统计学处理,了解手术前后患者血浆D-二聚体水平的变化及肝素的干预作用.结果:①RFCA术后患者血浆D-二聚体水平明显升高.②经左心导管组术中虽应用了肝素钠,但其术后血浆D-二聚体水平仍会升高.③经右心导管组手术也会引起血浆D-二聚体升高,其升高的程度与经左心导管组手术术中应用肝素钠者无显著差异.④血浆D-二聚体升高的程度与放电时间、累计放电能量、消融温度及手术时间无相关性.结论:①RFCA术可引起机体呈高凝状态和继发性纤溶亢进,血凝状态改变,有血栓形成风险.②肝素钠还不足以对RFCA术所致的血凝状态改变产生保护作用.③经右心导管行RFCA的患者也应考虑给予适当的抗凝及抗血小板活化药物,以减少RFCA术后潜在的血栓危险.%Objective:To explore the impact of radiofrequency catheter ablalion( RFCA) on coagulation function and the preventive effect of heparin in relaled patients. Methods: A total of 31 conseculive patients with Lachyarrhythmia who received RFCA treatment were recruited and divided into 2 groups according Lo their surgical pathways. Via right heart catheterization (Right group) ,n=16,and via left heart calheter-ization (Left group) ,n= 15. The patients in Left group received heparin 50 U/kg via vascular sheath injection in surgery,while Right group had no heparin. Blood samples were collected before surgery and 20 hours after surgery lo examine plasma D-dimer levels and to

  17. Risk factors for the appearance of central venous catheters colonization

    Directory of Open Access Journals (Sweden)

    Mioljević Vesna

    2007-01-01

    Full Text Available Introduction/Aim. Intravascular device placement (IVD is a part of everyday medical practice, however, its application is associated with a high risk of onset of nosocomial infections (NI and increased mortality and morbidity. Nosocomial blood infections (NBIs account for 10% of all the registered NI. NBIs are more frequent in patients with a placed IVD and it present an important risk factor for the onset of NBI, i.e. catheter-associated NBIs (CANBIs. Pathogenesis of CANBIs is complex and conditioned by the presence of different characteristics related to a catheter, patient and a specific causative organism. The most common CRBSI causes include coagulase-negative staphylococcus, S. aureus, Enterobacter spp, Candida spp, Klebsiella spp, Pseudomonas spp. and Enterococcus spp. Methods. All the patients hospitalized at the Intensive Care Department of the Clinic of Digestive Diseases over the period January 1, 2004-September 1, 2004 were retrospectively analyzed. The study included 107 patients in whom central venous catheter (CVC was placed for more than 48 h. All the causes isolated from a CVC segment were recorded. Culture, isolation and identification of the causative organisms were performed using standard microbiological methods in the Bacteriological Laboratory within the Emergency Center, Clinical Center of Serbia. Catheter segment samples (tip of the CVC 3-5 cm long were analyzed. Based on the insight into medical documentation, patients’ examination and medical staff interview, catheter and patient-related characteristics were recorded. Results. A total of 107 CVCs were analyzed, out of which 56 (52% were sterile while 51 (48% were colonized. The results of our study evidenced that total parenteral nutrition (TPN (p < 0.05, number of catheterization days (p < 0.05, and central venous pressure measurement (p < 0.05 were significantly associated with CVC colonization. In this study, no statistically significant difference in catheter

  18. Catheter-directed Thrombolysis in Acute Superior Vena Cava Syndrome Caused by Central Venous Catheters.

    Science.gov (United States)

    Cui, Jie; Kawai, Tasuo; Irani, Zubin

    2015-01-01

    Indwelling central venous catheters have been reported to increase the risk of superior venous cava (SVC) syndrome. This case report describes the development of acute SVC syndrome in a 28-year-old woman with end-stage renal disease implanted with a left-side hemodialysis reliable outflow graft and a right-side double lumen hemodialysis catheter via internal jugular veins. Her symptoms were not alleviated after catheter removal and systemic anticoagulation therapy. She was eventually treated with catheter-directed thrombolysis and a predischarge computer tomographic venogram on postthrombolytic procedure day 7 showed patent central veins and patient remained asymptomatic. This case demonstrates that catheter-directed thrombolysis can be safely employed to treat refractory catheter-induced acute SVC syndrome in end-stage renal disease patients.

  19. THE KISSING BALLOON TECHNIQUE WITH 2 OVER-THE-WIRE BALLOON CATHETERS THROUGH A SINGLE 8-FRENCH GUIDING CATHETER

    NARCIS (Netherlands)

    DENHEIJER, P; BERNINK, PJLM; VANDIJK, RB; TWISK, SPM; LIE, KI

    1991-01-01

    Some of the newer over-the-wire coronary angioplasty catheters have shaft sizes of 3.0 French (F) or less. The inner diameter of modern 8-F guiding catheters is large enough to accommodate two of such balloon catheters. We report a kissing balloon procedure with two over-the-wire catheters through a

  20. Periinterventional prophylactic antibiotics in radiological port catheter implantation; Periinterventionelle prophylaktische Antibiotikagabe bei der radiologischen Portkatheterimplantation

    Energy Technology Data Exchange (ETDEWEB)

    Gebauer, B.; Teichgraeber, U.; Werk, M. [Charite, Universitaetsmedizin Berlin (Germany). Klinik fuer Strahlenheilkunde; Wagner, H.J. [Vivantes Klinikum im Friedrichshain und am Urban (Germany). Inst. fuer Radiologie

    2007-08-15

    Purpose: To evaluate whether catheter-related infections after radiologically placed port catheters can be reduced by single-shot periinterventional antibiosis. Materials and Method: Between January and September 2002, 164 consecutive patients with indication for central venous port catheter implantation were included in the present study. During implantation the interventional radiologist was responsible for deciding whether to administer a prophylactic single-shot antibiosis. The prophylactic antibiosis entailed intravenous administration of ampicillin and sulbactam (3 g Unacid, Pfizer) or 100 mg ciprofloxacine (Ciprobay, Bayer) in the case of an allergy history to penicillins. Catheter-related infection was defined as a local or systemic infection necessitating port catheter extraction. Results: Indication for port catheter implantation was a malignant disease requiring chemotherapy in 158 cases. The port catheter (Chemosite [Tyco Healthcare] [n = 123], low-profile [Arrow International] [n = 35], other port system [n = 6]) was implanted via sonographically guided puncture of the right jugular vein in 139 patients, via the left jugular vein in 24 cases and via the right subclavian vein in one patient. 75 patients received periinterventional prophylactic antibiosis (Unacid [n = 63] Ciprobay [n = 12]) and 89 patients did not receive antibiosis. The prophylactic antibiosis caused a minor allergic reaction in one patient that improved with antihistamic and corticoid medication. A total of 7 ports, 6 without prophylactic antibiosis versus one with periinterventional prophylaxis, were extracted due to infectious complications. Conclusion: Single-shot periinterventional prophylactic antibiosis can reduce early and late infectious complications after radiological-interventional placement of central venous port catheters. (orig.)

  1. Using urokinase to restore patency in double lumen catheters.

    Science.gov (United States)

    Northsea, C

    1994-08-01

    All hemodialysis patients with temporary or permanent double lumen catheters are at risk for catheter occlusion. Clinical outcomes and cost-effectiveness of using urokinase, a thrombolytic agent, to declot occluded double lumen dialysis catheters were evaluated for 2 years. Patency was restored in 95 of 102 catheters. These data support the use of urokinase to safely and effectively restore patency, thereby extending the length of time a catheter can be used for dialysis.

  2. Clinical and molecular characteristics of bloodstream infections caused by Candida albicans in children from 2003 to 2011.

    Science.gov (United States)

    Tsai, M-H; Wang, S-H; Hsu, J-F; Lin, L-C; Chu, S-M; Huang, H-R; Chiang, M-C; Fu, R-H; Lu, J-J; Huang, Y-C

    2015-11-01

    We investigated the clinical and molecular characteristics of Candida albicans bloodstream infection (BSI) in children from a tertiary-level medical centre in Taiwan over a 9-year period from January 2003 to December 2011. We performed multilocus sequence typing (MLST) to investigate the genetic relatedness of these C. albicans BSI isolates. A total of 79 episodes of C. albicans BSI in 76 paediatric patients were identified, including 41 (51.9%) from the paediatric intensive care unit, 24 (30.4%) from the neonatal intensive care unit and 14 (17.7%) from general wards. More than half (59.5%) of these patients had underlying chronic co-morbidities, and the majority (94.9%) had a catheter or some other artificial device. All the isolates were susceptible to the antifungal agents tested. Only 32.9% (26/79) received effective antifungal agents within 24 h of onset of candidaemia. Twenty-five (31.6%) patients had persistent candidaemia (>3 days after the start of antifungal treatment) and candidaemia-attributable mortality rate was 22.8% (18/79). The 72 isolates available for MLST yielded 53 unique diploid sequence types (DSTs). Forty-five DSTs were singletons and eight DSTs were shared by 27 (37.5%) isolates. Seventy-one (98.6%) isolates were clustered within previously known clades. Based on the definition of two or more strains with shared DST occurring within a period of 90 days, 10.1% of the infections were categorized as nosocomial clusters, most commonly identified in the intensive care units. Although cluster-associated candidaemia was not associated with a higher mortality rate, none of the clusters were identified by the hospital infection control team.

  3. An Unusual Complication of Suprapubic Catheter Insertion

    Directory of Open Access Journals (Sweden)

    Krishnan Ananthakrishnan

    2006-01-01

    Full Text Available A patient who had a small bowel mesentery perforation following insertion of a suprapubic catheter (SPC is described. He had no bowel complaints immediately following the procedure, but presented 10 weeks later with insidious onset bowel obstruction due to the kink caused by the catheter. This complication occurred despite cystoscopy control and adequate bladder distension prior to the procedure. This isolated case illustrates the fact that regardless of the ease and frequency of SPC insertion, complications do occur.

  4. 住院患者导管相关性血流感染病原菌分布与耐药分析%The distribution and drug resistance of pathogens isolated from inpatients with catheter related blood stream infection

    Institute of Scientific and Technical Information of China (English)

    陈萍; 方清永; 王政; 王豪; 成瑶; 南玲; 黄庆玲; 刘丁

    2012-01-01

    Objective To discuss the distribution and drug resistance of pathogens isolated from catheter related blood stream infection (CRBSI), and provide evidence for CRBSI diagnosis and treatment. Methods The statistical analysis was performed on 643 strains isolated from CRBSI patients from January 2011 to February 2012 in regards to their distribution and drug resistance. Results the incidence of CRBSI was 4. 1% in hospitalized patients, among which the infection caused by multidrug resistant bacteria accounted for 3. 0%. The pathogens were mainly consisted of Gram-negative bacilli (55. 4%) and Gram-positive cocci (43. 2%). Klebsiella pneumoniae and Escherichia coli were the major Gram-negative bacilli, and showed a low drug resistance to cefoperazone/sulbactam, piperacillin/tazobactam and amikacin. The drug resistant rate of Acinetobacter baunammii to imipem was in an upward tendency. Methicillin-resistant coagulase negative Staphylococcus (MRCNS) was dominant in the Gram-positive cocci. No vancomycin-resistant Enterococcus was found. Conclusion The nosocomial CRBSIs and occurrence of resistant strains can be significantly reduced by strengthening the monitoring of drug tolerance and using antibiotics reasonably.%目的 探讨住院患者血管导管相关性血流感染的病原菌分布及耐药情况,为医院感染的控制提供依据.方法 对2011年1月至2012年2月住院患者中导管相关性血流感染病例的643株细菌的耐药性进行统计分析.结果 导管相关性血流感染发生率为4.1%,其中多重耐药细菌感染发生率为3.0%,分离病原菌以革兰阴性杆菌为主,占55.4%,革兰阳性球菌占43.2%.革兰阴性杆菌以肺炎克雷伯菌、大肠埃希菌为主,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星耐药率低,鲍曼不动杆菌对亚胺培南耐药率增高;革兰阳性球菌以耐甲氧西林凝固酶阴性葡萄球菌为主,未出现耐万古霉素肠球菌.结论 加强细菌耐药

  5. Determination of urethral catheter surface lubricity.

    Science.gov (United States)

    Kazmierska, Katarzyna; Szwast, Maciej; Ciach, Tomasz

    2008-06-01

    Device for in-vitro measurement of static and kinetic friction coefficient of catheter surface was developed. Tribometer was designed and constructed to work with exchangeable counter-faces (polymers, tissue) and various types of tubes, in wet conditions in order to mimic in-vivo process. Thus seven commercially available urethral catheters, made from vinyl polymers, natural latex with silicone coating, all-silicone or hydrogel coated, and one made from polyvinylchloride with polyurethane/polyvinylpyrrolidone hydrogel coating obtained in our laboratory, were tested against three various counter faces: polymethacrylate (organic glass), inner part of porcine aorta and porcine bladder mucosa. Additionally, the hydrophility/hydrophobity of tested catheters was stated via water wetting contact angle measurement. Super-hydrophilic biomaterials revealed low friction on tissue and hydrophobic counter-face; slightly hydrophobic showed higher friction in both cases, while more hydrophobic manifested low friction on tissue but high on hydrophobic polymer. The smoothest friction characteristic was achieved in all cases on tissue counter-faces. The measured values of the static coefficient of friction of catheters on bladder mucosa counter-face were as follows: the highest (0.15) for vinyl and siliconised latex catheters and 3 folds lower (0.05) for all-silicone ones. Hydrogel coated catheters exhibited the lowest static and kinetic friction factors. PMID:18071872

  6. Colonization of peripheral intravascular catheters with biofilm producing microbes: Evaluation of risk factors

    Directory of Open Access Journals (Sweden)

    Monil Singhai

    2012-01-01

    Full Text Available Background: Biofilms often colonize catheters and contribute to catheter-related septicemia. However, predictors of catheter colonization by biofilms remain poorly defined. The aim of this study was to evaluate clinical factors that may be associated with biofilm colonization of catheters. Materials and Methods: A total of 54 isolates colonizing the peripheral intravascular catheters (IVCs were studied and their biofilm production ability was analyzed by the tube method and antimicrobial susceptibility was also done. A detailed clinical history and examination was done of each subject to know age, sex, duration of use of IVCs, site of IVCs, swelling/purulence around the IVCs, number of attempts to install the catheter, and duration of hospital stay. Results: 44 (81.4% out of 54 isolates colonizing the catheters showed biofilm formation. Biofilm formations were significantly associated with duration of hospital stay of more than 7 days [odds ratio (OR = 6.6; 95% confidence interval (CI = 1.3-34; P value (P = 0.02], multiple attempts to install the catheter (OR=7; CI=1.5-31.8; P=0.01, and multidrug resistance (OR=9.5; CI=1.8 - 51.1: P=0.008. Klebsiella pneumoniae and Candida spp. comprised most of the biofilm-producing isolates. The overall susceptibility to antimicrobials was low among biofilm-producing compared to nonbiofilm-producing microbes. Conclusion: The results of this study suggest that evaluation of predictors of biofilm production is important in order to understand, prevent or manage biofilm colonization of IVCs.

  7. Percutaneous versus laparoscopic placement of peritoneal dialysis catheters: Simplicity and favorable outcome

    Directory of Open Access Journals (Sweden)

    Abdulla K Al-Hwiesh

    2014-01-01

    Full Text Available Implantation of peritoneal dialysis (PD catheters via the laparoscopic technique is expanding, but none of the studies concerning this technique have compared its outcome with the percutaneous insertion done by the nephrologist. We compared the technical survival and outcome of 52 PD catheters placed in 43 patients with end-stage renal disease (ESRD in our center from March 2006 to October 2007. Of these, 27 PD catheters were inserted percutaneously by a nephrologist (group 1 and 25 were placed by a surgeon using the conventional laparoscopic technique (group 2. Very obese patients, those with previous abdominal surgery, and those who refused local anesthesia were excluded from the study. All catheters were evaluated for mechanical and infectious complications and the overall technique survival was analyzed. The incidence of complications in PD catheters did not largely differ between the two groups. Early catheter-related infection episodes (within two weeks of catheter placement occurred in three of 22 (13.6% patients in group 1, versus three of 21 (14.3% patients in group 2 (P >0.05. The incidence of exit site leak was higher in group 2 (19.0% compared to (4.5% group 1 (P 0.05. We conclude that in our study, the percutaneous bedside placements of PD catheters done by nephrologists were comparable with the laparoscopic insertions performed by surgeons where the high-risk patients were avoided, and the former provided a safer and more reliable access that allowed a rapid initiation of PD.

  8. Placement of an implantable port catheter in the biliary stent: an experimental study in dogs

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Gi Young; Lee, Im Sick; Choi, Won Chan [Asan Medical Center, Seoul (Korea, Republic of)

    2004-04-01

    To investigate the feasibility of port catheter placement following a biliary stent placement. We employed 14 mongrel dogs as test subject and after the puncture of their gaIl bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications.

  9. Placement of an implantable port catheter in the biliary stent: an experimental study in dogs

    International Nuclear Information System (INIS)

    To investigate the feasibility of port catheter placement following a biliary stent placement. We employed 14 mongrel dogs as test subject and after the puncture of their gaIl bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications

  10. Trypanin, a component of the flagellar Dynein regulatory complex, is essential in bloodstream form African trypanosomes.

    Directory of Open Access Journals (Sweden)

    Katherine S Ralston

    2006-09-01

    Full Text Available The Trypanosoma brucei flagellum is a multifunctional organelle with critical roles in motility, cellular morphogenesis, and cell division. Although motility is thought to be important throughout the trypanosome lifecycle, most studies of flagellum structure and function have been restricted to the procyclic lifecycle stage, and our knowledge of the bloodstream form flagellum is limited. We have previously shown that trypanin functions as part of a flagellar dynein regulatory system that transmits regulatory signals from the central pair apparatus and radial spokes to axonemal dyneins. Here we investigate the requirement for this dynein regulatory system in bloodstream form trypanosomes. We demonstrate that trypanin is localized to the flagellum of bloodstream form trypanosomes, in a pattern identical to that seen in procyclic cells. Surprisingly, trypanin RNA interference is lethal in the bloodstream form. These knockdown mutants fail to initiate cytokinesis, but undergo multiple rounds of organelle replication, accumulating multiple flagella, nuclei, kinetoplasts, mitochondria, and flagellum attachment zone structures. These findings suggest that normal flagellar beat is essential in bloodstream form trypanosomes and underscore the emerging concept that there is a dichotomy between trypanosome lifecycle stages with respect to factors that contribute to cell division and cell morphogenesis. This is the first time that a defined dynein regulatory complex has been shown to be essential in any organism and implicates the dynein regulatory complex and other enzymatic regulators of flagellar motility as candidate drug targets for the treatment of African sleeping sickness.

