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Guidelines for the Management of Intravascular Catheter-Related Infections

Published online by Cambridge University Press:  02 January 2015

Leonard A. Mermel ,
Barry M. Farr ,
Robert J. Sherertz ,
Issam I. Raad ,
Naomi O'Grady ,
JoAnn S. Harris  and
Donald E. Craven
Leonard A. Mermel
Affiliation:
Division of Infectious Diseases, Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island
Barry M. Farr
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
Robert J. Sherertz
Affiliation:
Section of Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Issam I. Raad
Affiliation:
Department of Internal Medicine Specialties, the University of Texas M.D. Anderson Cancer Center, Houston, Texas
Naomi O'Grady
Affiliation:
Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland
JoAnn S. Harris
Affiliation:
Section of Pediatric Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts
Donald E. Craven*
Affiliation:
Section of Infectious Diseases, Boston University Schools of Medicine and Public Health, Boston Medical Center, Boston, Massachusetts Lahey Clinic Medical Center, Burlington, Massachusetts
*
Lahey Clinic Medical Center, Burlington, MA 01806 (Donald.E.Craven@Lahey.org)
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Extract

These guidelines from the Infectious Diseases Society of America (IDSA), the American College of Critical Care Medicine (for the Society of Critical Care Medicine), and the Society for Healthcare Epidemiology of America contain recommendations for the management of adults and children with, and diagnosis of infections related to, peripheral and nontunneled central venous catheters (CVCs), pulmonary artery catheters, tunneled central catheters, and implantable devices. The guidelines, written for clinicians, contain IDSA evidence-based recommendations for assessment of the quality and strength of the data. Recommendations are presented according to the type of catheter, the infecting organism, and the associated complications.

Intravascular catheter-related infections are a major cause of morbidity and mortality in the United States. Coagulase-negative staphylococci, Staphylococcus aureus, aerobic gram-negative bacilli, and Candida albicans most commonly cause catheter-related bloodstream infection. Management of catheter-related infection varies according to the type of catheter involved. After appropriate cultures of blood and catheter samples are done, empirical iv antimicrobial therapy should be initiated on the basis of clinical clues, the severity of the patient's acute illness, underlying disease, and the potential pathogen (s) involved. In most cases of nontunneled CVC-related bacteremia and fungemia, the CVC should be removed.

Type
Special Report
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 4 , April 2001 , pp. 222 - 242
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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