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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 2002 Jul;87(1):F21–F24. doi: 10.1136/fn.87.1.F21

Diagnosis, prevention, and management of catheter related bloodstream infection during long term parenteral nutrition

D Hodge, J Puntis
PMCID: PMC1721416  PMID: 12091284

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Selected References

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  1. Andris D. A., Krzywda E. A., Edmiston C. E., Krepel C. J., Gohr C. M. Elimination of intraluminal colonization by antibiotic lock in silicone vascular catheters. Nutrition. 1998 May;14(5):427–432. doi: 10.1016/s0899-9007(98)00013-6. [DOI] [PubMed] [Google Scholar]
  2. Atkinson J. B., Chamberlin K., Boody B. A. A prospective randomized trial of urokinase as an adjuvant in the treatment of proven Hickman catheter sepsis. J Pediatr Surg. 1998 May;33(5):714–716. doi: 10.1016/s0022-3468(98)90194-4. [DOI] [PubMed] [Google Scholar]
  3. Blot F., Schmidt E., Nitenberg G., Tancrède C., Leclercq B., Laplanche A., Andremont A. Earlier positivity of central-venous- versus peripheral-blood cultures is highly predictive of catheter-related sepsis. J Clin Microbiol. 1998 Jan;36(1):105–109. doi: 10.1128/jcm.36.1.105-109.1998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brun-Buisson C., Abrouk F., Legrand P., Huet Y., Larabi S., Rapin M. Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. Arch Intern Med. 1987 May;147(5):873–877. [PubMed] [Google Scholar]
  5. Cleri D. J., Corrado M. L., Seligman S. J. Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis. 1980 Jun;141(6):781–786. doi: 10.1093/infdis/141.6.781. [DOI] [PubMed] [Google Scholar]
  6. Darouiche R. O., Raad I. I., Heard S. O., Thornby J. I., Wenker O. C., Gabrielli A., Berg J., Khardori N., Hanna H., Hachem R. A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group. N Engl J Med. 1999 Jan 7;340(1):1–8. doi: 10.1056/NEJM199901073400101. [DOI] [PubMed] [Google Scholar]
  7. Elliott T. S., Tebbs S. E., Moss H. A., Worthington T., Spare M. K., Faroqui M. H., Lambert P. A. A novel serological test for the diagnosis of central venous catheter-associated sepsis. J Infect. 2000 May;40(3):262–266. doi: 10.1053/jinf.2000.0656. [DOI] [PubMed] [Google Scholar]
  8. Flynn P. M., Shenep J. L., Barrett F. F. Differential quantitation with a commercial blood culture tube for diagnosis of catheter-related infection. J Clin Microbiol. 1988 May;26(5):1045–1046. doi: 10.1128/jcm.26.5.1045-1046.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Grabe N., Jakobsen C. J. Bacterial contamination of 'Venflon' intravenous cannulae with valved injection sideport. J Hosp Infect. 1983 Sep;4(3):291–295. doi: 10.1016/0195-6701(83)90030-0. [DOI] [PubMed] [Google Scholar]
  10. Groeger J. S., Lucas A. B., Coit D., LaQuaglia M., Brown A. E., Turnbull A., Exelby P. A prospective, randomized evaluation of the effect of silver impregnated subcutaneous cuffs for preventing tunneled chronic venous access catheter infections in cancer patients. Ann Surg. 1993 Aug;218(2):206–210. doi: 10.1097/00000658-199308000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Henrickson K. J., Axtell R. A., Hoover S. M., Kuhn S. M., Pritchett J., Kehl S. C., Klein J. P. Prevention of central venous catheter-related infections and thrombotic events in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solution: A randomized, multicenter, double-blind trial. J Clin Oncol. 2000 Mar;18(6):1269–1278. doi: 10.1200/JCO.2000.18.6.1269. [DOI] [PubMed] [Google Scholar]