  11. [Quantitative cultures from catheters, using the Brun Buisson technique].

    Science.gov (United States)

    Soloaga, R; Guelfand, L; Manganello, S; Llanos, A; Cecchi, S; Schmoll, V; Cambareri, M; Fernández, A; Gutfraind, Z; Tokumoto, M

    2002-01-01

    The objective of this collaborative work carried out in the Fundación Favaloro and the Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, was to determine optimal conditions for incubation (time and atmosphere) of quantitative cultures of catheters processed according to the technique of vortex agitation (Brun Buisson method). From 689 processed catheters, 551 yielded negative cultures. From the 138 positive cultures, 125 yielded monomicrobial cultures and 13 polimicrobial cultures (total number of microorganisms was 151). In the last situation each micoorganism was considered on an individual basis. A total of 58 episodes of catheter related bacteremias occurred, being 52 monomicrobial and 6 polimicrobial (total number of microorganisms was 64). When colony counts were compared in aerobic and in 5-10% CO2 atmospheres, a very good correlation was obtained (p = 0.27; r2 = 0.9268). No advantage was observed by incubating plates for more than 48 hours. Colony counts performed at the second versus the third day, and at the second day versus the seventh, gave very good correlation (p = 0.10 and r2 = 0.9996; p = 0.31 and r2 = 0.9995, respectively).

  12. Microbiological pattern of arterial catheters in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Patel Bharat

    2010-10-01

    Full Text Available Abstract Background Intravascular catheter related infection (CRI is one of the most serious nosocomial infections. Diagnostic criteria include a positive culture from the catheter tip along with blood, yet in many patients with signs of infection, current culture techniques fail to identify pathogens on catheter segments. We hypothesised that a molecular examination of the bacterial community on short term arterial catheters (ACs would improve our understanding of the variety of organisms that are present in this niche environment and would help develop new methods for the diagnosis of CRI. Results The whole bacterial community presenting on all ACs was evaluated by molecular methods, i.e., a strategy of whole community DNA extraction, PCR amplification followed by cloning and 16S rDNA sequence analysis. Ten ACs were removed from patients suspected of CRI and 430 clones from 5 "colonised" and 5 "uncolonised" (semi-quantitative method AC libraries were selected for sequencing and subsequent analysis. A total of 79 operational taxonomic units (OTUs were identified at the level of 97% similarity belonging to six bacterial divisions. An average of 20 OTUs were present in each AC, irrespective of colonisation status. Conventional culture failed to reveal the majority of these bacteria. Conclusions There was no significant difference in the bacterial diversity between the 'uncolonised' and 'colonised' ACs. This suggests that vascular devices cultured conventionally and reported as non infective may at times potentially be a significant source of sepsis in critically ill patients. Alternative methods may be required for the accurate diagnosis of CRI in critically ill patients.

  13. Poor value of surveillance cultures for prediction of septicaemia caused by coagulase-negative staphylococci in patients undergoing haemodialysis with central venous catheters

    DEFF Research Database (Denmark)

    Nielsen, J; Kolmos, H J; Rosdahl, V T

    1998-01-01

    Surveillance cultures for the demonstration of coagulase-negative staphylococci in patients on catheter haemodialysis were performed in an attempt to predict dialysis catheter-related septicaemia. In all, 43 patients with 67 haemodialysis catheters were followed for a 1-y period. Once a week, swab...... specimens were obtained from the skin at the insertion site and the hub, and blood cultures were obtained from the catheter. Among coagulase-negative staphylococci, S. epidermidis was the most frequently (80%) isolated species, and two biotypes accounted for 55.7% of the 41 biotypes isolated. 11 septicaemia...... cases due to coagulase-negative staphylococci occurred, all caused by S. epidermidis, and the incidence of S. epidermidis septicaemia was 21% among patients and 16% among catheter periods. S. epidermidis septicaemia occurred in 17%, 31% and 33% of all catheter periods in which S. epidermidis...

  14. Fast integrated intravascular photoacoustic/ultrasound catheter

    Science.gov (United States)

    Choi, Changhoon; Cho, Seunghee; Kim, Taehoon; Park, Sungjo; Park, Hyoeun; Kim, Jinmoo; Lee, Seunghoon; Kang, Yeonsu; Jang, Kiyuk; Kim, Chulhong

    2016-03-01

    In cardiology, a vulnerable plaque is considered to be a key subject because it is strongly related to atherosclerosis and acute myocardial infarction. Because conventional intravascular imaging devices exhibit several limitations with regard to vulnerable plaque detection, the need for an effective lipid imaging modality has been continuously suggested. Photoacoustic (PA) imaging is a medical imaging technique with a high level of ultrasound (US) resolution and strong optical contrast. In this study, we successfully developed an integrated intravascular photoacoustic/ultrasound (IV-PAUS) imaging system with a catheter diameter of 1.2 mm for lipid-rich atherosclerosis imaging. An Nd:YAG pulsed laser with an excitation wavelength of 1064 nm was utilized. IV-PAUS offers 5-mm depth penetration and axial and lateral PA imaging resolutions of 94 μm and 203 μm, respectively, as determined by imaging a 6-μm carbon fiber. We initially obtained 3-dimensional (3D) co-registered PA/US images of metal stents. Subsequently, we successfully obtained 3D coregistered PA/US ex vivo images using an iliac artery from a rabbit atherosclerosis model. Accordingly, lipid-rich plaques were sufficiently differentiated from normal tissue in the ex vivo experiment. We validated these findings histologically to confirm the lipid content.

  15. Malfunctioning central venous catheters in children: a diagnostic approach

    Energy Technology Data Exchange (ETDEWEB)

    Barnacle, Alex; Arthurs, Owen J.; Roebuck, Derek; Hiorns, Melanie P. [Great Ormond Street Hospital, Radiology Department, London (United Kingdom)

    2008-04-15

    Central venous access is increasingly becoming the domain of the radiologist, both in terms of the insertion of central venous catheters (CVCs) and in the subsequent management of these lines. This article seeks to provide an overview of the CVC types available for paediatric patients and a more detailed explanation of the spectrum of complications that may lead to catheter malfunction. A standard catheter contrast study or 'linogram' technique is described. The normal appearances of such a study and a detailed pictorial review of abnormal catheter studies are provided, together with a brief overview of how information from catheter investigations can guide the management of catheter complications. (orig.)

  16. Clonal relationships among bloodstream isolates of Escherichia coli.

    Science.gov (United States)

    Maslow, J N; Whittam, T S; Gilks, C F; Wilson, R A; Mulligan, M E; Adams, K S; Arbeit, R D

    1995-01-01

    The clonal relationships among 187 bloodstream isolates of Escherichia coli from 179 patients at Boston, Mass., Long Beach, Calif., and Nairobi, Kenya, were determined by multilocus enzyme electrophoresis (MLEE), analysis of polymorphisms associated with the ribosomal operon (ribotyping), and serotyping. MLEE based on 20 enzymes resolved 101 electrophoretic types (ETs), forming five clusters; ribotyping resolved 56 distinct patterns concordant with the analysis by MLEE. The isolates at each study site formed a genetically diverse group and demonstrated similar clonal structures, with the same small subset of lineages accounting for the majority of isolates at each site. Moreover, two ribotypes accounted for approximately 30% of the isolates at each study site. One cluster contained the majority (65%) of isolates and, by direct comparison of the ETs and ribotypes of individual isolates, was genetically indistinguishable from the largest cluster for each of two other collections of E. coli causing pyelonephritis and neonatal meningitis (R. K. Selander, T. K. Korhonen, V. Väisänen-Rhen, P. H. Williams, P. E. Pattison, and D. A. Caugent, Infect. Immun. 52:213-222, 1986; M. Arthur, C. E. Johnson, R. H. Rubin, R. D. Arbeit, C. Campanelli, C. Kim, S. Steinbach, M. Agarwal, R. Wilkinson, and R. Goldstein, Infect. Immun. 57:303-313, 1989), thus defining a virulent set of lineages. The isolates within these virulent lineages typically carried DNA homologous to the adhesin operon pap or sfa and the hemolysin operon hly and expressed O1, O2, O4, O6, O18, O25, or O75 antigens. DNA homologous to pap was distributed among isolates of each major cluster, whereas hly was restricted to isolates of two clusters, typically detected in pap-positive strains, and sfa was restricted to isolates of one cluster, typically detected in pap- and hly-positive strains. The occurrence of pap-positive isolates in the same geographically and genetically divergent lineages suggests that this

  17. Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

    NARCIS (Netherlands)

    Kett, D.H.; Azoulay, E.; Echeverria, P.M.; Vincent, J.L.; Pickkers, P.

    2011-01-01

    OBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the I

  18. Disease: H01144 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available catheter-related infections, causing bloodstream infection in patients on hemodialysis. Other manifestation...m anthropi bloodstream infection complicating hemodialysis. Am J Kidney Dis 40:E17 (2002) PMID:22099546 Shri...shrimal K Recurrent Ochrobactrum anthropi and Shewanella putrefaciens bloodstream infection complicating hemodialysis. Hemodial Int 16:113-5 (2012) ...

  19. Robustness of IPSA optimized high-dose-rate prostate brachytherapy treatment plans to catheter displacements

    Science.gov (United States)

    Whitaker, May

    2016-01-01

    Purpose Inverse planning simulated annealing (IPSA) optimized brachytherapy treatment plans are characterized with large isolated dwell times at the first or last dwell position of each catheter. The potential of catheter shifts relative to the target and organs at risk in these plans may lead to a more significant change in delivered dose to the volumes of interest relative to plans with more uniform dwell times. Material and methods This study aims to determine if the Nucletron Oncentra dwell time deviation constraint (DTDC) parameter can be optimized to improve the robustness of high-dose-rate (HDR) prostate brachytherapy plans to catheter displacements. A set of 10 clinically acceptable prostate plans were re-optimized with a DTDC parameter of 0 and 0.4. For each plan, catheter displacements of 3, 7, and 14 mm were retrospectively applied and the change in dose volume histogram (DVH) indices and conformity indices analyzed. Results The robustness of clinically acceptable prostate plans to catheter displacements in the caudal direction was found to be dependent on the DTDC parameter. A DTDC value of 0 improves the robustness of planning target volume (PTV) coverage to catheter displacements, whereas a DTDC value of 0.4 improves the robustness of the plans to changes in hotspots. Conclusions The results indicate that if used in conjunction with a pre-treatment catheter displacement correction protocol and a tolerance of 3 mm, a DTDC value of 0.4 may produce clinically superior plans. However, the effect of the DTDC parameter in plan robustness was not observed to be as strong as initially suspected. PMID:27504129

  20. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc, E-mail: Luc.Beaulieu@phy.ulaval.ca [Département de physique, de génie physique et d’optique et Centre de recherche sur le cancer de l’Université Laval, Université Laval, Québec, Québec G1V 0A6, Canada and Département de radio-oncologie et Axe Oncologie du Centre de recherche du CHU de Québec, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Binnekamp, Dirk [Integrated Clinical Solutions and Marketing, Philips Healthcare, Veenpluis 4-6, Best 5680 DA (Netherlands)

    2015-03-15

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora{sup ®} Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators.

  1. Impacto dos conectores sem agulhas na infecção da corrente sanguínea: revisão sistemática Impacto de los conectores sin agujas en la infección de la corriente sanguínea: revisión sistemática Impact of needleless connectors in the bloodstream infection: a systematic review

    Directory of Open Access Journals (Sweden)

    Silvia Helena Frota Mendonça

    2010-01-01

    Full Text Available Esta revisão sistemática buscou evidenciar o impacto do uso de conectores sem agulhas para sistema fechado de infusão na ocorrência de infecção da corrente sanguínea relacionada ao cateter venoso central. A amostra constitui-se de 14 estudos, os quais investigaram somente conectores sem agulhas. A infecção da corrente sanguínea relacionada ao cateter venoso central foi o desfecho de nove estudos. Seis apresentaram diferenças a favor do conector valvulado; quatro a favor do conector puncionável com cânula; um a favor do conector puncionável com agulha; um a favor do conector valvulado com pressão positiva e dois a favor do dispositivo usado antes da troca. A heterogeneidade dos estudos não permitiu a realização de metanálise.Esta revisión sistemática buscó evidenciar el impacto del uso de conectores sin agujas para sistemas cerrados de infusión en el caso de ocurrir una infección en la corriente sanguínea relacionada al catéter venoso central. La muestra fue constituida de 14 estudios, los cuales investigaron solamente conectores sin agujas. La infección de la corriente sanguínea relacionada al catéter venoso central fue el resultado de nueve estudios. Seis presentaron diferencias a favor del conector de válvula; cuatro a favor del conector para punción con cánula; uno a favor del conector para punción con aguja; uno a favor do conector de válvula con presión positiva y dos a favor del dispositivo usado antes del cambio. La heterogeneidad de los estudios no permitió la realización de una meta-análisis.This systematic review was intended to evaluate the impact of using needleless connectors in closed infusion systems in the event of a bloodstream infection related to central venous catheter. The sample consisted of 14 studies, which investigated only needleless connectors. The bloodstream infection related to central venous catheter was the result of nine studies. Six produced evidence in favor of the valve

  2. Everting (toposcopic) catheter for broad clinical application.

    Science.gov (United States)

    Shook, D R; Doppman, J L; Cattau, E L; Goldstein, S R

    1986-05-01

    The advanced development of the clinical everting (toposcopic) catheter is described. A detailed discussion of the design and outline of the fabrication techniques are followed by a thorough performance evaluation and summary of the first two clinical applications. The everting element is a low-durometer thermoplastic polyurethane elastomer. Surface treatments include the bonding of a hydrophilic polymeric coating, optimized for lubricity, to the sliding internal surfaces of the catheter. Eversion pressures and infusion/aspiration flow rates have been measured under various conditions and the infusate-in-blood mixing potential investigated. A preliminary assessment is given of the clinical performance of the catheter in the vascular delivery of chemotherapy and standard endoscopic retrograde cholangiopancreatography. PMID:3724105

  3. Ultrasound Assisted Catheter Directed Thrombolysis in the Management of a Right Atrial Thrombus: A New Weapon in the Armamentarium?

    Science.gov (United States)

    Kaur, Ramanjit; Javed, Arshad; Elder, Mahir; Afonso, Luis; Kaki, Amir

    2016-01-01

    Catheter related thrombosis (CRT) is a commonly encountered entity fraught with substantial risk for mortality secondary to various complications including pulmonary embolism (PE), tricuspid regurgitation, endocarditis, right sided heart failure, and cardiogenic and septic shock. CRT carries a mortality rate of 18% in hemodialysis patients and more than 40% in nonhemodialysis patients. Management strategies include systemic anticoagulation, systemic thrombolysis, surgical evacuation, and percutaneous retrieval with no established guidelines. Ultrasound assisted catheter directed thrombolysis emerges as promising modality with a relatively lower risk of hemorrhage compared to systemic thrombolysis. We report a case of a 75-year-old man with dialysis catheter related thrombosis without PE for which ultrasound assisted catheter directed thrombolysis was used successfully as an alternative therapy. PMID:27648311

  4. [Phlebitogenicity of venous catheters of Vialon].

    Science.gov (United States)

    Fassolt, A

    1985-12-01

    During three days 132 surgical patients with postoperative infusion treatment were checked on the frequency of venous reactions in the arms when catheters/cannulas of 4 different materials were used and the outcome compared. A significant result was obtained in connection with the I-cath catheter made of vialon (a polyurethanelike resin polymer) and the L-cath of polyurethane. Phlebitis was decreased to 27.3% resp. 24.2% - approximately half of its usual frequency - when I-cath of polyvinyl-chloride and FEP-teflon vasofix cannulas were applied (both 51.5%). The different predisposing factors of infusion phlebitis are under discussion. PMID:4093198

  5. Force control of flexible catheter robots for beating heart surgery

    OpenAIRE

    Kesner, Samuel Benjamin; Howe, Robert D.

    2011-01-01

    Recent developments in cardiac catheter technology promise to allow physicians to perform most cardiac interventions without stopping the heart or opening the chest. However, current cardiac devices, including newly developed catheter robots, are unable to accurately track and interact with the fast moving cardiac tissue without applying potentially damaging forces. This paper examines the challenges of implementing force control on a flexible robotic catheter. In particular, catheter frictio...

  6. Selective indication for check cystogram before catheter removal following robot assisted radical prostatectomy

    Science.gov (United States)

    Yadav, Rajiv; Bansal, Somendra; Gupta, Narmada P.

