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Damar İçi Kateter İnfeksiyonlarına Güncel Yaklaşım

Current Approach To Intravascular Catheter Infection

Journal Name:

Publication Year:

DOI: 
http://dx.doi.org/10.5505/abantmedj.2012.33042

Keywords (Original Language):

Abstract (2. Language): 
A great majority of nosocomial bloodstream infections in hospitalized patients in risky departments of hospitals originate from an infected central venous catheter (CVC). Catheter- related bloodstream infection (CRBSI) is one of the considerable reason for morbidity and mortality and causes an increase in both duration and cost of hospital care. CRBSI usually arises around the catheter inserion site and at the hub of the catheters. Coagulase-negative staphylococci, Staphylococcus aureus, enterococci, and Candida species are the most common causative organisms for CRBSI. Isolation of the same organism from the catheter and peripheral blood contitutes the basis for the diagnosis of CRBSI. CRBSI is usually treated by withdrawal of the catheter and using systemic antibiotics. Applying prevention bundles accompanied with the evidence based strategies, planning multidisciplinary trainings, analysing retrospective data of the cases, doing infection control surveyances properly and providing acreditation in terms of quality is compulsory to avoid from CRBSI.
Abstract (Original Language): 
Hastanelerin riskli ünitelerinde yatan hastalarda nozokomiyal kan dolaşımı infeksiyonlarının önemli bir kısmı damar içi kateter infeksiyonlarından kaynaklanmaktadır. Kateterle ilişkili kan dolaşımı infeksiyonu (KİKDİ), önemli bir morbidite ve mortalite nedenidir. Hastanede kalış süresi ve bakım maliyetlerini artırır. İnfeksiyon sıklıkla kateter giriş yeri ve birleşim yerinden kaynaklanmaktadır. KİKDİ için en sık etken mikroorganizmalar koagülaz-negatif stafilokok, Staphylococcus aureus, Enterokoklar ve Candida türleridir. Kateter ile periferik kanda aynı etkenin üremesi tanının temelini oluşturur. Tedavide, genellikle kateter çıkarılır ve sistemik antibiyotik başlanır. Kanıta dayalı stratejiler eşliğinde paket önlemlerin uygulanması, multidisipliner eğitimlerin verilmesi, geriye dönük bildirimlerin sağlanması, infeksiyon kontrol sürveyansının düzgün çalışması ve kalite açısından akreditasyonun sağlanması KİKDİ’lerin önlenmesi için zorunludur.
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REFERENCES

References: 

