Central line-associated bloodstream infection: Difference between revisions
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| + | ==Management== |
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| − | [https://academic.oup.com/view-large/figure/74158738/49-1-1-fig002.gif] |
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| + | ===Short-term CVC or arterial line infection=== |
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| + | * '''Uncomplicated:''' no other foci of infection, fever resolves promptly ≤72h, no other intravascular hardware, no evidence of endocarditis or suppurative thrombophlebitis, and (if [[S. aureus]]) no active malignancy or immunosuppression |
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| + | ** [[Coagulase-negative staphylococci]]: remove catheter and treat with antibiotic for 5-7 days; if catheter not removed, do lock therapy and treat for 10-14 days |
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| + | ** ''[[Staphylococcus aureus]]'': remove catheter and treat with antibiotic for ≥14 days |
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| + | ** ''[[Enterococcus]]'': remove catheter and treat with antibiotic for 7-14 days |
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| + | ** ''[[Gram-negative bacillus]]'': remove catheter and treat with antibiotic for 7-14 days |
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| + | ** ''[[Candida]]'': remove catheter and treat with antifungal for 14 days from first negative blood culture |
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| + | * '''Complicated:''' anyone not meeting above definition of uncomplicated |
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| + | ** Remove catheter and treat with antimicrobial for 4-6 weeks, or for 6-8 weeks if osteomyelitis |
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| + | |||
| + | ==Further Reading== |
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| + | * Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update. ''Clin Infect Dis''. 2009:49(1):1-45. doi: [https://doi.org/10.1086/599376 10.1086/599376] |
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[[Category:Endovascular infections]] |
[[Category:Endovascular infections]] |
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Revision as of 07:25, 12 June 2020
Management
Short-term CVC or arterial line infection
- Uncomplicated: no other foci of infection, fever resolves promptly ≤72h, no other intravascular hardware, no evidence of endocarditis or suppurative thrombophlebitis, and (if S. aureus) no active malignancy or immunosuppression
- Coagulase-negative staphylococci: remove catheter and treat with antibiotic for 5-7 days; if catheter not removed, do lock therapy and treat for 10-14 days
- Staphylococcus aureus: remove catheter and treat with antibiotic for ≥14 days
- Enterococcus: remove catheter and treat with antibiotic for 7-14 days
- Gram-negative bacillus: remove catheter and treat with antibiotic for 7-14 days
- Candida: remove catheter and treat with antifungal for 14 days from first negative blood culture
- Complicated: anyone not meeting above definition of uncomplicated
- Remove catheter and treat with antimicrobial for 4-6 weeks, or for 6-8 weeks if osteomyelitis
Further Reading
- Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update. Clin Infect Dis. 2009:49(1):1-45. doi: 10.1086/599376
References
- ^ Isaac See, Alison G. Freifeld, Shelley S. Magill. Causative Organisms and Associated Antimicrobial Resistance in Healthcare-Associated, Central Line–Associated Bloodstream Infections From Oncology Settings, 2009–2012. Clinical Infectious Diseases. 2016;62(10):1203-1209. doi:10.1093/cid/ciw113.
- ^ Michelle Gompelman, Carmen Paus, Ashley Bond, Reinier P Akkermans, Chantal P Bleeker-Rovers, Simon Lal, Geert JA Wanten. Comparing success rates in central venous catheter salvage for catheter-related bloodstream infections in adult patients on home parenteral nutrition: a systematic review and meta-analysis. The American Journal of Clinical Nutrition. 2021;114(3):1173-1188. doi:10.1093/ajcn/nqab164.