    2016-01-01

    Introduction: With the improvement in anastomotic technique, it is rare to find anastomotic site leak after robot-assisted radical prostatectomy (RARP). It may not always be necessary to do regular check cystogram before catheter removal. We evaluated our 230 consecutive RARP patients and their cystograms to determine the indications for selective use of cystogram before catheter removal. Materials and Methods: We reviewed our prospectively collected RARP database of 230 consecutive patients. Cystography was performed at low pressure by gravity instillation of diluted contrast through the catheter. Patients were observed under fluoroscopy in lateral oblique position for any contrast leak at the site of anastomosis. All patients were followed for a minimum of 6 months, and the longest follow-up was 5 years. Results: A total of 207 patients (90%) underwent catheter removal on postoperative day 7. Nine patients (3.9%) had extravasation on initial cystogram. Two patients with leak had a history of transurethral resection of prostate (TURP) and seven other had bladder neck reconstruction for wide bladder neck. Three patients with minimal leak did not require catheter replacement. In rest of the 6 patient with leak, continued catheter drainage was done. No significant difference in the intraoperative variables, blood loss, duration of drain, length of hospital stay, and continence outcomes was noted between the patients with leak compared to rest of the patients. None of the patient needed any procedure/intervention related to the surgery and none developed bladder neck stenosis. Conclusion: In usual circumstances, catheter removal can be done safely on a postoperative day 7 without routine cystography. Selective use of check cystogram can be done in the case where bladder neck reconstruction is performed or those had a prior TURP and a wide bladder neck. PMID:27127354

  7. Adaptation of the CVT algorithm for catheter optimization in high dose rate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, Eric; Fekete, Charles-Antoine Collins; Beaulieu, Luc [Département de Physique, de Génie Physique et d’Optique et Centre de recherche sur le cancer de l’Université Laval, Université Laval, Québec, Québec G1V 0A6, Canada and Département de Radio-Oncologie et Axe oncologie du Centre de Recherche du CHU de Québec, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Létourneau, Mélanie [Département de Radio-Oncologie, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Fenster, Aaron [Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive, London, Ontario N6A 5K8 (United Kingdom); Pouliot, Jean [Department of Radiation Oncology, University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, 1600 Divisadero Street, San Francisco, California 94143-1708 (United States)

    2013-11-15

    Purpose: An innovative, simple, and fast method to optimize the number and position of catheters is presented for prostate and breast high dose rate (HDR) brachytherapy, both for arbitrary templates or template-free implants (such as robotic templates).Methods: Eight clinical cases were chosen randomly from a bank of patients, previously treated in our clinic to test our method. The 2D Centroidal Voronoi Tessellations (CVT) algorithm was adapted to distribute catheters uniformly in space, within the maximum external contour of the planning target volume. The catheters optimization procedure includes the inverse planning simulated annealing algorithm (IPSA). Complete treatment plans can then be generated from the algorithm for different number of catheters. The best plan is chosen from different dosimetry criteria and will automatically provide the number of catheters and their positions. After the CVT algorithm parameters were optimized for speed and dosimetric results, it was validated against prostate clinical cases, using clinically relevant dose parameters. The robustness to implantation error was also evaluated. Finally, the efficiency of the method was tested in breast interstitial HDR brachytherapy cases.Results: The effect of the number and locations of the catheters on prostate cancer patients was studied. Treatment plans with a better or equivalent dose distributions could be obtained with fewer catheters. A better or equal prostate V100 was obtained down to 12 catheters. Plans with nine or less catheters would not be clinically acceptable in terms of prostate V100 and D90. Implantation errors up to 3 mm were acceptable since no statistical difference was found when compared to 0 mm error (p > 0.05). No significant difference in dosimetric indices was observed for the different combination of parameters within the CVT algorithm. A linear relation was found between the number of random points and the optimization time of the CVT algorithm. Because the

  8. Does antibiotic lock therapy prevent catheter-associated bacteremia in hemodialysis?

    Directory of Open Access Journals (Sweden)

    Macarena Jiménez

    2015-01-01

    Full Text Available Central venous catheter-related blood stream infection is a major cause of morbidity and mortality in patients with renal disease treated with hemodialysis. Antibiotic lock solutions can be effective in preventing this complication in patients with hemodialysis. Searching in Epistemonikos database, which is maintained by screening more than twenty databases, we identified eight systematic reviews including seventeen randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that antibiotic lock solutions probably decrease catheter-related blood stream infection in hemodialysis patients.

  9. 21 CFR 870.1230 - Fiberoptic oximeter catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fiberoptic oximeter catheter. 870.1230 Section 870...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1230 Fiberoptic oximeter catheter. (a) Identification. A fiberoptic oximeter catheter is a device used to estimate the...

  10. 21 CFR 868.5350 - Nasal oxygen catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nasal oxygen catheter. 868.5350 Section 868.5350...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5350 Nasal oxygen catheter. (a) Identification. A nasal oxygen catheter is a device intended to be inserted through a patient's nostril...

  11. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    OpenAIRE

    Bonasso, Patrick C.; Brandon Lucke-Wold; Uzer Khan

    2016-01-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  12. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    Directory of Open Access Journals (Sweden)

    Patrick C. Bonasso

    2016-07-01

    Full Text Available Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  13. Small Bowel Obstruction Due to Suprapubic Catheter Placement.

    Science.gov (United States)

    Bonasso, Patrick C; Lucke-Wold, Brandon; Khan, Uzer

    2016-07-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection. PMID:27335801

  14. Activity of sparfloxacin on Staphylococcus epidermidis attached to plastic catheters.

    Science.gov (United States)

    Pascual, A; García, I; Ramirez de Arellano, E; Perea, E J

    1995-08-01

    The activity of sparfloxacin on Staphylococcus epidermidis biofilms on different plastic catheters was evaluated. Sparfloxacin showed high bactericidal activity against S. epidermidis biofilms on Vialon and polyvinylchloride catheters. The combination of sparfloxacin with amikacin or rifampicin significantly increased its activity against bacterial biofilms on polyurethane and Teflon catheters. PMID:8522473

  15. Secular Trends in Nosocomial Bloodstream Infections : Antibiotic-Resistant Bacteria Increase the Total Burden of Infection

    NARCIS (Netherlands)

    Ammerlaan, H. S. M.; Harbarth, S.; Buiting, A. G. M.; Crook, D. W.; Fitzpatrick, F.; Hanberger, H.; Herwaldt, L. A.; van Keulen, P. H. J.; Kluytmans, J. A. J. W.; Kola, A.; Kuchenbecker, R. S.; Lingaas, E.; Meessen, N.; Morris-Downes, M. M.; Pottinger, J. M.; Rohner, P.; dos Santos, R. P.; Seifert, H.; Wisplinghoff, H.; Ziesing, S.; Walker, A. S.; Bonten, M. J. M.

    2013-01-01

    Background. It is unknown whether rising incidence rates of nosocomial bloodstream infections (BSIs) caused by antibiotic-resistant bacteria (ARB) replace antibiotic-susceptible bacteria (ASB), leaving the total BSI rate unaffected. Methods. We investigated temporal trends in annual incidence densit

  16. Bloodstream Infections in Very Low Birth Weight Infants with Intestinal Failure

    NARCIS (Netherlands)

    Cole, Conrad R.; Hansen, Nellie I.; Higgins, Rosemary D.; Bell, Edward F.; Shankaran, Seetha; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Das, Abhik; Stoll, Barbara J.

    2012-01-01

    Objective To examine pathogens and other characteristics associated with late-onset bloodstream infections (BSIs) in infants with intestinal failure (IF) as a consequence of necrotizing enterocolitis (NEC). Study design Infants weighing 401-1500 g at birth who survived for >72 hours and received car

  17. Routine Surveillance for Bloodstream Infections in a Pediatric Hematopoietic Stem Cell Transplant Cohort: Do Patients Benefit?

    Directory of Open Access Journals (Sweden)

    Heather Rigby

    2007-01-01

    Full Text Available BACKGROUND: Hematopoietic stem cell transplant (HSCT recipients are at a high risk for late bloodstream infection (BSI. Controversy exists regarding the benefit of surveillance blood cultures in this immunosuppressed population. Despite the common use of this practice, the practical value is not well established in non-neutropenic children following HSCT.

  18. Patients with Central Lines - What You Need to Know to Avoid a Bloodstream Infection PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-03-01

    This 60 second PSA is based on the March, 2011 CDC Vital Signs report which indicates bloodstream infections in patients with central lines are largely preventable when healthcare providers use CDC-recommended infection control steps.  Created: 3/1/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/1/2011.

  19. Infección asociada al catéter en nutrición parenteral domiciliaria: resultados del grupo NADYA y presentación del nuevo protocolo Catheter-related infection in home-based parenteral nutrition: outcomes from the NADYA Group and presentation of a new protocol

    Directory of Open Access Journals (Sweden)

    C. Cuerda Compés

    2006-04-01

    Full Text Available La nutrición parenteral domiciliaria (NPD es una modalidad de soporte nutricional que permite la administración de las bolsas de nutrición parenteral en el propio domicilio del enfermo. Desde su utilización a finales de los años 60, este tratamiento ha permitido mantener con vida a pacientes con fallo intestinal que previamente estaban destinados a la muerte. En nuestro país la utilización de este tratamiento es de 2,15 pacientes/ millón de habitantes. Según los datos de NADYA las infecciones del catéter suponen el 50% de todas las complicaciones relacionadas con la NPD. En las series con mayor número de pacientes las tasas de infección son de 0,5-2 infecciones/1000 días o de 0,3-0,5 infecciones/paciente/ año. La mayoría de ellas están producidas por microorganismos gram positivos que migran desde la piel o desde las conexiones del catéter hasta la punta del mismo. El diagnóstico de estas infecciones se realiza con datos clínicos y con diferentes tipos de cultivos microbiológicos. En el tratamiento de estas infecciones es importante intentar mantener el catéter, administrando los antibióticos a través del mismo de forma convencional o bien mediante la técnica del sellado con antimicrobianos.Hom parenteral nutrition (HPN is a nutritional support modality that allows for the supply of parenteral nutrition bags to the patient's home. Since its first use in the late 60s, this therapy has allowed maintaining patients with intestinal failure alive that previously were doomed to death. In our country, this therapy is used by 2.15 patients pmp. According to the NADYA data, catheter-related infections account for 50% of all HPN-related complications. In larger series,infection rates are 0.5-2 infections/1000 days or 0.3-0.5 infections/patient/year. Most of them are produced by gram-positive organisms that migrate from the skin or from catheter connections to the tip. These infections are diagnosed by means of clinical data and

  20. 胃癌术后行胃肠外营养患者中心静脉导管相关性感染的影响因素分析%Analysis of the influence factors of central venlus catheters-related infections in postoperative patients with gastric carcinoma treated with parenteral nutrition

    Institute of Scientific and Technical Information of China (English)

    陶燕霞; 赵岳; 舒娜; 闫贵明

    2015-01-01

    目的 探讨胃癌术后行胃肠外营养患者中心静脉导管相关性感染(CVC-RI)的影响因素,为CVC-RI的预防和治疗提供科学依据.方法 采用回顾性调查方法,选择2013年12月至2014年3月胃癌术后行胃肠外营养患者150例.收集患者相关信息,包括年龄、性别、既往病史、置管时间、营养液滴速等,以及置管期间是否发生CVC-RI.发生CVC-RI者为感染组,未感染者为对照组,对其进行二项Logistic回归分析.结果 150例患者中发生CVC-RI 21例,感染率为14.00%(21/150).感染组21例,对照组129例.单因素分析表明,感染组和对照组在年龄、既往病史、置管时间和营养液滴速方面比较差异有统计学意义,x2=17.126、5.447、12.795、7.973,均P<0.05,而在患者的性别、医保、置管成功率和营养液中是否添加谷氨酰胺方面比较差异无统计学意义,P>0.05;二项Logistic回归分析表明,年龄(OR=15.927,95%CI 3.305~76.756,P<0.05)和置管时间(OR=3.511,95%CI 1.028~11.992,P<0.05)是CVC-RI的独立危险因素,而营养液滴速(OR=0.140,95%CI0.033~0.597,P<0.05)是保护因素.结论 对于胃癌术后行胃肠外营养患者,CVC-RI的发生与年龄、置管时间和营养液滴速密切相关,应尽量缩短置管时间,在病情允许下尽早恢复肠内营养,适当加快营养液滴速,同时应将老年患者作为感染监控的重点.%Objective To investigate the influence factors of central venous catheter related infections (CVC-RI) in postoperative patients with gastric carcinoma treated with parenteral nutrition,in order to provide scientific basis for prevention and treatment.Methods Using the retrospective study method,150 patients who treated with parenteral nutrition after operation of gastric carcinoma from December 2013 to March 2014 were selected.Information including age,sex,anamnesis,catheter indwelling time,infusion rate of nutrient solution,and so on were collected.Patients with

  1. Use of cultivation-dependent and -independent techniques to assess contamination of central venous catheters: a pilot study

    DEFF Research Database (Denmark)

    Larsen, M.K.; Thomsen, T.R.; Moser, C.;

    2008-01-01

    ABSTRACT: BACKGROUND: Catheters are the most common cause of nosocomial infections and are associated with increased risk of mortality, length of hospital stay and cost. Prevention of infections and fast and correct diagnosis is highly important. METHODS: In this study traditional semiquantitative...... culture-dependent methods for diagnosis of bacteria involved in central venous catheter-related infections as described by Maki were compared with the following culture-independent molecular biological methods: Clone libraries, denaturant gradient gel electrophoresis, phylogeny and fluorescence in situ...... observed on most of the catheters and were much more common than the cultivation-dependent methods indicated. CONCLUSION: The results show that diagnosis based on molecular methods improves the detection of microorganisms involved in central catheter-related infections. The importance...

  2. Implantation of peritoneal catheters by laparotomy: nephrologists obtained similar results to general surgeons

    Directory of Open Access Journals (Sweden)

    Restrepo CA

    2014-10-01

    Full Text Available Cesar A Restrepo, Carlos Alberto Buitrago, Cielo Holguin Division of Nephrology, Department of Health Sciences, Caldas University, Caldas, ColombiaPurpose: To analyze the complications and costs of minilaparotomies performed by a nephrologist (group A compared with conventional laparotomies performed by a surgeon (group B for peritoneal catheter implantation.Setting: Two university hospitals (Santa Sofia and Caldas in Manizales, Caldas, Colombia.Methods: The study included stage 5 chronic kidney disease patients, with indication of renal replacement therapy, who were candidates for peritoneal dialysis and gave informed consent for a peritoneal catheter implant. Minilaparotomies were performed by a nephrologist in a minor surgery room under local anesthesia. Conventional laparotomies were performed by a surgeon in an operating room under general anesthesia.Results: Two nephrologists inserted 157 peritoneal catheters, and seven general surgeons inserted 185 peritoneal catheters. The groups had similar characteristics: the mean age was 55 years, 49.5% were men, and the primary diagnoses were diabetic nephropathy, hypertensive nephropathy, and unknown etiology. The implant was successful for 98.09% of group A and 99.46% of group B. There was no procedure-related mortality. The most frequent complications in the first 30 days postsurgery in group A versus group B, respectively, were: peritonitis (6.37% versus 3.78%, exit-site infection (3.82% versus 2.16%, tunnel infection (0% versus 0.54%, catheter entrapment by omentum (1.27% versus 3.24%, peritoneal effluent spillover (1.91% versus 2.16%, draining failure (4.46% versus 6.49%, hematoma (0% versus 1.08%, catheter migration with kinking (3.18% versus 2.70%, hemoperitoneum (1.27% versus 0%, and hollow viscera accidental puncture (1.91% versus 0.54%. There were no statistically significant differences in the number of complications between groups. In 2013, the cost of a surgeon-implanted peritoneal

  3. Not to Knot a Catheter. Case Report of the Knotting of a Suprapubic Catheter

    Directory of Open Access Journals (Sweden)

    S. A. Farook

    2007-01-01

    Full Text Available A 20-month-old boy, who underwent left nephrectomy, had a suprapubic catheter inserted that knotted within the bladder. This case report identifies possible causes for such occurrences and how best to manage them.

  4. Not to Knot a Catheter. Case Report of the Knotting of a Suprapubic Catheter

    OpenAIRE

    Farook, S. A.; Kariholu, U.; Kousidis, G.; Powlis, M.

    2007-01-01

    A 20-month-old boy, who underwent left nephrectomy, had a suprapubic catheter inserted that knotted within the bladder. This case report identifies possible causes for such occurrences and how best to manage them.

  5. A comparison of the priming properties of two central venous catheters and one pulmonary artery catheter.

    Science.gov (United States)

    Sanderson, P M

    1995-01-01

    The time taken to prime the individual lumina of two multilumen central venous catheters (Viggo-Spectramed 14G 20 cm Hydrocath and Vialon 14G 20 cm Deltacath) and one pulmonary artery catheter (Viggo-Spectramed 110 cm 7.5F Pentacath) at flows between 5 ml.h-1 and 99 ml.h-1 is reported. The catheters supplied by different manufacturers but of identical length and gauge have significantly different priming times (p < 0.001). A protocol which may be used to prime the individual lumina of the three catheters studied is described. By means of an in vitro test the accuracy of this protocol is validated. PMID:7702147

  6. Complications after placement of peritoneal catheter

    Directory of Open Access Journals (Sweden)

    Đurđević-Mirković Tatjana

    2011-01-01

    Full Text Available Introduction. Peritoneal dialysis is one of the modalities used for treatment of end-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis and renal transplantation. Owing to the rich vascularization of the peritoneum, it is used in the processes of osmosis and diffusion, enabling the removal of uremic material from the body. The procedure includes introduction of peritoneal fluid via the peritoneal catheter. Complications. The catheter is placed through the anterior abdominal wall with its tip positioned in the small pelvis. There are several techniques for catheter placement considered minimally invasive, which, however, may be associated with various complications. These complications can be divided into mechanical (catheter dysfunction, cuff protrusion, hernia, dialysate leaks, visceral perforation and infectious (early peritonitis, exit site or tunnel infection, surgical wounds. In most cases, such complications are rare and can be successfully managed using conservative therapy; however, in some situations severe complications can endanger the life of the patient. On-time recognition of complications, particularly in patients at risk, is of paramount importance for an effective treatment. The development of complications can increase the morbidity and the chance of treatment failure, and therefore transfer to haemodialysis. Conclusion. The preoperative evaluation and determination of the risk factors as well as the early recognition and adequate management of complications are essential in their prevention.

  7. The risks and benefits of suprapubic catheters.

    Science.gov (United States)

    Yates, Ann

    Suprapubic catheterisation can improve some patients' quality of life but the insertion procedure, as well as changing and managing the catheter, carry risks of infection and other negative patient outcomes. This article highlights the advantages and disadvantages, indications and contraindications, and the potential benefits, so health professionals can understand the relevant issues and assess and inform patients accordingly. PMID:27017651

  8. 21 CFR 874.4175 - Nasopharyngeal catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nasopharyngeal catheter. 874.4175 Section 874.4175 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... intended for use in probing or dilating the eustachian tube. This generic type of device...

  9. Epidural catheter fragment entrapment: a case report

    Directory of Open Access Journals (Sweden)

    Mohammadi M

    2010-07-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Epidural catheters are seldom difficult to remove from patients. The breakage of the catheters is uncommon, troublesome and occasionally dangerous. "n"nCase presentation: A lumbar epidural catheter inserted in a 17 year-old man for applying anesthesia for internal fixation of femur fracture and subsequent postoperative epidural analgesia. In the third postoperative day, during unsuccessful attempt for removing the catheter, it was broken and was retained in his back. A CT- scan was performed and shows a fragment of catheter in the sub- laminar ligament between L3 and L4 without any connection with epidural space. As the patient had no complaint the fractured fragment was left in site and he was just followed up in the clinic."n"nConclusion: The knowledge of practical method in locating the retained epidural catheter, and the indication for surgical removal are very important. CT- scan is useful in showing the mechanism and locating the epidural catheter entrapment and facilitating surgical follow-up.

  10. Transradial percutaneous coronary intervention for chronic total occlusion of coronary artery disease using sheathless standard guiding catheters

    OpenAIRE

    Huang-Chung Chen; Wei-Chieh Lee; Shu-Kai Hsueh; Cheng-I Cheng; Chien-Jen Chen; Cheng-Hsu Yang; Chih-Yuan Fang; Chi-Ling Hang; Hon-Kan Yip; Chiung-Jen Wu; Hsiu-Yu Fang

    2015-01-01

    Objectives: Our aim was to evaluate the feasibility and safety of routine transradial approach (TRA) percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions using the sheathless technique with standard guiding catheters. Background: Transradial approach PCI was applied for CTO lesions. A major limitation of TRA CTO PCI is the inability to use large guiding catheters because of the relatively small size of the radial artery. Therefore, the sheathless technique for...