  12. Isaacman D. J., Karasic R. B., Reynolds E. A., Kost S. I. Effect of number of blood cultures and volume of blood on detection of bacteremia in children. J Pediatr. 1996 Feb;128(2):190–195. doi: 10.1016/s0022-3476(96)70388-8. [DOI] [PubMed] [Google Scholar]
  13. Keohane P. P., Jones B. J., Attrill H., Cribb A., Northover J., Frost P., Silk D. B. Effect of catheter tunnelling and a nutrition nurse on catheter sepsis during parenteral nutrition. A controlled trial. Lancet. 1983 Dec 17;2(8364):1388–1390. doi: 10.1016/s0140-6736(83)90922-4. [DOI] [PubMed] [Google Scholar]
  14. Kite P., Dobbins B. M., Wilcox M. H., Fawley W. N., Kindon A. J., Thomas D., Tighe M. J., McMahon M. J. Evaluation of a novel endoluminal brush method for in situ diagnosis of catheter related sepsis. J Clin Pathol. 1997 Apr;50(4):278–282. doi: 10.1136/jcp.50.4.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Kite P., Dobbins B. M., Wilcox M. H., McMahon M. J. Rapid diagnosis of central-venous-catheter-related bloodstream infection without catheter removal. Lancet. 1999 Oct 30;354(9189):1504–1507. doi: 10.1016/S0140-6736(99)04070-2. [DOI] [PubMed] [Google Scholar]
  16. Luna J., Masdeu G., Pérez M., Claramonte R., Forcadell I., Barrachina F., Panisello M. Clinical trial evaluating a new hub device designed to prevent catheter-related sepsis. Eur J Clin Microbiol Infect Dis. 2000 Sep;19(9):655–662. doi: 10.1007/s100960000346. [DOI] [PubMed] [Google Scholar]
  17. MacFie J. Enteral versus parenteral nutrition: the significance of bacterial translocation and gut-barrier function. Nutrition. 2000 Jul-Aug;16(7-8):606–611. doi: 10.1016/s0899-9007(00)00249-5. [DOI] [PubMed] [Google Scholar]
  18. Maki D. G., Cobb L., Garman J. K., Shapiro J. M., Ringer M., Helgerson R. B. An attachable silver-impregnated cuff for prevention of infection with central venous catheters: a prospective randomized multicenter trial. Am J Med. 1988 Sep;85(3):307–314. doi: 10.1016/0002-9343(88)90579-7. [DOI] [PubMed] [Google Scholar]
  19. Maki D. G., Stolz S. M., Wheeler S., Mermel L. A. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Ann Intern Med. 1997 Aug 15;127(4):257–266. doi: 10.7326/0003-4819-127-4-199708150-00001. [DOI] [PubMed] [Google Scholar]
  20. Maki D. G., Weise C. E., Sarafin H. W. A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med. 1977 Jun 9;296(23):1305–1309. doi: 10.1056/NEJM197706092962301. [DOI] [PubMed] [Google Scholar]
  21. McAndrew H. F., Lloyd D. A., Rintala R., van Saene H. K. Intravenous glutamine or short-chain fatty acids reduce central venous catheter infection in a model of total parenteral nutrition. J Pediatr Surg. 1999 Feb;34(2):281–285. doi: 10.1016/s0022-3468(99)90191-4. [DOI] [PubMed] [Google Scholar]
  22. McAndrew H. F., Lloyd D. A., Rintala R., van Saene H. K. The effects of intravenous epidermal growth factor on bacterial translocation and central venous catheter infection in the rat total parenteral nutrition model. Pediatr Surg Int. 2000;16(3):169–173. doi: 10.1007/s003830050715. [DOI] [PubMed] [Google Scholar]
