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Catheter-relatedbloodstream infection

( CRBSI )Laurence Chandrawan

11201404!nastesi-RS"#

$ara%an&'a%arta

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!lso called catheter-related sesis the resence of bacteraemiaori*inatin* from an i+, catheter

$he most freuent& lethal and costl.comlication of central ,enouscatheteri/ation

ost common cause of nosocomialbacteraemia

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CRBSI occurs in 67 of catheri/ations

8owe,er the incidence ma. be ashi*h as 197

Reresent 2-60 eisodes er 1000catheter da.s+

3ri*inate from eriheral i+, andintra-arterial cannulae ( rare )

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!$83:SIS

Immediatl. the surfaces of C;Cbecome coated with lasma roteins&articularl.

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CRBSI tri**ers a s.stemicin>ammator. resose& ran*in* fromfe,er and leucoc.tosis trou*h setic

shoc% and multile or*an failure

ortalit. rate 6 to 2?7

etastatic infection is ossible setic arthitis& setic trombosis&endocarditis+

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old standart dia*nosis combination of the ositi,e bloodculture with the same or*anism

isolated from the catheter

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!SS3CI!$# @!C$3RS

Immunosuresion& either relati,e orabsolute ( criticall. ill & mali*nanc. )

$he microbiolo*ical en,iroment also

in>unces the rate of CRBSI with hi*er rate (IC" )

@reuent accessin* of the catheter andoor asetic techniue

Subcla,ian C;Cs ha,e the lowest infectionrate followed b. internal 'u*ular andfemoral catheters+

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$reatment

$he catheter should be remo,ed if CRBSI issusected

If the remo,ed catheter ro,en onmicrobiolo*ical eAamination to be the source ofsesis selected another site

!ntibiotic thera. based on the culture reorts

3ne wee%s treatment after the catheter hasbeen remo,ed

$wo wee%s if the infection caused b.stah.lococcus aureus or fun*i

rolon* if needed or failure treatment

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R;:$I3:

Selection of catheter t.e

Sin*le lumen& lon* term use( imlantable and tunnelled catheter )&hi*h ris% ( antimicrobacterial catheter )

Selection of catheter insertion site

!setic tecniue durin* insertion

Catheter and catheter site care

Relacement strate*ies

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C3:CL"SI3:

CRBSI is an iatro*enic roblem thatcauses si*ni