  11. Distribution and antimicrobial resistance of venous catheter-related infections in a neurosurgical intensive care unit%神经外科重症监护病房导管相关性感染病原菌分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    苏敏; 徐鹏

    2012-01-01

    目的 探讨神经外科重症监护病房导管相关性感染病原菌分布及其对常用抗菌药物的耐药情况. 方法 对2008年1月~2010年12月送检的169例导管标本进行分离培养,并对分离出的病原菌进行抗菌药物敏感性检测.结果 共检出导管相关性感染病原菌62株,其中革兰阳性球菌38株,革兰阴性杆菌24株,以表皮葡萄球菌(15株,24.19%)、鲍曼不动杆菌(9株,14.52%)、金黄色葡萄球菌(8株,12.90%)、溶血葡萄球菌(6株,9.68%)和肺炎克雷伯菌(6株,9.68%)为主要病原菌;药敏结果示革兰阳性菌对万古霉素较为敏感,而革兰阴性菌对亚胺培南敏感性较高.结论 神经外科重症监护病房导管相关性感染以革兰阳性球菌为主,并呈现多重耐药性.%Objective To investigate the distribution of pathogens responsible for venous catheter-related infections in a neurosurgical intensive care unit (NICU) and their drug resistance. Methods The pathogens from 169 catheter specimens collected from January 2008 to December 2010 were isolated and cultured and the drug sensitivity testing of the isolated pathogens was performed. Results In total, 62 strains of bacteria responsible for venous catheter-related infection were identified; of these, 38 strains were Gram-positive cocci while 24 were Gram-negative bacilli. Staphylococcus epidermidis (24. 19%) , Acinetobacter baumannii (14.52%), Staphylococcus aureus (12.90%), Staphylococcus hemo-lyticus (9. 68%) , and Klebsiella pneumonia (9. 68%) were the pathogens isolated most often. The results of drug sensitivity testing showed that Gram-positive bacterial isolates were sensitive to vancomycin while Gram-negative bacteria were sensitive to imipenem. Conclusion Gram-positive cocci were the pathogens predominantly responsible for venous catheter-related infections in a NICU, and these pathogens have multidrug resistance.

  12. Repositioning of malpositioned or flipped central venous catheters

    Energy Technology Data Exchange (ETDEWEB)

    Thalhammer, A.; Jacobi, V.; Balzer, J.; Vogl, T.J. [Institute for Diagnostic and Interventional Radiology, Central Radiology Clinic, J.W. Goethe University, Frankfurt am Main (Germany)

    2002-03-01

    Primary misplaced or secondary flipped implanted catheters are located mostly in the right jugular vein. We demonstrate an effective method to replace fix implanted catheters such as Ports, Grochomg or Hickman catheters. Using a femoral venous approach, replacement into the superior vena cava can easily be done with a Sidewinder 1 catheter which is hooked over the misplaced central venous approach. In all our patients the method was successful. The repositioning technique described is simple, fast and has low costs. We can keep sterile conditions and do not need to solve the catheters' fixation. (orig.)

  13. Risk factors for hospital-acquired bloodstream infections caused by gram-positive cocci and analysis of prognosis%医院获得性革兰阳性球菌血流感染的危险因素及预后分析

    Institute of Scientific and Technical Information of China (English)

    温晓星; 李华茵; 周晴; 周春妹; 高晓东; 胡必杰

    2014-01-01

    OBJECTIVE To explore the risk factors for hospital-acquired bloodstream infections caused by gram-positive cocci and observe the prognosis so as to provide guidance for control of the infections and improve the prognosis .METHODS The clinical data were retrospectively collected from the patients with hospital-acquired bloodstream infections caused by gram-positive cocci who were treated in the hospital from Jan 2012 to Jun 2014 , then the distribution and drug resistance of pathogens were compared between the survival group and the death group;the mortality of the hospitalized patients and the related factors for death were analyzed .RESULTS The coagulase-negative Staphylococcus was the predominant species of gram-positive cocci causing the bloodstream infections ,accounting for 54 .26% ;25 patients died with the mortality rate of 24 .04% .The drug resistance rate of the coagulase-negative Staphylococcus to penicillin was the highest (97 .01% ) ,followed by erythromycin (88 .24% ) and oxacillin (85 .00% );the drug resistance rate of the coagulase-negative Staphylococcus of the death group was higher than that of the survival group except for penicillin ,there was statistically significant difference (P<0 .05) .The isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 100 .00% in the death group ,significantly higher than that of the survival group (P= 0 .045) .The multivariate logistic regression analysis indicated that the hospital-acquired bloodstream infections showed significant correlation with the medical device implanting duration ,catheter indwelling time ,highest body temperature during infection ,total protein before drug therapy ,multidrug-resistant bacteria infections ,and mortality .CONCLUSION The medical device implanting duration ,catheter indwelling time ,highest body temperature during infection ,and multidrug-resistant bacteria infections are the independent risk factors for the death .%目的:了解医院获得性革兰阳

  14. Analysis of risk factors and the establishment of a risk model for peripherally inserted central catheter thrombosis

    Institute of Scientific and Technical Information of China (English)

    Fang Hu; Ruo-Nan Hao; Jie Zhang; Zhi-Cheng Ma

    2016-01-01

    Objective: To investigate the main risk factors of peripherally inserted central catheter (PICC) related upper extremity deep venous thrombosis and establish the risk predictive model of PICC-related upper extremity deep venous thrombosis. Methods: Patients with PICC who were hospitalized between January 2014 and July 2015 were studied retrospectively; they were divided into a thrombosis group (n ¼ 52), with patients who had a venous thrombosis complication after PICC, and a no-thrombosis group (n ¼ 144), with patients without venous thrombosis. To compare between the two groups, significantly different variables were selected to perform multivariate logistic regression to establish the risk-predictive model. Results: The PICC catheter history, catheter tip position, and diameter of blood vessel were the key factors for thrombosis. The logistic regression predictive model was as follows:Y ¼ 3.338 þ 2.040 ? PICC catheter history þ1.964? catheter tip position ?1.572? diameter of vessel. The area under the receiver operating characteristic curve for the model was 0.872, 95%CI (0.817e0.927). The cut-off point was 0.801, the sensitivity of the model was 0.832, and the specificity was 0.745. Conclusions: The PICC catheterization history, catheter tip position, the diameter of blood vessel were the key factors for thrombosis. The logistic regression risk model based on these factors is reliable for predicting PICC-related upper extremity deep venous thrombosis.

  15. The bowed catheter sign: a risk for pericardial tamponade

    Energy Technology Data Exchange (ETDEWEB)

    Towbin, Richard [Phoenix Children' s Hospital, Department of Radiology, Phoenix, AZ (United States)

    2008-03-15

    The use of a central venous catheter (CVC) has become commonplace in the care of children with a wide variety of medical and surgical problems. Complications resulting from the insertion of these catheters are well recognized and can be life-threatening. When a temporary CVC or other catheter is inserted into the central venous system it is secured to the skin with a combination of sutures and sterile dressing. This fixes the catheter in place and does not allow it to retract, thereby putting pressure on the right atrial wall via the catheter tip if it is too long. The probability of wall penetration is increased if a catheter or device is tapered at the point of contact. The purpose of this case report is to present the bowed catheter sign and to review the anatomy of the cavotricuspid isthmus, a possible predisposing factor to cardiac perforation and tamponade. (orig.)

  16. Depth of insertion of right internal jugular central venous catheter: Comparison of topographic and formula methods

    Science.gov (United States)

    Vinay, M; Tejesh, CA

    2016-01-01

    Background: Central venous catheters (CVCs) are inserted in many critically ill patients, but there is no gold standard in estimating their approximate depth of insertion. Many techniques have been described in literature. In this study, we compare the topographic method with the standard formula technique. Materials and Methods: 260 patients, in whom central venous catheterization was warranted, were randomly assigned to either topographic method or formula method (130 in each group). The position of the CVC tip in relation to carina was measured on a postprocedure chest X-ray. The primary endpoint was the need for catheter repositioning. Results: The majority of the CVCs tips positioned by the formula method were situated below the carina, and 68% of these catheters required repositioning after obtaining postprocedure chest X-ray (P formula approach in estimating the depth of insertion of right internal jugular CVCs.

  17. Needle catheter jejunostomy: a controlled, prospective, randomized trial in patients with gynecologic malignancy.

    Science.gov (United States)

    Spirtos, N M; Ballon, S C

    1988-06-01

    Sixty patients with gynecologic cancer entered a prospective, randomized study of immediate postoperative feeding. Thirty-three women in the study group received an elemental diet (Vivonex HN) delivered through a needle catheter jejunostomy. Twenty-seven patients in the control group were given standard 5% dextrose and electrolyte solutions. Patients in both groups were stratified according to nutritional status as determined by anthropometric evaluation and levels of serum albumin, total protein, and transferrin. These parameters also were measured at intervals throughout the study. Only one catheter-related complication occurred. Patients in the study group received significantly more calories (p = 0.01) and were better able to maintain serum levels of transferrin (p = 0.05) than those in the control group. An elemental diet administered through the needle catheter jejunostomy effectively maintains postoperative nutrition and is associated with few complications. PMID:3132853

  18. Peritonitis and catheter exit-site infection in patients on peritoneal dialysis at home1

    Science.gov (United States)

    Abud, Ana Cristina Freire; Kusumota, Luciana; dos Santos, Manoel Antônio; Rodrigues, Flávia Fernanda Luchetti; Damasceno, Marta Maria Coelho; Zanetti, Maria Lúcia

    2015-01-01

    Objective: to analyze the complications related to peritonitis and catheter exit-site infections, in patients on peritoneal dialysis at home. Method: quantitative and cross-sectional study, carried out with 90 patients on peritoneal dialysis at home, in a municipality in the Northeast region of Brazil. For data collection, it was used two structured scripts and consultation on medical records. Descriptive analysis and comparison tests among independent groups were used, considering p<0.05 as level of statistical significance. Results: by comparing the frequency of peritonitis and the length of treatment, it was found that patients over two years of peritoneal dialysis were more likely to develop peritonitis (X²=6.39; p=0.01). The number of episodes of peritoneal catheter exit-site infection showed association with the length of treatment (U=224,000; p=0.015). Conclusion: peritonitis and catheter exit-site infection are associated with the length of treatment. PMID:26487141

  19. Long-term follow-up for lumbar intrathecal baclofen catheters placed using the paraspinal subfascial technique.

    Science.gov (United States)

    Thakur, Saumitra K; Rubin, Benjamin A; Harter, David H

    2016-03-01

    OBJECT Intrathecal baclofen (ITB) is a valuable therapeutic option for patients with spasticity and dystonia. The techniques that place an ITB pump catheter into the subcutaneous fat of a lumbar incision are well described. Because patients who require ITB often have low body fat content, they may be predisposed to catheter-related complications. The senior author used a novel technique to place the catheter in a paraspinal subfascial fashion, and the short-term results were previously published. That study demonstrated no development of hardware erosions, catheter migrations, or CSF leaks within an average follow-up of 5 months. This study followed up on those initial findings by looking at the long-term outcomes since this technique was introduced. METHODS Using the institutional review board-approved protocol, the electronic medical records were reviewed retrospectively for all patients who underwent paraspinal subfascial catheter placement by the senior author. Patients received follow-up with the surgeon at 2 weeks postoperatively and were followed routinely by their physiatrist thereafter. RESULTS Of the 43 patients identified as having undergone surgery by the senior author using the paraspinal subfascial technique between July 2010 and February 2014, 12 patients (27.9%) required reoperation. There were 5 patients (11.6%) who had complications related to the catheter or lumbar incision. No hardware erosions or CSF leaks were identified. These patients received a median follow-up of 3.0 years, with 30 of 43 patients receiving follow-up over 2.0 years. CONCLUSION This follow-up study suggests that the technique of paraspinal subfascial catheter placement translates to long-term decreases in CSF leakage and complications from erosion, infection, and also catheter malfunctions. It does not seem to affect the overall rate of complications. PMID:26588457

  20. Safety and Complications of Double-Lumen Tunnelled Cuffed Central Venous Dialysis Catheters; Clinical and radiological perspective from a tertiary centre in Oman

    Directory of Open Access Journals (Sweden)

    Rana S. Hamid

    2015-11-01

    Full Text Available Objectives: This study aimed to assess the technical success, safety and immediate and delayed complications of double-lumen tunnelled cuffed central venous catheters (TVCs at the Sultan Qaboos University Hospital (SQUH, Muscat, Oman. Methods: This retrospective study took place between January 2012 and October 2013. The clinical records and radiological data of all patients who underwent ultrasound- and fluoroscopy-guided TVC placement at SQUH during the study period were reviewed. Demographic data and information regarding catheter placement, technical success and peri- and post-procedure complications (such as catheter-related infections or thrombosis were collected. Results: A total of 204 TVCs were placed in 161 patients. Of these, 68 were female (42.2% and 93 were male (57.8%. The mean age of the patients was 54.4 ± 17.3 years. The most common reason for catheter placement was the initiation of dialysis (63.4%. A total of 203 procedures were technically successful (99.5%. The right internal jugular vein was the most common site of catheter placement (74.9%. Mild haemorrhage which resolved spontaneously occurred in 11 cases (5.4%. No other complications were observed. Subsequent follow-up data was available for 132 catheters (65.0%; of these, thrombosis-related catheter malfunction was observed in 22 cases (16.7% and catheter-related infection in 29 cases (22.0%. Conclusion: Radiological-guided placement of tunnelled haemodialysis catheters can be performed safely with excellent technical success. The success rate of catheter insertion at SQUH was favourable in comparison with other studies reported in the literature.

  1. Causes of catheter-related urinary tract infections and treatment strategies%导尿管相关性尿路感染的病因分析及治疗策略

    Institute of Scientific and Technical Information of China (English)

    刘晟; 张海涛; 蔡海荣; 燕东亮

    2013-01-01

    目的 总结由于留置导尿管而引起的尿路感染(UTI)病因分析以及治疗策略.方法 将80例UTI患者随机分为治疗组和对照组各40例,对照组采用静脉注射头孢曲松治疗,治疗组采用静脉注射头孢曲松联合口服氧氟沙星治疗.结果 UTI患者检出病原菌主要为革兰阴性杆菌,其中以大肠埃希菌、克雷伯菌属较为常见,分别占33.80%、14.08%;治疗组总有效率为l00.00%,对照组总有效率为75.00%,两组疗效比较,差异有统计学意义(P<0.05).结论 UTI的菌群主要为革兰阴性杆菌,静脉注射头孢曲松联合口服氧氟沙星胶囊的方法对于革兰阴性杆菌有抑制作用,所以对治疗UTI有一定疗效.%OBJECTIVE To summarize the causes of urinary tract infections (UTI) induced by the catheter indwelling and put forward the treatment strategies.METHODS A total of 80 cases of patients with UTI were randomly divided into the treatment group and the control group with 40 cases in each,then the control was treated with intravenous ceftriaxone,while the treatment group was treated with intravenous ceftriaxone combined with oral ofloxacin.RESULTS The gram-negative bacilli were the main pathogens isolated from the UTI patients,among which the Escherichia coli and the Klebsiella were the most common species,accounting for 33.80% and 14.08%,respectively.The overall effective rate of the treatment group was 100.00%,the control group 75.00%,as compared with the clinical efficacy between the two groups,the difference was significant (P<0.05).CONCLUSION The gram-negative bacilli are the predominant pathogens causing UTI,and the intravenous ceftriaxone combined with oral administration of ofloxacin capsules can inhibit the gram-negative bacilli,therefore,it can achieve certain curative effect on treatment of UTI.

  2. Comparison of complications between transjugular and axillosubclavian approach for placement of tunneled, central venous catheters in patients with hematological malignancy: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hoon; Hahn, Seong Tai [Catholic University of Korea, Diagnostic Radiology, Seoul (Korea)

    2005-06-01

    This study was designed to compare the incidence of mechanical, thrombotic and infective complications in transjugular (IJV) and axillosubclavian (SCV) central venous catheters (CVC) in patients with hematological malignancy. In a prospective observational trial, 131 consecutive patients were classified into two groups: Group A included those with IJV catheter insertions under sonography guidance (n=61) and group B included those with SCV insertions under venography guidance (n=70). After catheter placement, patients were prospectively acquired and recorded to obtain the following data: success rates, total catheter days, and complication episodes per 100 catheter days. All procedures were technically successful. Total catheter days were 7800 (group A) versus 8391(group B). Mechanical complications were observed in three cases from group A and 11 from group B, with an incidence rate of 0.04 per 100 catheter days versus 0.13 (P=0.043), respectively. Two symptomatic thrombotic complications were observed in group B. The number of infective complications was not significantly different between the two groups (P=0.312). There was no difference in infective complication incidence between the two groups. To minimize catheter-related mechanical and thrombotic complications, however, the IJV approach is superior to the SCV approach. (orig.)

  3. A novel approach using Neuron 6F guiding catheter for the embolization of intracranial aneurysm with coiling of the parent internal carotid artery.