  23. McClure R. J., Newell S. J. Randomised controlled study of clinical outcome following trophic feeding. Arch Dis Child Fetal Neonatal Ed. 2000 Jan;82(1):F29–F33. doi: 10.1136/fn.82.1.F29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Mermel L. A. Prevention of intravascular catheter-related infections. Ann Intern Med. 2000 Mar 7;132(5):391–402. doi: 10.7326/0003-4819-132-5-200003070-00009. [DOI] [PubMed] [Google Scholar]
  25. Moukarzel A. A., Haddad I., Ament M. E., Buchman A. L., Reyen L., Maggioni A., Baron H. I., Vargas J. 230 patient years of experience with home long-term parenteral nutrition in childhood: natural history and life of central venous catheters. J Pediatr Surg. 1994 Oct;29(10):1323–1327. doi: 10.1016/0022-3468(94)90107-4. [DOI] [PubMed] [Google Scholar]
  26. O'Boyle C. J., MacFie J., Mitchell C. J., Johnstone D., Sagar P. M., Sedman P. C. Microbiology of bacterial translocation in humans. Gut. 1998 Jan;42(1):29–35. doi: 10.1136/gut.42.1.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Page S., Abel G., Stringer M. D., Puntis J. W. Management of septicaemic infants during long-term parenteral nutrition. Int J Clin Pract. 2000 Apr;54(3):147–150. [PubMed] [Google Scholar]
  28. Puntis J. W., Holden C. E., Smallman S., Finkel Y., George R. H., Booth I. W. Staff training: a key factor in reducing intravascular catheter sepsis. Arch Dis Child. 1991 Mar;66(3):335–337. doi: 10.1136/adc.66.3.335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Raad I., Buzaid A., Rhyne J., Hachem R., Darouiche R., Safar H., Albitar M., Sherertz R. J. Minocycline and ethylenediaminetetraacetate for the prevention of recurrent vascular catheter infections. Clin Infect Dis. 1997 Jul;25(1):149–151. doi: 10.1086/514518. [DOI] [PubMed] [Google Scholar]
  30. Raad I., Darouiche R., Dupuis J., Abi-Said D., Gabrielli A., Hachem R., Wall M., Harris R., Jones J., Buzaid A. Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. The Texas Medical Center Catheter Study Group. Ann Intern Med. 1997 Aug 15;127(4):267–274. doi: 10.7326/0003-4819-127-4-199708150-00002. [DOI] [PubMed] [Google Scholar]
  31. Raad I., Davis S., Khan A., Tarrand J., Elting L., Bodey G. P. Impact of central venous catheter removal on the recurrence of catheter-related coagulase-negative staphylococcal bacteremia. Infect Control Hosp Epidemiol. 1992 Apr;13(4):215–221. doi: 10.1086/646512. [DOI] [PubMed] [Google Scholar]
  32. Rackoff W. R., Weiman M., Jakobowski D., Hirschl R., Stallings V., Bilodeau J., Danz P., Bell L., Lange B. A randomized, controlled trial of the efficacy of a heparin and vancomycin solution in preventing central venous catheter infections in children. J Pediatr. 1995 Jul;127(1):147–151. doi: 10.1016/s0022-3476(95)70276-8. [DOI] [PubMed] [Google Scholar]
  33. Raucher H. S., Hyatt A. C., Barzilai A., Harris M. B., Weiner M. A., LeLeiko N. S., Hodes D. S. Quantitative blood cultures in the evaluation of septicemia in children with Broviac catheters. J Pediatr. 1984 Jan;104(1):29–33. doi: 10.1016/s0022-3476(84)80584-3. [DOI] [PubMed] [Google Scholar]
  34. Rushforth J. A., Hoy C. M., Kite P., Puntis J. W. Rapid diagnosis of central venous catheter sepsis. Lancet. 1993 Aug 14;342(8868):402–403. doi: 10.1016/0140-6736(93)92815-b. [DOI] [PubMed] [Google Scholar]
  35. Ryan J. A., Jr, Abel R. M., Abbott W. M., Hopkins C. C., Chesney T. M., Colley R., Phillips K., Fischer J. E. Catheter complications in total parenteral nutrition. A prospective study of 200 consecutive patients. N Engl J Med. 1974 Apr 4;290(14):757–761. doi: 10.1056/NEJM197404042901401. [DOI] [PubMed] [Google Scholar]