1. Seifert H, Jansen B, Widmer AF, Farr BM: Central-
Venous Catheters. In: Seifert H, Jansen B, Farr BM (Eds):
Catheter-Related Infections. 2th edition, New York, Marcel
Dekker 2005: 293-326.
2. O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland
J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson
ML, Raad II, Randolph AG, Rupp ME, Saint S; Healthcare
Infection Control Practices Advisory Committee. Guidelines
for the prevention of intravascular catheterrelated
infections. Am J Infect Control 2011; 39: 1-34.
3. Beekmann SE, Henderson DK: Infections caused by
percutaneous intravascular devices. In: Mandell GL, Bennett
JE, Dolin R (Eds): Mandell, Douglas, and Bennett's
Principles and Practice of Infectious Diseases. 7th edition,
Philadelphia, PA: Churchill, Livingstone, Elsevier 2010:
3347-62.
4. Pascual A. Pathogenesis of catheter-related infections:
lessons for new designs. Clin Microbiol Infect 2002; 8:
256-64.
5. Zhang L, Gowardman J, Rickard CM. Impact of microbial
attachment on intravascular catheter-related infections.
Int J Antimicrob Agents 2011; 38: 9-15.
6. Bouza E, Burillo A, Munoz P. Catheter-related infections:
diagnosis and intravascular treatment. Clin Microbiol
Infect 2002; 8: 265-74.
7. Edgeworth J. Intravascular catheter infections. J Hosp
Infect 2009; 73: 323-30.
8. Safdar N, Maki DG. The pathogenesis of catheterrelated
bloodstream infection with noncuffed short-termcentral venous catheters. Intensive care med 2004; 30:
62-7.
9. Macias AE, Huertas M, de Leon SP, Munoz JM, Chavez
AR, Sifuentes-Osornio J, Romero C, Bobadilla M. Contamination
of intravenous fluids: a continuing cause of hospital
bacteremia. Am J Infect Control 2010; 38: 217-21.
10. Weber DJ, Rutala WA. Central line-associated bloodstream
infections: prevention and management. Infect Dis
Clin North Am 2011; 25: 77-102.
11. Ge X, Cavallazzi R, Li C, Pan SM, Wang YW, Wang FL.
Central venous access sites for the prevention of venous
thrombosis, stenosis and infection in patients requiring
long-term intravenous therapy. Cochrane Database Syst
Rev 2012; 3: CD004084.
12. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream
infection in adults with different intravascular devices; a
systematic review of 200 published prospective studies.
Mayo Clin Proc 2006; 81: 1159-71.
13. Eggimann P, Pittet D. Overview of catheter-related
infections with special emphasis on prevention based on
educational programs. Clin Microbiol Infect 2002; 8: 295-
309.
14. Walz JM, Memtsoudis SG, Heard SO. Prevention of
central venous catheter bloodstream infections. J Intensive
Care Med 2010; 25: 131-8.
15. Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N,
Harris JS, Craven DE. Guidelines for the management of
intravascular catheter-related infections. Clin Infect Dis
2001; 32: 1249-72.
16. Polderman KH, Girbes AR. Mechanical and infectious
complications of central venous catheters. Minerva Anestesiol
2003; 69: 330-2.
17. Öncü S. İnravenöz kateter infeksiyonları. ANKEM Derg
2012; 26: 180-3.
18. Öztürk R: Damar içi kateterlere bağlı infeksiyonlar ve
korunma. Hastane İnfeksiyonları (Ed): Hastane infeksiyonları
derneği yayını No:1, bilimsel tıp yayınevi, Ankara
2003:489-517.
19. Crump JA, Collignon PJ. Intravascular catheterassociated
infections. Eur J Clin Microbiol Infect Dis 2000;
19: 1-8.
20. Bouza E, Alvarado N, Alcala L, Perez MJ, Rincon C, Munoz
P. A randomized and prospective study of 3 procedures
for the diagnosis of catheter-related bloodstream infection
without catheter withdrawal. Clin Infect Dis 2007;
44: 820-6.
21. Eggimann P. Diagnosis of intravascular catheter infection.
Curr Opin Infect Dis 2007; 20: 353-9.
22. Paiva JA, Pereira JM. Treatment of the afebrile patient
after catheter withdrawal: drugs and duration. Clin Microbiol
Infect 2002; 8: 290-4.
23. Carratala J. The antibiotic-lock technique for therapy of
‘highly needed’ infected catheters. Clin Microbiol Infect
2002; 8: 282-9.
24. Bouza E, Burillo A, Munoz P. Catheter-related infections:
diagnosis and intravascular treatment. Clin Microbiol
Infect 2002; 8: 265-74.
25. McLaws ML, Burrell AR. Zero risk for central lineassociated
bloodstream infection: are we there yet?. Crit
Care Med 2012; 40: 388-93.
26. Marwick C, Davey P. Care bundles: The holy grail of
infectious risk management in hospital? Curr Opin Infect
Dis 2009; 22: 364-9.
27. Güner R. Kateter ilişkili kan dolaşımı infeksiyonlarından
korunmada paket önlemler. ANKEM Derg 2011; 25: 25-7.
28. Berenholtz SM, Pronovost PJ, Lipsett PA, Hobson D,
Earsing K, Farley JE, Milanovich S, Garrett-Mayer E, Winters
BD, Rubin HR, Dorman T, Perl TM. Eliminating catheter-
related bloodstream infections in the intensive care
unit. Crit Care Med 2004; 32: 2014-20.
29. Bizzarro MJ, Sabo B, Noonan M, Bonfiglio MP, Northrup
V, Diefenbach K. A quality improvement initiative to reduce
central line-associated bloodstream infections in a neonatal
intensive care unit. Infect Control Hosp Epidemiol
2010; 31: 241-8.
30. Shapey IM, Foster MA, Whitehouse T, Jumaa P, Bion JF.
Central venous catheter-related bloodstream infections:
improving postinsertion catheter care. J Hosp Infect 2009;
71:117-22.
31. Peredo R, Sabatier C, Villagrá A, González J, Hernández
C, Pérez F, Suárez D, Vallés J. Reduction in catheterrelated
bloodstream infections in critically ill patients
through a multiple system intervention. Eur J Clin Microbiol
Infect Dis 2010; 29: 1173-7.
32. Vergidis P, Patel R. Novel approaches to the diagnosis,
prevention, and treatment of medical device-associated
infections. Infect Dis Clin North Am 2012; 26: 173-86.
33. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P,
O'Grady NP, Raad II, Rijnders BJ, Sherertz RJ, Warren DK.
Clinical practice guidelines for the diagnosis and management
of intravascular catheter-related infection: 2009
Update by the Infectious Diseases Society of America. Clin
Infect Dis 2009; 49: 1-45.
34. Rosenthal VD, Maki DG, Jamulitrat S, Medeiros EA, Todi
SK, Gomez DY, Leblebicioglu H, Abu Khader I, Miranda
Novales MG, Berba R, Ramírez Wong FM, Barkat A, Pino
OR, Dueñas L, Mitrev Z, Bijie H, Gurskis V, Kanj SS, Mapp
T, Hidalgo RF, Ben Jaballah N, Raka L, Gikas A, Ahmed A,
Thu le TA, Guzmán Siritt ME. International Nosocomial
Infection Control Consortium (INICC) report, data summary
for 2003-2008, issued June 2009. Am J Infect Control
2010; 38: 95-104.

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