    Science.gov (United States)

    Wang, Donghai; Wang, Ying; Su, Wandong; Wang, Yunyan; Li, Gang; Li, Xingang

    2015-01-01

    To describe our initial experience and early outcomes with distal placement of the Neuron 6F guiding catheter through coiled ICA for aneurysmal EVT. We examined the utility of the Neuronf 70 6F guiding catheter for the embolization procedure in such cases, fourteen cases of aneurysm with coiling of the parent ICA are presented via traditional guiding catheters. With the support of 8F ENVOY guiding catheter as a shuttle sheath, the Neuron(TM) 70 6F guiding catheter was successfully placed through coiled extracranial ICA, so the mirocatheter could be delivered to a more strategic position for embolization of the aneurysm. Coiling of extracranial ICA was found as parent artery on angiogram in all patients with ruptured aneurysms. Even where there were two curvatures of more than 360° in the coiled segment of the ICA, Neuron(TM) 70 6F guiding catheter could be placed through the coiling to a distal position and enabled EVT of intracranial aneurysms with no related neurological complications. Neuron guiding catheter is a useful device for embolization of aneurysm where there is coiling of parent ICA, easily placed through the coiling of the ICA and provided robust anatomical support via enhanced catheter-to-vessel wall engagement. PMID:25785169

  4. Biological safety evaluation of the modified urinary catheter

    Energy Technology Data Exchange (ETDEWEB)

    Kowalczuk, Dorota, E-mail: dorota.kowalczuk@umlub.pl [Department of Medicinal Chemistry, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin (Poland); Przekora, Agata; Ginalska, Grazyna [Department of Biochemistry and Biotechnology, Medical University of Lublin, Chodzki 1, 20-093 Lublin (Poland)

    2015-04-01

    The purpose of this study was to evaluate in vitro safety of the novel tosufloxacin (TOS)-treated catheters with the prolonged antimicrobial activity. The test samples of silicone latex catheter were prepared by the immobilization of TOS on chitosan (CHIT)-coated catheter by means of covalent bonds and non-covalent interactions. Each step of the modification process of catheter surface was observed using ATR–Fourier transform infrared spectroscopy. In vitro cytotoxicity of the modified and unmodified catheters was assessed by direct and indirect tests in accordance with ISO standards using green monkey kidney (GMK) cell line. The MTT, lactate dehydrogenase activity (LDH), WST-8, Sulforhodamine B (SRB) test results and microscopic observation clearly indicated that unmodified silicone latex catheters decrease cell metabolic activity, act as a cytotoxic agent causing cell lysis and induce cell death through necrotic or apoptotic process. We suggest that chitosan coat with TOS immobilized limits leaching of harmful agents from silicone latex material, which significantly enhances survivability of GMK cells and therefore is quite a good protection against the cytotoxic effect of this material. - Highlights: • Characterization of the novel antimicrobial urinary catheters • Monitoring of the catheter modification by FTIR analysis • Confirmation of high cytotoxicity of latex-based catheter used in urological practice • Chitosan-coated and tosufloxacin-treated catheter is less toxic than the untreated one. • The proposed surface modification protects cells against latex-induced death.

  5. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate.

  6. Distributed pressure sensors for a urethral catheter.

    Science.gov (United States)

    Ahmadi, Mahdi; Rajamani, Rajesh; Timm, Gerald; Sezen, A S

    2015-08-01

    A flexible strip that incorporates multiple pressure sensors and is capable of being fixed to a urethral catheter is developed. The urethral catheter thus instrumented will be useful for measurement of pressure in a human urethra during urodynamic testing in a clinic. This would help diagnose the causes of urinary incontinence in patients. Capacitive pressure sensors are fabricated on a flexible polyimide-copper substrate using surface micromachining processes and alignment/assembly of the top and bottom portions of the sensor strip. The developed sensor strip is experimentally evaluated in an in vitro test rig using a pressure chamber. The sensor strip is shown to have adequate sensitivity and repeatability. While the calibration factors for the sensors on the strip vary from one sensor to another, even the least sensitive sensor has a resolution better than 0.1 psi. PMID:26738054

  7. Pancreas tumor interstitial pressure catheter measurement

    Science.gov (United States)

    Nieskoski, Michael D.; Gunn, Jason; Marra, Kayla; Trembly, B. Stuart; Pogue, Brian W.

    2016-03-01

    This paper highlights the methodology in measuring interstitial pressure in pancreatic adenocarcinoma tumors. A Millar Mikrotip pressure catheter (SPR-671) was used in this study and a system was built to amplify and filter the output signal for data collection. The Millar pressure catheter was calibrated prior to each experiment in a water column at 37°C, range of 0 to 60 inH2O (112 mmHg), resulting in a calibration factor of 33 mV / 1 inH2O. The interstitial pressures measured in two orthotopically grown pancreatic adenocarcinoma tumor were 57 mmHg and 48 mmHg, respectively. Verteporfin uptake into the pancreatic adenocarcinoma tumor was measured using a probe-based experimental dosimeter.

  8. Monopole antennas for microwave catheter ablation

    Energy Technology Data Exchange (ETDEWEB)

    Labonte, S.; Blais, A.; Legault, S.R.; Ali, H.O.; Roy, L. [Univ. of Ottawa, Ontario (Canada). Dept. of Electrical Engineering

    1996-10-01

    The authors study the characteristics of various monopole antennas for microwave catheter ablation of the endocardium. The investigation is done with a computer model based on the finite-element method in the frequency domain. Three monopole geometries are considered: open-tip, dielectric-tip, and metal-tip. Calculations are made for the magnetic field, the reflection coefficient and the power deposition pattern of the antennas immersed in normal saline. The theoretical results are compared with measurements performed on prototypes and good agreement is obtained. The antenna characteristics suggest that the metal-tip monopole best fulfills the requirements of catheter ablation. The computer model is then used to compare metal-tip monopoles of different dimensions and to determine design trade-offs.

  9. Choice of valve type and poor ventricular catheter placement: Modifiable factors associated with ventriculoperitoneal shunt failure.

    Science.gov (United States)

    Jeremiah, Kealeboga Josephine; Cherry, Catherine Louise; Wan, Kai Rui; Toy, Jennifer Ah; Wolfe, Rory; Danks, Robert Andrew

    2016-05-01

    Ventriculoperitoneal (VP) shunt insertion is a common neurosurgical procedure, essentially unchanged in recent years, with high revision rates. We aimed to identify potentially modifiable associations with shunt failure. One hundred and forty patients who underwent insertion of a VP shunt from 2005-2009 were followed for 5-9years. Age at shunt insertion ranged from 0 to 91years (median 44, 26% hydrocephalus were congenital (26%), tumour-related (25%), post-haemorrhagic (24%) or normal pressure hydrocephalus (19%). Fifty-eight (42%) patients required ⩾1 shunt revision. Of these, 50 (88%) were for proximal catheter blockage. The median time to first revision was 108days. Early post-operative CT scans were available in 105 patients. Using a formal grading system, catheter placement was considered excellent in 49 (47%) but poor (extraventricular) in 13 (12%). On univariate analysis, younger age, poor ventricular catheter placement and use of a non-programmable valve were associated with shunt failure. On logistic regression modelling, the independent associations with VP shunt failure were poor catheter placement (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.3-18.9, p=0.02) and use of a non-programmable valve (OR 0.4, 95% CI 0.2-1.0, p=0.04). In conclusion, poor catheter placement (revision rate 77%) was found to be the strongest predictor of shunt failure, with no difference in revisions between excellent (43%) and moderate (43%) catheter placement. Avoiding poor placement in those with mild or moderate ventriculomegaly may best reduce VP shunt failures. There may also be an influence of valve choice on VP shunt survival.

  10. In vitro catheter and sorbent-based method for clearance of radiocontrast material during cerebral interventions

    Energy Technology Data Exchange (ETDEWEB)

    Angheloiu, George O., E-mail: goangheloiu@drmc.org [Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA (United States); Department of Cardiology, Dubois Regional Medical Center, Dubois, PA (United States); Hänscheid, Heribert; Reiners, Christoph [Department of Nuclear Medicine, University of Würzburg, Würzburg (Germany); Anderson, William D. [Cardiology Department, Exempla Healthcare, Denver, CO (United States); Kellum, John A. [CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA (United States)

    2013-07-15

    Background: Contrast-induced acute kidney injury is a severe condition resulting from the use of radiology contrast in patients with predisposing factors. Hypothesis: We hypothesized that a novel system including a device containing polymer resin sorbent beads and a custom-made suctioning catheter could efficiently remove contrast from an in vitro novel model of circulatory system (MOCS) mimicking the cerebral circulation. Methods: A custom-made catheter was built and optimized for cerebral venous approach. The efficiency of a system made of a polymer resin sorbent beads column (CST 401, Cytosorbents) and this particular catheter was tested in the MOCS running a solution composed of 0.9% saline and radio-contrast. During two series of 18 cycles of first-pass experiments we assessed the catheter's suctioning efficiency and the system's ability to clear radio-contrast injected into the MOCS's cerebral arterial segment. We also assessed the functioning and reliability of the MOCS. Results: Mean suctioning efficiency of the catheter was 84% ± 24%. The polymer sorbent column contrast removal rate was initially 96% and gradually decreased with subsequent cycles in a linear fashion during an experiment lasting approximately 90 minutes. The MOCS had a reliability of 0.9946×min{sup −1} where 1 × min{sup −1} was the optimum value. Conclusion: A system including a polymer resin sorbent beads column and a custom-made suctioning catheter had an excellent initial efficiency in quickly removing contrast from an artificial MOCS mimicking the cerebral circulation. MOCS is an inexpensive and relatively reliable custom-made system that can be used for training or testing purposes.

  11. Cluster of Candida parapsilosis primary bloodstream infection in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Silva Carmem Lúcia P. da

    2001-01-01

    Full Text Available Candida parapsilosis is an increasingly important bloodstream pathogen in neonatal intensive care units (NICU. We investigated a cluster of bloodstream infections in a NICU to determine whether nosocomial transmission occurred. During a 3-day period, 3 premature infants hospitalized in the same unit presented with sepsis caused by C. parapsilosis. Electrophoretic karyotype of the organisms was performed by using pulsed field gel electrophoresis in a countour-clamped homogeneous electric field system. The isolate from 1 newborn could not be typed, and the isolates from the remaining 2 infants had identical patterns. All 3 cases are described. We conclude that nosocomial transmission of C. parapsilosis occurred and that neonates under intensive care may represent a risk group for this pathogen.

  12. The Impact of Infectious Disease Specialist Consultation for Staphylococcus aureus Bloodstream Infections: A Systematic Review.

    Science.gov (United States)

    Paulsen, Julie; Solligård, Erik; Damås, Jan Kristian; DeWan, Andrew; Åsvold, Bjørn Olav; Bracken, Michael B

    2016-03-01

    Staphylococcus aureus is a common cause of severe bloodstream infection. We performed a systematic review to assess whether consultation with infectious disease specialists decreased all-cause mortality or rate of complications of S aureus bloodstream infections. The review also assessed parameters associated with the quality of management of the infection. We searched for eligible studies in PubMed, Embase, Scopus, and clinical trials.gov as well as the references of included studies. We identified 22 observational studies and 1 study protocol for a randomized trial. A meta-analysis was not performed because of the high risk of bias in the included studies. The outcomes are reported in a narrative review. Most included studies reported survival benefit, in the adjusted analysis. Recommended management strategies were carried out significantly more often among patients seen by an infectious disease specialist. Trials, such as cluster-randomized controlled trials, can more validly assess the studies at low risk of bias. PMID:27047985

  13. Transpleural central venous catheter discovered during thoracotomy

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    Ashima Malhotra

    2014-01-01

    Full Text Available We report an uncommon complication of subclavian central venous catheterization, discovered at thoracotomy. The central venous catheter (CVC was placed by left infraclavicular route after induction of general anesthesia. CVC was secured after aspiration of blood and satisfactory central venous tracing. On thoracotomy, CVC was noticed to traverse the pleural cavity while the tracing was normal. CVC was thus removed consequent to which bleeding from each puncture site was noticed, that were secured surgically.

  14. Electromagnetic tracking and steering for catheter navigation

    OpenAIRE

    O'Donoghue, Kilian

    2014-01-01

    This thesis explores the use of electromagnetics for both steering and tracking of medical instruments in minimally invasive surgeries. The end application is virtual navigation of the lung for biopsy of early stage cancer nodules. Navigation to the peripheral regions of the lung is difficult due to physical dimensions of the bronchi and current methods have low successes rates for accurate diagnosis. Firstly, the potential use of DC magnetic fields for the actuation of catheter devices with ...

  15. Robotic Catheters for Beating Heart Surgery

    OpenAIRE

    Kesner, Samuel Benjamin

    2011-01-01

    Compliant and flexible cardiac catheters provide direct access to the inside of the heart via the vascular system without requiring clinicians to stop the heart or open the chest. However, the fast motion of the intracardiac structures makes it difficult to modify and repair the cardiac tissue in a controlled and safe manner. In addition, rigid robotic tools for beating heart surgery require the chest to be opened and the heart exposed, making the procedures highly invasive. The novel robot...

  16. National Bloodstream Infection Surveillance in Switzerland 2008-2014: Different Patterns and Trends for University and Community Hospitals.

    Science.gov (United States)

    Buetti, Niccolò; Marschall, Jonas; Atkinson, Andrew; Kronenberg, Andreas

    2016-09-01

    OBJECTIVE To characterize the epidemiology of bloodstream infections in Switzerland, comparing selected pathogens in community and university hospitals. DESIGN Observational, retrospective, multicenter laboratory surveillance study. METHODS Data on bloodstream infections from 2008 through 2014 were obtained from the Swiss infection surveillance system, which is part of the Swiss Centre for Antibiotic Resistance (ANRESIS). We compared pathogen prevalences across 26 acute care hospitals. A subanalysis for community-acquired and hospital-acquired bloodstream infections in community and university hospitals was performed. RESULTS A total of 42,802 bloodstream infection episodes were analyzed. The most common etiologies were Escherichia coli (28.3%), Staphylococcus aureus (12.4%), and polymicrobial bloodstream infections (11.4%). The proportion of E. coli increased from 27.5% in 2008 to 29.6% in 2014 (P = .04). E. coli and S. aureus were more commonly reported in community than university hospitals (34.3% vs 22.7%, Phospitals (41.0% vs 32.4%, Pinfections increased in community hospitals only. Community-acquired polymicrobial infections (9.9% vs 5.6%, Phospitals. CONCLUSIONS The role of E. coli as predominant pathogen in bloodstream infections has become more pronounced. There are distinct patterns in community and university hospitals, potentially influencing empirical antibiotic treatment. Infect Control Hosp Epidemiol 2016;37:1060-1067.

  17. Three Epidemics of Invasive Multidrug-Resistant Salmonella Bloodstream Infection in Blantyre, Malawi, 1998–2014

    OpenAIRE

    Feasey, Nicholas A.; Masesa, Clemens; Jassi, Chikondi; Faragher, E. Brian; Mallewa, Jane; Mallewa, Macpherson; MacLennan, Calman A.; Msefula, Chisomo; Robert S Heyderman; Gordon, Melita A.

    2015-01-01

    Background.  The Malawi Liverpool Wellcome Trust Clinical Research Programme (MLW) has routinely collected specimens for blood culture from febrile patients, and cerebrospinal fluid from patients with suspected meningitis, presenting to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, since 1998. Methods.  We present bloodstream infection (BSI) and meningitis surveillance data from 1998 to 2014. Automated blood culture, manual speciation, serotyping, and antimicrobial susceptibility...

  18. Risk of vancomycin-resistant enterococci bloodstream infection among patients colonized with vancomycin-resistant enterococci

    Directory of Open Access Journals (Sweden)

    Ahu Kara

    2015-02-01

    Full Text Available Background:Vancomycin-resistant enterococci colonization has been reported to increase the risk of developing infections, including bloodstream infections.Aim:In this study, we aimed to share our experience with the vancomycin-resistant enterococci bloodstream infections following gastrointestinal vancomycin-resistant enterococci colonization in pediatric population during a period of 18 months.Method:A retrospective cohort of children admitted to a 400-bed tertiary teaching hospital in Izmir, Turkey whose vancomycin-resistant enterococci colonization was newly detected during routine surveillances for gastrointestinal vancomycin-resistant enterococci colonization during the period of January 2009 and December 2012 were included in this study. All vancomycin-resistant enterococci isolates found within 18 months after initial detection were evaluated for evidence of infection.Findings: Two hundred and sixteen patients with vancomycin-resistant enterococci were included in the study. Vancomycin-resistant enterococci colonization was detected in 136 patients (62.3% while they were hospitalized at intensive care units; while the remaining majority (33.0% were hospitalized at hematology-oncology department. Vancomycinresistant enterococci bacteremia was present only in three (1.55% patients. All these patients were immunosuppressed due to human immunodeficiency virus (one patient and intensive chemotherapy (two patients.Conclusion:In conclusion, our study found that 1.55% of vancomycin-resistant enterococcicolonized children had developed vancomycin-resistant enterococci bloodstream infection among the pediatric intensive care unit and hematology/oncology patients; according to our findings, we suggest that immunosupression is the key point for developing vancomycinresistant enterococci bloodstream infections.

  19. Delays in Appropriate Antibiotic Therapy for Gram-Negative Bloodstream Infections: A Multicenter, Community Hospital Study

    OpenAIRE

    Moehring, Rebekah W.; Richard Sloane; Chen, Luke F.; Smathers, Emily C.; Schmader, Kenneth E.; Fowler, Vance G.; Weber, David J.; Sexton, Daniel J.; Anderson, Deverick J.

    2013-01-01

    BACKGROUND: Gram-negative bacterial bloodstream infection (BSI) is a serious condition with estimated 30% mortality. Clinical outcomes for patients with severe infections improve when antibiotics are appropriately chosen and given early. The objective of this study was to estimate the association of prior healthcare exposure on time to appropriate antibiotic therapy in patients with gram-negative BSI. METHOD: We performed a multicenter cohort study of adult, hospitalized patients with gram-ne...

  20. Efficacy of an infection control programme in reducing nosocomial bloodstream infections in a Senegalese neonatal unit.

    Science.gov (United States)

    Landre-Peigne, C; Ka, A S; Peigne, V; Bougere, J; Seye, M N; Imbert, P

    2011-10-01

    Neonatal nosocomial infections are public health threats in the developing world, and successful interventions are rarely reported. A before-and-after study was conducted in the neonatal unit of the Hôpital Principal de Dakar, Senegal to assess the efficacy of a multi-faceted hospital infection control programme implemented from March to May 2005. The interventions included clustering of nursing care, a simple algorithm for empirical therapy of suspected early-onset sepsis, minimal invasive care and promotion of early discharge of neonates. Data on nosocomial bloodstream infections, mortality, bacterial resistance and antibiotic use were collected before and after implementation of the infection control programme. One hundred and twenty-five infants were admitted immediately before the programme (Period 1, January-February 2005) and 148 infants were admitted immediately after the programme (Period 2, June-July 2005). The two groups of infants were comparable in terms of reason for admission and birth weight. After implementation of the infection control programme, the overall rate of nosocomial bloodstream infections decreased from 8.8% to 2.0% (P=0.01), and the rate of nosocomial bloodstream infections/patient-day decreased from 10.9 to 2.9/1000 patient-days (P=0.03). Overall mortality rates did not differ significantly. The proportion of neonates who received antimicrobial therapy for suspected early-onset sepsis decreased significantly from 100% to 51% of at-risk infants (Pnosocomial bloodstream infections, and the efficacy of these interventions was long-lasting. Such interventions could be extended to other low-income countries.

