. 2012 Nov 23;2:48. doi: 10.1186/2110-5820-2-48

Table 2.

Characteristics of the main trials studying dialysis catheter infection in ICU

Author	Date	Study design	No. of patients	Catheters number	Site of insertion	Catheter tip culture	Catheter-related infection definition	Colonization (/1,000 c.d.)	Catheter-related infection (/1,000 c.d.)	TC (days, mean ± SD)
Souweine^a	1995-1996	Prospective, open, monocentric	170	151	Femoral and jugular	Simplified Brun Buisson	CRBSI: catheter colonization and blood culture positive for the same organism; site infection: presence of pus at the insertion site.	24.2	1.5	6.8 ± 6
Wester^a	1997-1998	Prospective, open, monocentric, CAVHDF, ICU	43	139	Axillary arteries, femoral veins and arteries, subclavian veins	Semiquantitative culture: >15 CFU; quantitative culture: >10^3 CFU	Exit site infection: erythema, tenderness, induration, or purulence within 2 cm of the skin at the exit site of the catheter; CRBSI: Same organism isolated from a culture of the catheter and from the blood with clinical symptoms of infection; in the absence of laboratory confirmation, defervescence after removal of a catheter may be considered indirect evidence of CRBSI.	46.8% vs. 39.1%	2.2%	4.2 ± 2 vs. 7.3 ± 4.5
Harb^a	1998-1999	prospective, open, monocentric, ICU	47	79	Femoral, subclavian, and jugular	Simplified Brun Buisson	Infected catheter: positive catheter tip culture with clinical signs of sepsis resolving within 48 hours after catheter removal; CRBSI: same microorganism isolated from the catheter tip culture and from cultured peripheral blood culture drawn during catheter placement or within the 24 hours following removal of the catheter. Differential time of positivity >2 hours.	5.4 (3.7%)	1.8 (1.2%)	6.9 ± 5.5
Chatzinikalaou^b	2000-2002	prospective, randomized, monocentric, antibiotic coated dialysis catheters, 82% ICU	130	130: 66 antibiotic coated vs. 64 non-coated catheters	Femoral	Sherertz	fever (>38°C), chills, hypotension, skin organisms cultured from at least one blood cultures from a peripheral vein that was not related to infection of another site, and antimicrobial therapy; same organism isolated from peripheral blood culture and from DC tip culture (>1,000 CFU); presence of a positive quantitative catheter culture in a patient with clinical signs of sepsis that disappeared within 48 hours after catheter removal.	22% of all catheters (20% of antibiotics coated catheters vs. 25% of uncoated catheters)	14.3 (11% of uncoated catheter)	8 ± 6
Souweine^a	2001-2004	prospective, open, monocentric	99	130	Femoral and jugular	Simplified Brun Buisson	CRBSI: isolation of the same phenotypic microorganism from both peripheral-blood culture and catheter-tip culture growing greater than 10^3 CFU/mL when there was no other source for bacteremia.	9.1	0	6.7 ± 4
Schönenberg^a	2003-2007	prospective, open, monocentric	173	173	Subclavian, jugular, and femoral	NR	CRBSI: criteria for laboratory diagnosis of infection and clinical signs of sepsis. Laboratory diagnosis of infection is defined as a positive blood culture with a strain not descending from a different site of infection.	NR	3.8	9.2
Klouche^b	2004-2005	prospective, monocentric, randomized, ICU	30	30: 15 tunneled vs. 15 non- tunneled catheters	Femoral	NR	Association of fever or chills or an overtly purulent exit site with a positive catheter clot or catheter culture result	NR	6.7%	13.5 ± 9.2 (tunneled) vs. 5.6 ± 3.4 (non-tunneled)
Parienti^b	2004-2007	prospective, multicentric, randomized, few coated catheter (21%), ICU	637	637: 366 jugular vs. 370 femoral catheters	Femoral and jugular	Simplified Brun Buisson	catheter tip colonization plus at least one peripheral blood culture yielding the same species with the same antimicrobial susceptibility as the catheter tip within 48 hours of catheter removal, with no other apparent source of sepsis	40.8 (25.9%, femoral catheter) vs. 35.7 (24.9%, jugular catheter)	1.5 (0.5%, femoral catheter) vs. 2.3 (0.5%, jugular catheter)	4.9 ± 2
Parienti^b	2004-2007	prospective, multicentric, randomized, few coated catheter (21%), ICU	637	637: 470 intermittent RRT vs. 266 continuous RRT	Femoral and jugular	Simplified Brun Buisson	catheter tip colonization plus at least one peripheral blood culture yielding the same species with the same antimicrobial susceptibility as the catheter tip within 48 hours of catheter removal, with no other apparent source of sepsis	38.9 (25.4%) [42.7 (intermittent hemodialysis) vs. 27.7 (continuous renal replacement therapy)]	1.9 (1.3%) [2.6 (intermittent hemodialysis) vs. 1.2 (continuous renal replacement therapy)]	6.3 (6.2) vs. 6.6 (6)
Dugué^b	2004-2007	prospective, multicentric, randomized, few coated catheter (21%), ICU	134	268: 57 femoral then jugular vs. 77 jugular then femoral catheter	femoral and jugular	simplified Brun Buisson	NR	25,4% (femoral catheter) vs. 26,9%(jugular catheter)	NR	7.9 (5.6)
Skofic^a	2004-2008	retrospective, monocentric, prospectively data collection	290	534	femoral, subclavian, and jugular	NR	exit site infection: local inflammation with purulent discharge and positive exit site culture; suspected CRBSI: proven systemic infection without any other recognized source of infection; confirmed CRBSI: at least one positive blood culture from a peripheral vein along with at least one positive blood culture from the catheter or positive catheter tip culture with an identical microorganism; possible CRBSI: at least one positive microbiological culture, good clinical response to catheter removal and antibiotic therapy, but lacking all criteria for confirmed CRBSI.	NR	4.6 (5.2%)	11
Hermite^b	2009-2010	prospective, monocentric, randomized, ICU	78	135: 77 saline vs. 58 citrate lock	femoral and jugular	NR	CRBSI: fever (>38°C) with concordant positive blood cultures drawn from the catheter and a peripheral vein or a peripheral blood culture and a concordant exit site culture; probable CRBSI: fever with one positive blood culture, in the absence of any other clinically identifiable source of infection other than the catheter.	NR	30 (saline lock) vs. 24 (citrate lock)	6 [3-10] saline lock group vs. 12 [8-17] citrate lock group

TC time of catheterization; ICU intensive care unit; CAVHDF Continuous arteriovenous hemodiafiltration; CRBSI Catheter-related bloodstream infection; CFU Colony-forming unit; NR not related; Simplified Brun Buisson and Sherertz as previously described [44,45]^aObservational descriptive studies; ^bcomparison studies.