Central venous catheter-related bacteremia due to gram-negative bacilli: significance of catheter removal in preventing relapse

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Hend HannaIssam Raad

Abstract

To study the characteristics of catheter-related, gram-negative bacteremia (GNB) and the role of central venous catheter (CVC) removal. This retrospective study involved a search of the microbiological department records of CVC and blood cultures and patients' medical records. University of Texas M. D. Anderson Cancer Center, a tertiary-care hospital in Houston, Texas. Patients with cancer who had catheter-related GNB, defined as (1) a positive catheter tip culture with at least 15 colony-forming units semiquantitatively, (2) isolation of the same organism from the tip and peripheral blood cultures, (3) no other source for bacteremia except the CVC, and (4) clinical manifestations of infection (fever or chills). Between January 1990 and December 1996, 72 cases of catheter-related GNB were available for review. Most of the patients (67; 93%) had their CVCs removed in response to the bacteremia. Few patients (5; 7%) retained their CVCs and were treated with appropriate antibiotics. When CVCs were removed, only 1 patient (1%) relapsed with the same organism, whereas all 5 patients with retained CVCs relapsed after having responded (P < .001). The most commonly isolated organisms were Enterobacter, Klebsiella, Stenotrophomonas, Pse...Continue Reading

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