  1. Muscle Releases Alpha-Sarcoglycan Positive Extracellular Vesicles Carrying miRNAs in the Bloodstream

    OpenAIRE

    Michele Guescini; Barbara Canonico; Francesco Lucertini; Serena Maggio; Giosué Annibalini; Elena Barbieri; Francesca Luchetti; Stefano Papa; Vilberto Stocchi

    2015-01-01

    In the past few years, skeletal muscle has emerged as an important secretory organ producing soluble factors, called myokines, that exert either autocrine, paracrine or endocrine effects. Moreover, recent studies have shown that muscle releases microRNAs into the bloodstream in response to physical exercise. These microRNAs affect target cells, such as hormones and cytokines. The mechanisms underlying microRNA secretion are poorly characterized at present. Here, we investigated whether muscle...

  2. Efficacy of intravascular catheter lock solutions containing preservatives in the prevention of microbial colonization.

    Science.gov (United States)

    Shenep, L E; Shenep, M A; Cheatham, W; Hoffman, J M; Hale, A; Williams, B F; Perkins, R; Hewitt, C B; Hayden, R T; Shenep, J L

    2011-12-01

    There is little published evidence regarding whether heparin lock solutions containing preservatives prevent catheter-related infections. However, adverse effects from preservative-containing flushes have been documented in neonates, leading many hospitals to avoid their use altogether. Infection control records from 1982 to 2008 at St. Jude Children's Research Hospital (SJCRH) were reviewed regarding the incidence of catheter-related infections and the use of preservative-containing intravenous locks. In addition, the antimicrobial activities of heparin lock solution containing the preservatives parabens (0.165%) or benzyl alcohol (0.9%), and 70% ethanol were examined against Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, Bacillus cereus, Pseudomonas aeruginosa and Candida albicans, and compared with preservative-free saline with and without heparin. Growth was assessed after exposure to test solutions for 0, 2, 4 and 24h at 35 °C. The activities of preservatives were assessed against both planktonic (free-floating) and sessile (biofilm-embedded) micro-organisms using the MBEC Assay. Infection control records revealed two periods of increased catheter-related infections, corresponding with two intervals when preservative-free heparin was used at SJCRH. Heparin solution containing preservatives demonstrated significant antimicrobial activity against both planktonic and sessile forms of all six microbial species. Ethanol demonstrated the greatest antimicrobial activity, especially following short incubation periods. Heparin lock solutions containing the preservatives parabens or benzyl alcohol, and 70% ethanol demonstrated significant antimicrobial activity against both planktonic and sessile micro-organisms commonly responsible for catheter-related infections. These findings, together with the authors' historical infection control experience, support the use of preservatives in intravenous lock solutions to reduce catheter related infections

  3. Robotic catheter cardiac ablation combining ultrasound guidance and force control

    OpenAIRE

    Kesner, Samuel Benjamin; Howe, Robert D.

    2014-01-01

    Cardiac catheters allow physicians to access the inside of the heart and perform therapeutic interventions without stopping the heart or opening the chest. However, conventional manual and actuated cardiac catheters are currently unable to precisely track and manipulate the intracardiac tissue structures because of the fast tissue motion and potential for applying damaging forces. This paper addresses these challenges by proposing and implementing a robotic catheter system that uses 3D ultras...

  4. The effect of lidocaine and tramadol on prevention and treatment catheter-related bladder discomfort%利多卡因凝胶联合曲马多防治尿管相关膀胱刺激症的效果观察

    Institute of Scientific and Technical Information of China (English)

    张宁; 周愚; 王蔚; 肖秀英; 彭小萍; 曾萍

    2014-01-01

    Objective:To observe the effect of lidocaine gel catheterization and tramadol on male patients of catheter-related bladder discomfort ( CRBD) undergoing general anesthesia. Methods:120 male patients undergoing thoracic or abdomen surgeries were selected and randomly divided into experimental group and control group. All patients received the same general anesthesia. Urethral catheterization performed under topical anesthesia with lidocaine gel un-der general anesthesia in experimental group and with liquid paraffin in control group. At the end of the surgery,tramadol of 1mg/kg were given intravenous in experimental group and saline were given in control group. Incidence of catheter-related bladder discomfort were compared. Results:The incidence and severity of CRBD were significantly decreased in experimental group compared with those in control group (P<0. 05). Conclusion:Lidocaine gel topical an-esthesia with low-dose tramadol intravenous injection could effectively prevent catheter-related bladder discomfort after urethral catheterization in patients undergoing general anesthesia,thus increase the degree of comfort during recovery of anesthesia.%目的:探讨联合使用利多卡因凝胶局部麻醉导尿及静脉注射曲马多对全身麻醉患者尿管相关膀胱刺激症的影响。方法:选择120例男性胸、腹部手术患者,将其随机等分为试验组和对照组。试验组全身麻醉气管插管结束后在利多卡因凝胶局部麻醉下导尿,术毕予小剂量曲马多静脉注射。对照组在全身麻醉后行常规导尿术,术毕予相同体积的生理盐水。比较两组患者膀胱刺激症的发生程度。结果:与对照组比较,试验组患者膀胱刺激症发生程度明显减轻(P<0.05)。试验组患者中有1例使用了曲马多自诉恶心,未呕吐。对照组患者没有出现明显的恶心呕吐等不良反应。结论:利多卡因凝胶局部麻醉联合静脉注射曲马多能降低全身麻醉

  5. A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients – the HEALTHY-CATH trial

    Directory of Open Access Journals (Sweden)

    Broom Jennifer K

    2012-11-01

    Full Text Available Abstract Background Tunnelled central venous dialysis catheter use is significantly limited by the occurrence of catheter-related infections. This randomised controlled trial assessed the efficacy of a 48 hour 70% ethanol lock vs heparin locks in prolonging the time to the first episode of catheter related blood stream infection (CRBSI. Methods Patients undergoing haemodialysis (HD via a tunnelled catheter were randomised 1:1 to once per week ethanol locks (with two heparin locks between other dialysis sessions vs thrice per week heparin locks. Results Observed catheter days in the heparin (n=24 and ethanol (n=25 groups were 1814 and 3614 respectively. CRBSI occurred at a rate of 0.85 vs. 0.28 per 1000 catheter days in the heparin vs ethanol group by intention to treat analysis (incident rate ratio (IRR for ethanol vs. heparin 0.17; 95%CI 0.02-1.63; p=0.12. Flow issues requiring catheter removal occurred at a rate of 1.6 vs 1.4 per 1000 catheter days in the heparin and ethanol groups respectively (IRR 0.85; 95% CI 0.20-3.5 p =0.82 (for ethanol vs heparin. Conclusions Catheter survival and catheter-related blood stream infection were not significantly different but there was a trend towards a reduced rate of infection in the ethanol group. This study establishes proof of concept and will inform an adequately powered multicentre trial to definitively examine the efficacy and safety of ethanol locks as an alternative to current therapies used in the prevention of catheter-associated blood stream infections in patients dialysing with tunnelled catheters. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000493246

  6. Atrial fibrillation radiofrequency ablation: safety using contact force catheter in a low-volume centre

    Directory of Open Access Journals (Sweden)

    Diego Vaccari, MD; Daniele Giacopelli, MSc; Eros Rocchetto, MSc; Sabina Vittadello, MD; Roberto Mantovan, MD; Gianfilippo Neri, MD

    2014-08-01

    Full Text Available The tip-to-tissue contact force (CF has been identified as a potential determinant of lesion quality during radiofrequency (RF ablation. The aim of this paper is to report the experience of a single low-volume centre in the atrial fibrillation (AF ablation procedure with an RF catheter capable of measuring this parameter. CF data and their possible implications on patient safety are presented. Thirty-nine consecutive patients suffering of paroxysmal or permanent AF received percutaneous ablation with the novel catheter studied. Procedural characteristics, CF applied and safety events related to the procedure were reported. During RF application the mean CF value was 17 ± 3 g, with a maximum mean value of 37 ± 8 g. CF value never exceeds 62 g and in the 74% of the RF applications ranged between 10 g and 30 g. No complication related to the catheter manipulation or to the energy delivered was observed. This study of a single centre with a low level of experience in AF ablation suggests that the ability to measure CF may provide additional useful information to the operator. It ensures uniform ablations, with little variability in the catheter manipulations, and it avoids excessive contact forces increasing the patient safety.

  7. Use of tunnelled catheters in haematological malignancy patients with neutropenia.

    Science.gov (United States)

    Sariosmanoglu, N; Uğurlu, B; Turgut, N H; Demirkan, F; Ozsan, H; Ergor, G; Gulay, Z; Hazan, E; Oto, O

    2008-01-01

    This prospective study analysed 83 patients (age 45 +/- 17 years) with haematological neoplasms, implanted with 93 tunnelled catheters, who were neutropenic or developed neutropenia during treatment. Catheters were implanted in the right (n = 82) or left (n = 11) jugular vein by the same surgical team using the same technique. They remained in place for 124 +/- 88 days: 29% were removed due to infection; 18% due to treatment termination and 2% due to mechanical problems. Seventeen patients died with catheters in place. At 30, 60, 90, 120 and 200 days mean catheter duration rates were 82%, 75%, 65%, 60% and 35%, respectively, and freedom from catheter removal due to infection was 92%, 88%, 80%, 77% and 67%, respectively. Patient diagnosis and history of previous catheter infection did not increase catheter infection risk, but patients undergoing stem cell transplantation had an increased infection risk. Tunnelled catheters can be used in high-risk patients with neutropenia. Systemic infections can be managed in most patients without catheter removal. PMID:18831907

  8. Encrusted and incarcerated urinary bladder catheter: what are the options?

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    Christopher C.K. Ho

    2010-11-01

    Full Text Available Urinary bladder catheter encrustations are known complications of long-term urinary catheterisation, which is commonly seen in clinical practice. These encrustations can impede deflation of the balloon and therefore cause problems in the removal of the catheter. The options in managing an encrusted and incarcerated urinary bladder catheter include extracorporeal shock wave lithotripsy and lithoclast. We describe here another technique of dealing with a stuck and encrustated catheter, via direct crushing of the encrustations with a rigid cystoscope inserted through a suprapubic cystostomy tract.

  9. Real-time multipoint gastrointestinal 19-fluorine catheter tracking

    OpenAIRE

    Hahn, Tobias; Kozerke, Sebastian; Schwizer, Werner; Fried, Michael; Boesiger, Peter; Steingoetter, Andreas

    2014-01-01

    PURPOSE: To develop MR based real-time gastrointestinal 19-Fluorine (19F) catheter tracking and visualization allowing for real-time detection and feedback of 3D catheter shape and movement as well as catheter-driven adjustments of 1H imaging geometry parameters. METHODS: Data were acquired on a 3T clinical system using 3D Golden Angle radial sampling. Two gastrointestinal catheters incorporating four fiducial 19F markers (65 or 50 µL marker volume) were tracked while being pulled through ...

  10. Outbreaks associated to bloodstream infections with Staphylococcus aureus and coagulase-negative Staphylococcus spp in premature neonates in a university hospital from Brazil Surtos associados a infecções sanguíneas por Staphylococcus aureus e Staphylococcus spp coagulase-negativa em neonatos prematuros em um hospital universitário do Brasil

    Directory of Open Access Journals (Sweden)

    Denise Von Dolinger de Brito

    2006-06-01

    Full Text Available Staphylococcus aureus and coagulase-negative staphylococci (CoNS are among the most important nosocomial pathogens in patients from neonatal intensive care units, mainly in bloodstream infections. The main objective of this study is to determine the occurrence of nosocomial infections by these microorganisms using two surveillance systems (Laboratorial Surveillance and National Nosocomial Infection Surveillance System and to determine the most important risk factors during a two-year period (2001-2002. Two outbreaks by both methicillin susceptible S. aureus (MSSA (1.5% and methicillin resistant CoNS (MRCoNS (1.0% were observed, from January to February/02 and August to September/02. Endemic incidence rates of 3.77% and 5.16% of S. aureus and CoNS, respectively were detected. Risk factors included age or = 7 days and utilization of polietilene central vascular catheter (CVC through vein dissection (phlebotomy, but none of these independent factors were confirmed by the multivariate analysis. However, oxacillin resistant CoNS prevailed (66.0% in the epidemic episodes. Molecular analysis by pulsed field gel electrophoresis showed the polyclonal nature of S. aureus isolates. In conclusion, two outbreaks were identified of mixed etiology by MSSA and MRCoNS associated to the lack of an adequate material (central venous catheter for neonates, related invasive procedure. The outbreaks were controlled with the substitution of polietilene CVC for peripherally inserted central catheter.Staphylococcus aureus e Estafilococos coagulase-negativa (ECN estão entre os patógenos hospitalares mais importantes em pacientes de unidades de terapia intensiva neonatal, principalmente em infecções da corrente sanguínea. O principal objetivo deste estudo foi determinar a ocorrência de infecções hospitalares por estes microrganismos usando dois sistemas de vigilância (laboratorial e "National Nosocomial Infection Surveillance" - NNIS e determinar os fatores de

  11. Impact of cefepime therapy on mortality among patients with bloodstream infections caused by extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and Escherichia coli.

    Science.gov (United States)

    Chopra, Teena; Marchaim, Dror; Veltman, Jennifer; Johnson, Paul; Zhao, Jing J; Tansek, Ryan; Hatahet, Dania; Chaudhry, Khawar; Pogue, Jason M; Rahbar, Hiro; Chen, Ting-Yi; Truong, Thientu; Rodriguez, Victor; Ellsworth, Joseph; Bernabela, Luigino; Bhargava, Ashish; Yousuf, Adnan; Alangaden, George; Kaye, Keith S

    2012-07-01

    Extended-spectrum-β-lactamase (ESBL)-producing pathogens are associated with extensive morbidity and mortality and rising health care costs. Scant data exist on the impact of antimicrobial therapy on clinical outcomes in patients with ESBL bloodstream infections (BSI), and no large studies have examined the impact of cefepime therapy. A retrospective 3-year study was performed at the Detroit Medical Center on adult patients with BSI due to ESBL-producing Klebsiella pneumoniae or Escherichia coli. Data were collected from the medical records of study patients at five hospitals between January 2005 and December 2007. Multivariate analysis was performed using logistic regression. One hundred forty-five patients with BSI due to ESBL-producing pathogens, including K. pneumoniae (83%) and E. coli (16.5%), were studied. The mean age of the patients was 66 years. Fifty-one percent of the patients were female, and 79.3% were African-American. Fifty-three patients (37%) died in the hospital, and 92 survived to discharge. In bivariate analysis, the variables associated with mortality (P catheter. In multivariate analysis, the predictors of in-hospital mortality included stay in the intensive care unit (odds ratio [OR], 2.17; 95% confidence interval [CI], 0.98 to 4.78), presence of a central-line catheter prior to positive culture (OR, 2.33; 95% CI, 0.77 to 7.03), presence of a rapidly fatal condition at the time of admission (OR, 5.13; 95% CI, 2.13 to 12.39), and recent prior hospitalization (OR, 1.92; 95% CI, 0.83 to 4.09). When carbapenems were added as empirical therapy to the predictor model, there was a trend between empirical carbapenem therapy and decreased mortality (OR, 0.61; 95% CI, 0.26 to 1.50). When added to the model, receipt of empirical cefepime alone (n = 43) was associated with increased mortality, although this association did not reach statistical significance (OR, 1.66; 95% CI, 0.71 to 3.87). The median length of hospital stay was shorter for patients

  12. Generalisability and Cost-Impact of Antibiotic-Impregnated Central Venous Catheters for Reducing Risk of Bloodstream Infection in Paediatric Intensive Care Units in England.

    Directory of Open Access Journals (Sweden)

    Katie Harron

    Full Text Available We determined the generalisability and cost-impact of adopting antibiotic-impregnated CVCs in all paediatric intensive care units (PICUs in England, based on results from a large randomised controlled trial (the CATCH trial; ISRCTN34884569.BSI rates using standard CVCs were estimated through linkage of national PICU audit data (PICANet with laboratory surveillance data. We estimated the number of BSI averted if PICUs switched from standard to antibiotic-impregnated CVCs by applying the CATCH trial rate-ratio (0.40; 95% CI 0.17,0.97 to the BSI rate using standard CVCs. The value of healthcare resources made available by averting one BSI as estimated from the trial economic analysis was £10,975; 95% CI -£2,801,£24,751.The BSI rate using standard CVCs was 4.58 (95% CI 4.42,4.74 per 1000 CVC-days in 2012. Applying the rate-ratio gave 232 BSI averted using antibiotic CVCs. The additional cost of purchasing antibiotic-impregnated compared with standard CVCs was £36 for each child, corresponding to additional costs of £317,916 for an estimated 8831 CVCs required in PICUs in 2012. Based on 2012 BSI rates, management of BSI in PICUs cost £2.5 million annually (95% uncertainty interval: -£160,986, £5,603,005. The additional cost of antibiotic CVCs would be less than the value of resources associated with managing BSI in PICUs with standard BSI rates >1.2 per 1000 CVC-days.The cost of introducing antibiotic-impregnated CVCs is less than the cost associated with managing BSIs occurring with standard CVCs. The long-term benefits of preventing BSI could mean that antibiotic CVCs are cost-effective even in PICUs with extremely low BSI rates.

  13. Generalisability and Cost-Impact of Antibiotic-Impregnated Central Venous Catheters for Reducing Risk of Bloodstream Infection in Paediatric Intensive Care Units in England

    Science.gov (United States)

    Harron, Katie; Mok, Quen; Hughes, Dyfrig; Muller-Pebody, Berit; Parslow, Roger; Ramnarayan, Padmanabhan; Gilbert, Ruth

    2016-01-01

    Background We determined the generalisability and cost-impact of adopting antibiotic-impregnated CVCs in all paediatric intensive care units (PICUs) in England, based on results from a large randomised controlled trial (the CATCH trial; ISRCTN34884569). Methods BSI rates using standard CVCs were estimated through linkage of national PICU audit data (PICANet) with laboratory surveillance data. We estimated the number of BSI averted if PICUs switched from standard to antibiotic-impregnated CVCs by applying the CATCH trial rate-ratio (0.40; 95% CI 0.17,0.97) to the BSI rate using standard CVCs. The value of healthcare resources made available by averting one BSI as estimated from the trial economic analysis was £10,975; 95% CI -£2,801,£24,751. Results The BSI rate using standard CVCs was 4.58 (95% CI 4.42,4.74) per 1000 CVC-days in 2012. Applying the rate-ratio gave 232 BSI averted using antibiotic CVCs. The additional cost of purchasing antibiotic-impregnated compared with standard CVCs was £36 for each child, corresponding to additional costs of £317,916 for an estimated 8831 CVCs required in PICUs in 2012. Based on 2012 BSI rates, management of BSI in PICUs cost £2.5 million annually (95% uncertainty interval: -£160,986, £5,603,005). The additional cost of antibiotic CVCs would be less than the value of resources associated with managing BSI in PICUs with standard BSI rates >1.2 per 1000 CVC-days. Conclusions The cost of introducing antibiotic-impregnated CVCs is less than the cost associated with managing BSIs occurring with standard CVCs. The long-term benefits of preventing BSI could mean that antibiotic CVCs are cost-effective even in PICUs with extremely low BSI rates. PMID:26999045

  14. Generalisability and Cost-Impact of Antibiotic-Impregnated Central Venous Catheters for Reducing Risk of Bloodstream Infection in Paediatric Intensive Care Units in England

    OpenAIRE

    Katie Harron; Quen Mok; Dyfrig Hughes; Berit Muller-Pebody; Roger Parslow; Padmanabhan Ramnarayan; Ruth Gilbert

    2016-01-01

    Background We determined the generalisability and cost-impact of adopting antibiotic-impregnated CVCs in all paediatric intensive care units (PICUs) in England, based on results from a large randomised controlled trial (the CATCH trial; ISRCTN34884569). Methods BSI rates using standard CVCs were estimated through linkage of national PICU audit data (PICANet) with laboratory surveillance data. We estimated the number of BSI averted if PICUs switched from standard to antibiotic-impregnated CVCs...