  36. Ryan J. A., Jr, Abel R. M., Abbott W. M., Hopkins C. C., Chesney T. M., Colley R., Phillips K., Fischer J. E. Catheter complications in total parenteral nutrition. A prospective study of 200 consecutive patients. N Engl J Med. 1974 Apr 4;290(14):757–761. doi: 10.1056/NEJM197404042901401. [DOI] [PubMed] [Google Scholar]
  37. Segura M., Alvarez-Lerma F., Tellado J. M., Jiménez-Ferreres J., Oms L., Rello J., Baró T., Sánchez R., Morera A., Mariscal D. A clinical trial on the prevention of catheter-related sepsis using a new hub model. Ann Surg. 1996 Apr;223(4):363–369. doi: 10.1097/00000658-199604000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Sheng W. H., Ko W. J., Wang J. T., Chang S. C., Hsueh P. R., Luh K. T. Evaluation of antiseptic-impregnated central venous catheters for prevention of catheter-related infection in intensive care unit patients. Diagn Microbiol Infect Dis. 2000 Sep;38(1):1–5. doi: 10.1016/s0732-8893(00)00166-8. [DOI] [PubMed] [Google Scholar]
  39. Sherertz R. J., Heard S. O., Raad I. I. Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies. J Clin Microbiol. 1997 Mar;35(3):641–646. doi: 10.1128/jcm.35.3.641-646.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Sherertz R. J., Raad I. I., Belani A., Koo L. C., Rand K. H., Pickett D. L., Straub S. A., Fauerbach L. L. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol. 1990 Jan;28(1):76–82. doi: 10.1128/jcm.28.1.76-82.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Sherertz R. J., Raad I. I., Belani A., Koo L. C., Rand K. H., Pickett D. L., Straub S. A., Fauerbach L. L. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol. 1990 Jan;28(1):76–82. doi: 10.1128/jcm.28.1.76-82.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Siegman-Igra Y., Anglim A. M., Shapiro D. E., Adal K. A., Strain B. A., Farr B. M. Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis. J Clin Microbiol. 1997 Apr;35(4):928–936. doi: 10.1128/jcm.35.4.928-936.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Sitges-Serra A., Linares J., Garau J. Catheter sepsis: the clue is the hub. Surgery. 1985 Mar;97(3):355–357. [PubMed] [Google Scholar]
  44. Tighe M. J., Kite P., Fawley W. N., Thomas D., McMahon M. J. An endoluminal brush to detect the infected central venous catheter in situ: a pilot study. BMJ. 1996 Dec 14;313(7071):1528–1529. doi: 10.1136/bmj.313.7071.1528. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Vanderhoof J. A. Short bowel syndrome in children and small intestinal transplantation. Pediatr Clin North Am. 1996 Apr;43(2):533–550. doi: 10.1016/s0031-3955(05)70419-3. [DOI] [PubMed] [Google Scholar]
  46. Veenstra D. L., Saint S., Saha S., Lumley T., Sullivan S. D. Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis. JAMA. 1999 Jan 20;281(3):261–267. doi: 10.1001/jama.281.3.261. [DOI] [PubMed] [Google Scholar]
  47. Vercaigne L. M., Sitar D. S., Penner S. B., Bernstein K., Wang G. Q., Burczynski F. J. Antibiotic-heparin lock: in vitro antibiotic stability combined with heparin in a central venous catheter. Pharmacotherapy. 2000 Apr;20(4):394–399. doi: 10.1592/phco.20.5.394.35063. [DOI] [PubMed] [Google Scholar]
  48. Wing E. J., Norden C. W., Shadduck R. K., Winkelstein A. Use of quantitative bacteriologic techniques to diagnose catheter-related sepsis. Arch Intern Med. 1979 Apr;139(4):482–483. [PubMed] [Google Scholar]

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