Abstract
Indwelling central-line catheters (n = 502) from 362 patients in intensive care units were analyzed prospectively. The skin site, 6-cm-distal and -proximal subcutaneous segments of the catheter, exudates, and blood were cultured. Semiqualitative roll plate cultures of the catheter segments were followed by broth cultures and examined for 72 h. All isolates were identified, and susceptibilities were determined. Line infections, defined clinically, yielded 22 different microbial species; 10 different species were recovered from colonized lines. Of the Staphylococcus epidermidis isolates recovered, 39% occurred singly and 21% occurred in combination with other microorganisms; Enterococcus faecalis, S. hominis, and Pseudomonas aeruginosa were next in frequency of isolation. Line infections also yielded other staphylococci, viridans group streptococci, several members of the family Enterobacteriaceae, acinetobacters, anaerobic bacteria, Candida spp., and Aspergillus fumigatus. While S. epidermidis was also the most frequent isolate among the line colonizers, different species and different frequencies of isolation were found among this group. The study showed that the distal catheter segment broth culture was the best predictor of clinical line infections; in addition, gram-negative bacteria were isolated only from the catheters of patients with overt infections.
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Selected References
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- Bentley D. W., Lepper M. H. Septicemia related to indwelling venous catheter. JAMA. 1968 Nov 18;206(8):1749–1752. [PubMed] [Google Scholar]
- Bernard R. W., Stahl W. M., Chase R. M., Jr Subclavian vein catheterizations: a prospective study. II. Infectious complications. Ann Surg. 1971 Feb;173(2):191–200. doi: 10.1097/00000658-197102000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bozzetti F. Central venous catheter sepsis. Surg Gynecol Obstet. 1985 Sep;161(3):293–301. [PubMed] [Google Scholar]
- Brereton R. B. Incidence of complications from indwelling venous catheters. Del Med J. 1969 Jan;40(1):1–8. [PubMed] [Google Scholar]
- Collignon P. J., Munro R., Sorrell T. C. Systemic sepsis and intravenous devices. A prospective survey. Med J Aust. 1984 Sep 15;141(6):345–348. doi: 10.5694/j.1326-5377.1984.tb132802.x. [DOI] [PubMed] [Google Scholar]
- Collignon P. J., Soni N., Pearson I. Y., Woods W. P., Munro R., Sorrell T. C. Is semiquantitative culture of central vein catheter tips useful in the diagnosis of catheter-associated bacteremia? J Clin Microbiol. 1986 Oct;24(4):532–535. doi: 10.1128/jcm.24.4.532-535.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Collins R. N., Braun P. A., Zinner S. H., Kass E. H. Risk of local and systemic infection with polyethylene intravenous catheters. A prospective study of 213 catheterizations. N Engl J Med. 1968 Aug 15;279(7):340–343. doi: 10.1056/NEJM196808152790702. [DOI] [PubMed] [Google Scholar]
- Freeman J. B., Lemire A., MacLean L. D. Intravenous alimentation and septicemia. Surg Gynecol Obstet. 1972 Nov;135(5):708–712. [PubMed] [Google Scholar]
- Goldmann D. A., Maki D. G. Infection control in total parenteral nutrition. JAMA. 1973 Mar 19;223(12):1360–1364. [PubMed] [Google Scholar]
- Maki D. G., Goldman D. A., Rhame F. S. Infection control in intravenous therapy. Ann Intern Med. 1973 Dec;79(6):867–887. doi: 10.7326/0003-4819-79-6-867. [DOI] [PubMed] [Google Scholar]
- 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]
- McCarthy M. C., Shives J. K., Robison R. J., Broadie T. A. Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. JPEN J Parenter Enteral Nutr. 1987 May-Jun;11(3):259–262. doi: 10.1177/0148607187011003259. [DOI] [PubMed] [Google Scholar]
- Michel L., McMichan J. C., Bachy J. L. Microbial colonization of indwelling central venous catheters: statistical evaluation of potential contaminating factors. Am J Surg. 1979 Jun;137(6):745–748. doi: 10.1016/0002-9610(79)90085-0. [DOI] [PubMed] [Google Scholar]
- Mogensen J. V., Frederiksen W., Jensen J. K. Subclavian vein catheterization and infection. A bacteriological study of 130 catheter insertions. Scand J Infect Dis. 1972;4(1):31–36. doi: 10.3109/inf.1972.4.issue-1.07. [DOI] [PubMed] [Google Scholar]
- Pinilla J. C., Ross D. F., Martin T., Crump H. Study of the incidence of intravascular catheter infection and associated septicemia in critically ill patients. Crit Care Med. 1983 Jan;11(1):21–25. doi: 10.1097/00003246-198301000-00007. [DOI] [PubMed] [Google Scholar]
- Reinhardt G. F., Gelbart S. M., Greenlee H. B. Catheter infection factors affecting total parenteral nutrition. Am Surg. 1978 Jul;44(7):401–405. [PubMed] [Google Scholar]
- Ricard P., Martin R., Marcoux J. A. Protection of indwelling vascular catheters: incidence of bacterial contamination and catheter-related sepsis. Crit Care Med. 1985 Jul;13(7):541–543. doi: 10.1097/00003246-198507000-00006. [DOI] [PubMed] [Google Scholar]
- 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]
- Sanders R. A., Sheldon G. F. Septic complications of total parenteral nutrition. A five year experience. Am J Surg. 1976 Aug;132(2):214–220. doi: 10.1016/0002-9610(76)90050-7. [DOI] [PubMed] [Google Scholar]
- Sitges-Serra A., Puig P., Jaurrieta E., Garau J., Alastrue A., Sitges-Creus A. Catheter sepsis due to Staphylococcus epidermidis during parenteral nutrition. Surg Gynecol Obstet. 1980 Oct;151(4):481–483. [PubMed] [Google Scholar]
- Smits H., Freedman L. R. Prolonged venous catheterization as a cause of sepsis. N Engl J Med. 1967 Jun 1;276(22):1229–1233. doi: 10.1056/NEJM196706012762204. [DOI] [PubMed] [Google Scholar]