  15. Late onset sepsis in newborn babies: epidemiology and effect of a bundle to prevent central line associated bloodstream infections in the neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Daiane Silva Resende

    2015-02-01

    Full Text Available Aim:We assessed late onset sepsis (LOS rates of neonates in a neonatal intensive care unit (NICU before and after implementing an evidence-based bundle to prevent these infections in a country with poor resources.Methods:We evaluate trends of LOS between October 2010 and August 2012 in a large tertiary hospital in Brazil. We designed a protocol based of CDC guidelines for insertion of maintenance of central venous catheter targeted to reduction of bloodstream infections. During this period two major events occurred: a great increase of LOS rates in January months and relocation of the unit to a provisory place. Additionally we evaluated the risk factors and etiology of these infections.Results:A total of 112 (20.3% cases defined as LOS were found. The overall incidence rate of LOS in the study was 16.1/1000 patient/days and 23.0/1000 CVC-days. Our monthly rates data of LOS/1000 patient-day reveal fluctuations over the studied period, with incidence rates of these infections in staff vacation period (January 2011 and 2012 significantly higher (59.6/1000 patients-days than compared with the other months rates (16.6/1000 patients-days (IRR = 3.59; p< 0.001. As opposite, the incidence rates of LOS during relocation period was lower (10.3/1000 patients-days when compared with baseline period 26.7/1000 patients-days (IRR = 2.59; p= 0.007. After the intervention period, these rates decreased in the post intervention period, when compared with preintervention 14.7/1000 patients-days and 23.4/1000 patients-days, respectively (IRR = 1.59; p= 0.04.Conclusion:Through simple infection control measures, LOS can be successfully controlled especially in NICUs of limited resources countries such as ours.

  16. Case-case-control study of patients with carbapenem-resistant and third-generation-cephalosporin-resistant Klebsiella pneumoniae bloodstream infections.

    Science.gov (United States)

    Gallagher, Jason C; Kuriakose, Safia; Haynes, Kevin; Axelrod, Peter

    2014-10-01

    Strains of third-generation-cephalosporin-resistant Klebsiella pneumoniae (3GCRKP) and carbapenem-resistant K. pneumoniae (CRKP) are rapidly spreading. Evidence is needed to establish whether differences exist between patients at risk for 3GCRKP and those at risk for CRKP bloodstream infections (BSIs); thus, this retrospective case-case-control study was conducted to determine if the risk factors for these two infections differ. The inclusion criteria for cases were positive blood cultures for K. pneumoniae, first episode of BSI, age of ≥18 years, and susceptibility results indicating resistance to either third-generation cephalosporins (3GCRKP group) or carbapenems and cephalosporins (CRKP group). Controls were patients admitted for ≥72 h and were matched to cases by month/year and medical unit. Variables of interest were analyzed by univariate analysis, and those of significance were analyzed by logistic regression. In total, 111 patients with 3GCRKP BSIs and 43 patients with CRKP BSIs were matched to 154 controls. Multivariate analyses of 3GCRKP case and control groups demonstrated that a length of stay (LOS) of >40 days (odds ratio [OR], 17.7; 95% confidence interval [CI], 3.7 to 84.3), the use of antibiotics in the past 90 days (OR, 4.3; 95% CI, 1.5 to 11.9), and the presence of a central venous catheter (OR, 4.1; 95% CI, 1.3 to 13.4) were independent risk factors. Multivariate analyses of the CRKP case and control groups demonstrated that a LOS of >40 days (OR, 13.5; 95% CI, 2.9 to 62.8) and the use of antibiotics in the past 90 days (OR, 5.9; 95% CI, 1.3 to 26.5) were independent risk factors. Similar factors put patients at risk for these two types of K. pneumoniae BSIs.

  17. Analysis of bloodstream infection in children with severe hematopathy%重症血液病患儿血流感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    张家源; 陈玉梅; 邹尧; 张丽; 阮敏; 陈晓娟; 刘晓明; 竺晓凡

    2014-01-01

    目的:探讨重症血液病患儿治疗过程中发生血流感染的原因、感染部位、病原菌分析及治疗对策。方法选择2007年1月-2009年9月住院治疗的血液病患儿2368例,对血液病患儿血流感染的发生率、感染部位与病原菌分布及相关因素进行分析,数据采用SPSS16.0统计软件进行处理,样本率的比较采用χ2检验。结果2368例住院治疗患儿中167例患儿发生血流感染,发生率7.1%;其中发生血流感染的急性淋巴细胞白血病患儿95例、急性髓性白血病患儿61例、重型再生障碍性贫血患儿9例、恶性淋巴瘤患儿2例,分别占56.9%、36.5%、5.4%、1.2%;感染部位以口腔黏膜与呼吸道为主,分别占12.6%与10.2%;经血培养检测,共分离出病原菌167株,其中革兰阴性杆菌90株占53.9%,革兰阳性球菌71株占42.5%,革兰阳性杆菌、真菌各3株,各占1.8%;急性淋巴细胞白血病患儿中应用糖皮质激素>2周及中性粒细胞绝对值<100/mm3与血流感染高度相关。结论急性髓性白血病较急性淋巴细胞白血病患儿易发生血流感染,血液病患儿中性粒细胞绝对值<100/mm3与血流感染的发生高度相关。%OBJECTIVE To explore the causes ,sites and pathogens of bloodstream infection in children with severe hematopathy and the method to decrease the mortality of bloodstream infection .METHODS Totally 2368 children with hematopathy were selected .The incidence rate ,infected sites ,pathogen distribution and related factors for bloodstream infection in children with hematopathy were analyzed . Data were processed by SPSS16 .0 , the comparison of sample rate was conducted with χ2 test .RESULTS There were 167 cases of bloodstream infection in the 2368 hospitalized children ,indicating the incidence was 7 .1% .The children who experienced bloodstream infection included 95 children with acute lymphoblastic

  18. Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns

    International Nuclear Information System (INIS)

    Purpose: To determine whether alternative high dose rate prostate brachytherapy catheter patterns can result in similar or improved dose distributions while providing better access and reducing trauma. Materials and Methods: Standard prostate cancer high dose rate brachytherapy uses a regular grid of parallel needle positions to guide the catheter insertion. This geometry does not easily allow the physician to avoid piercing the critical structures near the penile bulb nor does it provide position flexibility in the case of pubic arch interference. This study used CT datasets with 3 mm slice spacing from ten previously treated patients and digitized new catheters following three hypothetical catheter patterns: conical, bi-conical, and fireworks. The conical patterns were used to accommodate a robotic delivery using a single entry point. The bi-conical and fireworks patterns were specifically designed to avoid the critical structures near the penile bulb. For each catheter distribution, a plan was optimized with the inverse planning algorithm, IPSA, and compared with the plan used for treatment. Irrelevant of catheter geometry, a plan must fulfill the RTOG-0321 dose criteria for target dose coverage (V100Prostate>90%) and organ-at-risk dose sparing (V75Bladder75Rectum125Urethra<<1 cc). Results: The three nonstandard catheter patterns used 16 nonparallel, straight divergent catheters, with entry points in the perineum. Thirty plans from ten patients with prostate sizes ranging from 26 to 89 cc were optimized. All nonstandard patterns fulfilled the RTOG criteria when the clinical plan did. In some cases, the dose distribution was improved by better sparing the organs-at-risk. Conclusion: Alternative catheter patterns can provide the physician with additional ways to treat patients previously considered unsuited for brachytherapy treatment (pubic arch interference) and facilitate robotic guidance of catheter insertion. In addition, alternative catheter patterns may

  19. Temperature-controlled irrigated tip radiofrequency catheter ablation: comparison of in vivo and in vitro lesion dimensions for standard catheter and irrigated tip catheter with minimal infusion rate

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, A;

    1998-01-01

    In patients with ventricular tachycardias due to structural heart disease, catheter ablation cures <60% partly due to the limited lesion size after conventional radiofrequency ablation. Irrigated tip radiofrequency ablation using power control and high infusion rates enlarges lesion size, but has...... increased risk of cratering. The present study explores irrigated tip catheter ablation in temperature-controlled mode, target temperature 60 degrees C, using an irrigation rate of 1 mL/min, comparing this to conventional catheter technique, target temperature 80 degrees C....

  20. Duration and Adverse Events of Non-cuffed Catheter in Patients With Hemodialysis

    Science.gov (United States)

    2014-10-09

    Renal Failure Chronic Requiring Hemodialysis; Central Venous Catheterization; Inadequate Hemodialysis Blood Flow; Venous Stenosis; Venous Thrombosis; Infection Due to Central Venous Catheter; Central Venous Catheter Thrombosis

  1. Comparison of Standard Catheters Versus Radial Artery-Specific Catheter in Patients Who Underwent Coronary Angiography Through Transradial Access.

    Science.gov (United States)

    Chen, On; Goel, Sunny; Acholonu, Michael; Kulbak, Guy; Verma, Shivani; Travlos, Efstratios; Casazza, Richard; Borgen, Elliot; Malik, Bilal; Friedman, Michael; Moskovits, Norbert; Frankel, Robert; Shani, Jacob; Ayzenberg, Sergey

    2016-08-01

    In this prospective, randomized controlled study, we aim to compare the performance outcomes of standard catheters with the radial artery-specific catheter. Over the past decade, transradial cardiac catheterization has gained widespread popularity because of its low complication rates compared with transfemoral access. Operators have the choice of using either standard catheters (used for both transfemoral and transradial approach, with need for separate catheter use for either right or left coronary artery engagement) or a dedicated radial artery catheter, which is specifically designed to engage both coronary arteries through radial artery access. A total of 110 consecutive patients who underwent coronary angiography at our institution from March 2015 to April 2015 were prospectively randomized to either radial artery-specific Tiger catheter (5Fr; Terumo Interventional Systems, Somerset, New Jersey) versus standard Judkins left and right catheters (5Fr R4, L4; Cordis Corporation, Miami, Florida). The end points of the study included fluoroscopy time, dose-area product, contrast volume used, and total procedure time for the coronary angiography. A total of 57 patients (52%) were randomized to radial artery-specific catheter and 53 (48%) to the standard catheter. Tiger catheter was associated with significantly lower fluoroscopy time (184 ± 91 vs 238 ± 131 seconds, p = 0.015), which was statistically significant. Other outcome measures such as dose-area product (2,882.4 ± 1,471.2 vs 3,524.6 ± 2,111.7 Gy·cm(2), p = 0.07), total contrast volume (48.1 ± 16.1 vs 53.4 ± 18.5 ml, p = 0.114), and total procedure time (337 ± 382 vs 434 ± 137 seconds, p = 0.085) were also lower in single-catheter group, but it did not reach statistical significance. A total of 8 patients (14%) were crossed over from radial-specific catheter arm to standard catheter arm because of substandard image quality and difficulty in coronary engagement. Six patients had to be

  2. Central venous access for haemodialysis using the Hickman catheter.

    Science.gov (United States)

    Cappello, M; De Pauw, L; Bastin, G; Prospert, F; Delcour, C; Thaysse, C; Dhaene, M; Vanherweghem, J L; Kinnaert, P

    1989-01-01

    One hundred and seven Hickman catheters for haemodialysis were inserted in 90 end-stage chronic renal failure patients, and were used for 1-448 days (median 45 days). Sixty-nine per cent of the patients were treated without any problem for 1-165 days (median 34 days). Clinically evident complications occurred in 44 catheters inserted in 28 patients, and included outflow obstruction (16.8% of the catheters) and thrombosis (13.1% of the catheters). However, many episodes of clotting or insufficient flow could be corrected by simple manoeuvres. Other less frequent complications were recorded: sepsis, mainly in patients with increased risk factors (4.1% of the catheters), laceration of the catheter (3.7%) and occasional cases of jugular-vein phlebitis, transient palsy of a vocal cord, haematoma of the wound, and bleeding of the cutaneous orifice. No clinical sign of subclavian or innominate-vein thrombosis was observed. Nevertheless, a prospective study conducted in 50 asymptomatic patients demonstrated a 12% rate of anomalies of the venous system, although two-thirds of these alterations were mild and had no consequence. When the present series is compared to the results obtained with currently available percutaneous haemodialysis catheters, it is concluded that the Hickman catheter is a safe, comfortable and efficient vascular access device. PMID:2516892

  3. Engineering Considerations Of Catheters For Intravascular Ultrasonic Measurements

    Science.gov (United States)

    Martin, Roy W.; Johnson, Christopher C.

    1989-08-01

    The mechanical properties of commonly used fluid transfusion or pressure monitoring catheters are similar to the properties required of catheters which include sensing devices. Consequently, bending and torsional stiffness of commercial catheters and tubes were measured at both room and body temperature. Five of these usually placed with the aid of fluoroscopy had an average Young's modulus of 5714x101 dyne/cm at 21°C which decreased 29% at body temperature; a shear modulus of 70.5x101 dyne/cm 4 at 21°C which decreased 13% at body temperature, and plastic deformation of 8% when loaded for 1 minute at 37°. Four of these were composed of a composite material. Catheters which are balloon directed during insertion had moduli values approximately 1/3 of these or less. The drag forces produced on balloons used on such catheters were measured for fluid velocities ranging from 10-50 cm/sec. Using this information the average force applied to a balloon throughout a cardiac cycle was calculated; values of 1280 dynes for a .6 ml balloon and 2490 dynes for a 1 ml balloon were found. The maximum wall thicknesses to catheter radii for single lumen catheters were determined for various material moduli which would allow the catheter tip to be directed by a balloon during its passage into the right heart.

  4. 21 CFR 870.1350 - Catheter balloon repair kit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Catheter balloon repair kit. 870.1350 Section 870... repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair or replace the... effect the repair or replacement. (b) Classification. Class III (premarket approval). (c) Date PMA...

  5. Dose requirements for UVC disinfection of catheter biofilms

    DEFF Research Database (Denmark)

    Bak, Jimmy; Ladefoged, Søren D.; Tvede, Michael;

    2009-01-01

    Bacterial biofilms on permanent catheters are the major sources of infection. Exposure to ultraviolet-C (UVC) light has been proposed as a method for disinfecting the inner surface of catheters. Specification of a UVC-based device for in vivo disinfection is based on the knowledge of the required...

  6. Safety and efficacy of catheter-directed thrombolysis

    DEFF Research Database (Denmark)

    Bækgaard, N; Klitfod, Lotte; Broholm, R

    2012-01-01

    To describe the background for--and mechanism of--catheter-directed thrombolysis (CDT) for iliofemoral deep venous thrombosis (DVT) accessed via the popliteal vein. Focus is on safety and efficacy.......To describe the background for--and mechanism of--catheter-directed thrombolysis (CDT) for iliofemoral deep venous thrombosis (DVT) accessed via the popliteal vein. Focus is on safety and efficacy....

  7. Investigation into the causes of indwelling urethral catheter implementation and its effects on clinical outcomes and health care resources among dementia patients with pneumonia: A retrospective cohort study.

    Science.gov (United States)

    Maeda, Toshiki; Babazono, Akira; Nishi, Takumi; Yasui, Midori; Harano, Yumi

    2016-08-01

    There is a possibility that unnecessary treatments and low-quality medical care, such as inappropriate indwelling urethral catheter use, are being provided to older Japanese individuals.The aim of this study was to investigate contextual effects relating to indwelling urethral catheters in older people with dementia and to clarify the effects of indwelling urethral catheter use on patients' mortality, length of stay (LOS), and health care spending. This retrospective cohort study involved 4501 male and female Japanese participants. Those who were aged 75 or older with dementia and had a primary diagnosis of acute lower respiratory disease with antibiotics administered during hospitalization were eligible for inclusion. Patient mortality, LOS, and total charge during hospitalization were the main study outcomes. This study showed that indwelling urethral catheter use was significantly associated with higher mortality, longer LOS, and higher total charge for hospitalization. The pattern of indwelling urethral catheter use was clustered by care facility level. Physician density was significantly associated with indwelling urethral catheter use; the relationship was not linear but U-shaped, such that the approximate median had the lowest rate of urethral catheter use and this increased gradually toward both lower and higher physician densities. Our study found considerable variation in indwelling urethral catheter use between care facilities in older people with dementia. Additionally, indwelling urethral catheter use was related to poor outcomes. Based on these findings, we consider there to be an urgent need for constructing a framework to measure, report on, and promote the improvement of care quality for older individuals in Japan. PMID:27583898

  8. Monitoring Atrial Fibrillation After Catheter Ablation

    Directory of Open Access Journals (Sweden)

    Giovanni B Forleo, MD PhD; MAssimo Moltrasio, MD; Michela Casella MD, PhD; Antonio Dello Russo MD, PhD; Getano Fassini, MD; Manfredi Tesauro, MD, PhD; Claudio Tondo, MD, PhD.

    2014-04-01

    Full Text Available Although catheter ablation is an effective treatment for recurrent atrial fibrillation (AF, there is no consensus on the definition of success or follow-up strategies. Symptoms are the major motivation for undergoing catheter ablation in patients with AF, however it is well known that reliance on perception of AF by patients after AF ablation results in an underestimation of recurrence of the arrhythmia. Because symptoms of AF occurrence may be misleading, a reliable assessment of rhythm outcome is essential for the definition of success in both clinical care and research trials. Continuous rhythm monitoring over long periods of time is superior to intermittent recording using external monitors to detect the presence of AF episodes and to quantify the AF burden. Today, new devices implanted subcutaneously using a minimally invasive technique have been developed for continuous AF monitoring. Implantable devices keep detailed information about arrhythmia recurrences and might allow identification of very brief episodes of AF, the significance of which is still uncertain. In particular, it is not known whether there is any critical value of daily AF burden that has a prognostic significance. This issue remains an area of active discussion, debate and investigation. Further investigation is required to determine if continuous AF monitoring with implantable devices is effective in reducing stroke risk and facilitating maintenance of sinus rhythm after AF ablation.

  9. 导尿管相关尿路感染的监测%Monitoring Catheter-associated Urinary Tract Infection

    Institute of Scientific and Technical Information of China (English)

    蔡玉琴

    2013-01-01

    Objective: To search the condition and reasons of indwelling catheter patients with urinary tract infection in medical ward, and to provide a scientific basis for the effective prevention and control of infection. Methods: The catheter-related urinary tract infection of all patients with indwelling catheters who hospitalized in medical ward from January 2011 to June 2012 were investigated by proactive monitoring. Results : 335 cases of patients with indwelling catheter were monitored, and there were 15 cases with urinary tract infection, so the infection rate was 4.48%. The rate of catheter-associated urinary tract infection was 2.5/ 1000 catheters per day. Conclusion: Understanding the occurrence of catheter associated urinary tract infection in a medical ward by targeted monitoring, it provides guidance for the effective control of urinary tract infections.%目的:了解内科病房留置尿管患者尿路感染发生状况及原因,为有效预防和控制感染提供科学依据.方法:采取主动监测方法,对2011年1月-2012年6月内科病房所有住院留置尿管患者发生导尿管相关尿路感染情况进行调查.结果:335例留置尿管患者,发生尿路感染15例,感染率为4.48%,导尿管相关尿路感染发生率为2.5/千导管日.结论:通过目标性监测,了解了内科病房导尿管相关尿路感染的发生状况,为有效控制尿路感染提供了指导.

  10. Ventriculoperitoneal shunt with a rare twist: small-bowel ischemia and necrosis secondary to knotting of peritoneal catheter.

    Science.gov (United States)

    Tan, Lee A; Kasliwal, Manish K; Moftakhar, Roham; Munoz, Lorenzo F

    2014-09-01

    Small-bowel ischemia and necrosis due to knotting of the peritoneal catheter is an extremely rare complication related to a ventriculoperitoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal catheter from the scalp incision were met with resistance, the distal catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed a knot in the distal catheter looping around and strangulating the distal ileum, causing small-bowel ischemia and necrosis in addition to the obstruction. A small-bowel resection with ileostomy was performed, with subsequent placement of ventriculoatrial shunt for treatment of hydrocephalus. The authors report this exceedingly rare clinical scenario to highlight the fact that any retained distal catheter must be carefully managed with immediate abdominal exploration to remove the distal catheter to avoid bowel necrosis as pulling of a knotted peritoneal catheter may strangulate the bowel and cause ischemia, with significant clinical morbidity and possible mortality.

  11. Risk factors for mortality in patients with bloodstream infections during the pre-engraftment period after hematopoietic stem cell transplantation

    Science.gov (United States)

    Karpov, Igor; Milanovich, Natalia; Uss, Anatoly; Iskrov, Igor

    2016-01-01

    Background Bloodstream infections (BSI) remain a frequent complication during the pre-engraftment period after hematopoietic stem cell transplantation (HSCT), resulting in high mortality rates. This study evaluated risk factors for mortality in hematopoietic stem cell transplant recipients with BSI in the pre-engraftment period. Methods This prospective case control study was performed at the Center of Hematology and Bone Marrow Transplantation in Minsk, Republic of Belarus. Data relating to patient age and gender, date and type of transplantation, conditioning chemotherapy regimen, microorganisms isolated from blood, and antibacterial therapy were prospectively collected from all hematopoietic stem cell recipients with microbiologically proven cases of BSI in the pre-engraftment period. The primary outcome was all-cause 30-day mortality after onset of febrile neutropenia. Results A total of 135 adult patients with microbiologically proven BSI after HSCT were studied, with 65.2% of cases caused by gram-negative microorganisms and 21.5% by non-fermenting bacteria. Inadequate empiric antibacterial therapy and isolation of carbapenem-resistant non-fermenting gram-negative bacteria (Acinetobacter baumannii and Pseudomonas aeruginosa) were independently associated with increased all-cause 30-day mortality in these patients. Conclusion The risk factors for mortality in adult patients with BSI in the pre-engraftment period after HSCT were inadequacy of empirical antibacterial therapy and isolation of carbapenem-resistant A. baumannii or P. aeruginosa. PMID:27382554

  12. Control method exploration of nosocomial bloodstream infection and its effect evaluation

    Institute of Scientific and Technical Information of China (English)

    CHAI Wen-zhao; WANG Xiao-ting; ZHOU Jiong; LI Xin; LUO Hong-bo; LIU Da-wei

    2012-01-01

    Background Currently,slightly more than 50% of bloodstream infections (BSIs) are hospital acquired.When these infections occur in patients in intensive care units,they are associated with a high mortality rate,additional hospital days and excess hospital costs.Because of multifactor of nosocomial BSIs,measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice.The aim of this study was to explore special way in accordance with self-hospital base on common principle.Methods In one ward of the Intensive Care Unit,Peking Union Medical College Hospital,at first,we divided the all operation about bloodstream way into three sections used as keypoints.By surveying keypoints respectively,some operation faults of blood way were discovered.For decreasing the mobidity of nosocomial BSls,some intervention measurements were executed.The rate of nosocomial BSIs was analyzed by chi-square test.Results According to the statistics from January to June,we received and cured 618 patients in total; among them,there were 13 cases of nosocomial BSI and the average occurrence was 2.3 cases/month.After intervention measurements from July to December 2011,we received and cured 639 patients in total with seven cases of nosocomial BSI,and the average occurrence was 1.2 cases/month (P <0.05).From January to April 2012,no nosocomial BSI occurred in the investigated ward.Conclusion Removing the operation faults of bloodstream way might decrease the nosocomial BSI rapidly and efficiently by utilizing a key point survey.

  13. Jugular versus subclavian totally implantable access ports: Catheter position, complications and intrainterventional pain perception

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    Plumhans, Cedric, E-mail: plumhans@rad.rwth-aachen.de [Department of Diagnostic Radiology, University Hospital, RWTH-Aachen University, Pauwelsstrasse 30, D-52074 Aachen (Germany); Mahnken, Andreas H. [Department of Diagnostic Radiology, University Hospital, RWTH-Aachen University, Pauwelsstrasse 30, D-52074 Aachen (Germany); Applied Medical Engineering, Helmholtz Institute, RWTH-Aachen University (Germany); Ocklenburg, Christina [Institute of Medical Statistics, University Hospital, RWTH-Aachen University (Germany); Keil, Sebastian; Behrendt, Florian F.; Guenther, Rolf W.; Schoth, Felix [Department of Diagnostic Radiology, University Hospital, RWTH-Aachen University, Pauwelsstrasse 30, D-52074 Aachen (Germany)

    2011-09-15

    Purpose: To determine the safest and most tolerable method for totally implantable access ports (TIAPs) particularly in regard to patient's pain perception and catheter-related complications. Materials and methods: From January 2007 to October 2008 a subcutaneous TIAP (Bardport, Bard Access System, UT, USA) was implanted in 138 oncological patients (60 male, 78 female; 18-85 years old; mean age of 56 {+-} 6 years) by experienced interventional radiologists. 94 TIAP were implanted through the subclavian vein (subclavian group) and 44 TIAP were implanted through the internal jugular vein (jugular group). Intrainterventional pain perception (visual analogue scale from 1 to 10), postinterventional catheter tip migration and radiation dose were documented for each method and implantation side and differences were compared with Wilcoxon t-test. For ordinal variables, comparison of two groups was performed with the Fisher's exact test. Results: No severe periinterventional complication occurred. Inadvertent arterial punctures without serious consequences were reported in one case for the jugular group versus four cases in the subclavian group. Significantly (p < 0.05) lower pain perception, radiation dose and tip migration rate were observed in the jugular group. Catheter occlusions occurred in 4% (n = 4) of the subclavian group versus 2% (n = 1) of the jugular group. The corresponding values for vein thrombosis and catheter dislocation were 3% (n = 3) and 1% (n = 1) in the subclavian group, while none of those complications occurred in the jugular group. Conclusion: Both techniques, the TIAP implantation via fluoroscopy-guided subclavian vein puncture and via ultrasound-guided jugular vein puncture, are feasible and safe. Regarding intrainterventional pain perception, radiation dose, postinterventional catheter tip position and port function the jugular vein puncture under ultrasound guidance seems to be advantageous.

  14. Multicenter study in monitoring central venous catheters complications in hematologic patiennts

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    Carmen García Gabás

    2013-05-01

    Full Text Available Most hematological patients suffer a significant venous damage related to different administrated intravenous therapy, being necessary to place central venous catheters (CVC. CVC is associated with various complications. The most common catheter-related complications are occlusion and infection. To avoid such of them, the development of protocols for insertion and care are needed, as well as recording and following up complications. To this end, we propose a cross-sectional carried out during 13 months whose main goal is to know the incidence of CVC- related complications (mainly occlusion and infection in hematological patients.Population included all the =14 ages patients admitted to different hematological units at Ramon y Cajal and Gregorio Marañón hospitals in Madrid and who signed informed consent. Socio-demographic, clinical characteristics and complications were entered into a log which included a pursuit of care protocol.

  15. Urethral catheter insertion forces: a comparison of experience and training

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    Benjamin K. Canales

    2009-02-01

    Full Text Available Purpose: This study was undertaken to evaluate the insertion forces utilized during simulated placement of a urethral catheter by healthcare individuals with a variety of catheter experience. Materials and Methods: A 21F urethral catheter was mounted to a metal spring. Participants were asked to press the tubing spring against a force gauge and stop when they met a level of resistance that would typically make them terminate a catheter placement. Simulated catheter insertion was repeated fives times, and peak compression forces were recorded. Healthcare professionals were divided into six groups according to their title: urology staff, non-urology staff, urology resident/ fellow, non-urology resident/ fellow, medical student, and registered nurse. Results: A total of fifty-seven healthcare professionals participated in the study. Urology staff (n = 6 had the lowest average insertion force for any group at 6.8 ± 2.0 Newtons (N. Medical students (n = 10 had the least amount of experience (1 ± 0 years and the highest average insertion force range of 10.1 ± 3.7 N. Health care workers with greater than 25 years experience used significantly less force during catheter insertions (4.9 ± 1.8 N compared to all groups (p < 0.01. Conclusions: We propose the maximum force that should be utilized during urethral catheter insertion is 5 Newtons. This force deserves validation in a larger population and should be considered when designing urethral catheters or creating catheter simulators. Understanding urethral catheter insertion forces may also aid in establishing competency parameters for health care professionals in training.

  16. JBP2, a SWI2/SNF2-like protein, regulates de novo telomeric DNA glycosylation in bloodstream form Trypanosoma brucei.

    Science.gov (United States)

    Kieft, Rudo; Brand, Verena; Ekanayake, Dilrukshi K; Sweeney, Kate; DiPaolo, Courtney; Reznikoff, William S; Sabatini, Robert

    2007-11-01

    Synthesis of the modified thymine base, beta-d-glucosyl-hydroxymethyluracil or J, within telomeric DNA of Trypanosoma brucei correlates with the bloodstream form specific epigenetic silencing of telomeric variant surface glycoprotein genes involved in antigenic variation. In order to analyze the function of base J in the regulation of antigenic variation, we are characterizing the regulatory mechanism of J biosynthesis. We have recently proposed a model in which chromatin remodeling by a SWI2/SNF2-like protein (JBP2) regulates the developmental and de novo site-specific localization of J synthesis within bloodstream form trypanosome DNA. Consistent with this model, we now show that JBP2 (-/-) bloodstream form trypanosomes contain five-fold less base J and are unable to stimulate de novo J synthesis in newly generated telomeric arrays. PMID:17706299

  17. Risk and Prognosis of Bloodstream Infections among Patients on Chronic Hemodialysis: A Population-Based Cohort Study.

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    Lars Skov Dalgaard

    Full Text Available Infections are common complications among patients on chronic hemodialysis. This population-based cohort study aims to estimate risk and case fatality of bloodstream infection among chronic hemodialysis patients.In this population-based cohort study we identified residents with end-stage renal disease in Central and North Jutland, Denmark who had hemodialysis as first renal replacement therapy (hemodialysis patients during 1995-2010. For each hemodialysis patient, we sampled 19 persons from the general population matched on age, gender, and municipality. Information on positive blood cultures was obtained from regional microbiology databases. All persons were observed from cohort entry until first episode of bloodstream infection, emigration, death, or end of hemodialysis treatment, whichever came first. Incidence-rates and incidence-rate ratios were computed and risk factors for bloodstream infection assessed by Poisson regression. Case fatality was compared by Cox regression.Among 1792 hemodialysis patients and 33 618 matched population controls, we identified 461 and 1126 first episodes of bloodstream infection, respectively. Incidence rates of first episode of bloodstream infection were 13.7 (95% confidence interval (CI, 12.5-15.0 per 100 person-years among hemodialysis patients and 0.53 (95% CI, 0.50-0.56 per 100 person-years among population controls. In hemodialysis patients, the most common causative microorganisms were Staphylococcus aureus (43.8% and Escherichia coli (12.6%. The 30-day case fatality was similar among hemodialysis patients and population controls 16% (95% CI, 13%-20% vs. 18% (95% CI, 15%-20%.Hemodialysis patients have extraordinary high risk of bloodstream infection while short-term case fatality following is similar to that of population controls.

  18. Risk and Prognosis of Bloodstream Infections among Patients on Chronic Hemodialysis: A Population-Based Cohort Study

    Science.gov (United States)

    Skov Dalgaard, Lars; Nørgaard, Mette; Jespersen, Bente; Jensen-Fangel, Søren; Østergaard, Lars Jørgen; Schønheyder, Henrik Carl; Søgaard, Ole Schmeltz

    2015-01-01

    Background and Objectives Infections are common complications among patients on chronic hemodialysis. This population-based cohort study aims to estimate risk and case fatality of bloodstream infection among chronic hemodialysis patients. Methods In this population-based cohort study we identified residents with end-stage renal disease in Central and North Jutland, Denmark who had hemodialysis as first renal replacement therapy (hemodialysis patients) during 1995–2010. For each hemodialysis patient, we sampled 19 persons from the general population matched on age, gender, and municipality. Information on positive blood cultures was obtained from regional microbiology databases. All persons were observed from cohort entry until first episode of bloodstream infection, emigration, death, or end of hemodialysis treatment, whichever came first. Incidence-rates and incidence-rate ratios were computed and risk factors for bloodstream infection assessed by Poisson regression. Case fatality was compared by Cox regression. Results Among 1792 hemodialysis patients and 33 618 matched population controls, we identified 461 and 1126 first episodes of bloodstream infection, respectively. Incidence rates of first episode of bloodstream infection were 13.7 (95% confidence interval (CI), 12.5–15.0) per 100 person-years among hemodialysis patients and 0.53 (95% CI, 0.50–0.56) per 100 person-years among population controls. In hemodialysis patients, the most common causative microorganisms were Staphylococcus aureus (43.8%) and Escherichia coli (12.6%). The 30-day case fatality was similar among hemodialysis patients and population controls 16% (95% CI, 13%–20%) vs. 18% (95% CI, 15%–20%). Conclusions Hemodialysis patients have extraordinary high risk of bloodstream infection while short-term case fatality following is similar to that of population controls. PMID:25910221

  19. Effectiveness of Fluoroscopic and US - Guided Percutaneous Catheter Drainage for Iliopsoas Abscess through the Anterolateral Transabdominal Approach

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    Choi, Ho Cheol; Shin, Tae Beom; Park, Mee Jung; Kim, Ji Eun; Choi, Hye Young; Bae, Kyung Soo; Choi, Dae Seob; Na, Jae Boem; Jeong, Seong Hoon [Gyeongsang National University Hospital, College of Medicine, Jinju (Korea, Republic of)

    2011-02-15

    We evaluated the effectiveness of performing fluoroscopic and ultrasonography guided percutaneous catheter drainage (PCD) through the anterolateral transabdominal approach for treating iliopsoas abscess. From January 2008 to December 2009, fluoroscopic and US-guided PCD through the anterolateral transabdominal approach was performed on sixteen iliopsoas abscesses of fourteen patients (7 males and 7 females; mean age: 63 years; age range: 30-87 years). Six abscesses were on the right side and ten abscesses were on the left side. The location of the abscesses were the psoas muscle (n=7), the iliacus muscle (n=7) and the iliopsoas muscle (n=2). All the procedures were performed under fluoroscopy and US guidance in the angiography room. The clinical findings before and after the procedure, the duration of catheter insertion and the procedure-related complications were evaluated. 15 out of the 16 iliopsoas abscesses were effectively treated. The duration of catheter insertion was 5- 27 days (mean: 14.6) days. No patient had significant complications during or after drainage. One patient died of uncontrolled diabetes complications and shock on the 9th day after percutaneous catheter drainage. One recurrence was noted 5 months after removal of the catheter. This patient underwent aspiration and antibiotic treatment for this lesion and the patient improved. Fluoroscopic and US-guided PCD for iliopsoas abscess through the anterolateral transabdominal approach is an effective and safe procedure

  20. Muscle Releases Alpha-Sarcoglycan Positive Extracellular Vesicles Carrying miRNAs in the Bloodstream.

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    Michele Guescini

    Full Text Available In the past few years, skeletal muscle has emerged as an important secretory organ producing soluble factors, called myokines, that exert either autocrine, paracrine or endocrine effects. Moreover, recent studies have shown that muscle releases microRNAs into the bloodstream in response to physical exercise. These microRNAs affect target cells, such as hormones and cytokines. The mechanisms underlying microRNA secretion are poorly characterized at present. Here, we investigated whether muscle tissue releases extracellular vesicles (EVs, which carry microRNAs in the bloodstream under physiological conditions such as physical exercise. Using density gradient separation of plasma from sedentary and physically fit young men we found EVs positive for TSG101 and alpha-sarcoglycan (SGCA, and enriched for miR-206. Cytometric analysis showed that the SGCA+ EVs account for 1-5% of the total and that 60-65% of these EVs were also positive for the exosomal marker CD81. Furthermore, the SGCA-immuno captured sub-population of EVs exhibited higher levels of the miR-206/miR16 ratio compared to total plasma EVs. Finally, a significant positive correlation was found between the aerobic fitness and muscle-specific miRNAs and EV miR-133b and -181a-5p were significantly up-regulated after acute exercise. Thus, our study proposes EVs as a novel means of muscle communication potentially involved in muscle remodeling and homeostasis.