Treatment and prevention of central venous catheter-related bloodstream infections / 国际外科学杂志

ABSTRACT

Objective Focusing on the diagnosis, treatment and prevention of central venous catheter (CVC)-related bloodstream infections(CRBSI) in clinical practice, to provide clinical evidences for reducing the incidence of central venous catheter-related bloodstream infections Methods The related articles within the latest 5 years were reviewed, and the related monitoring data of the hospital were analyzed. Results ( 1 )The pathogens of CRBSI invaded bloodstream through the puncture point/hub, and the pathogens of the secondary CRBSI came from the infections in other sites, invading bloodstream and adhering the catheter tip. (2)Highlights on the diagnosis of CRBSI For the patients with CVC, the possibility of the CRBSI should be considered when severe fever not due to non-infectious causes occurred. Infection occurring time and pathogen are different between the general catheters and the anti-infective catheters. The effect of antiinfection of the anti-infective catheters are limited. To pull out the catheters is the most effective treatment measures. Routine puncture point culture should be rejected. ( 3 ) Prevention of CRBSI The indications of CVC intubation should be undisputed. Silicone catheter should be used. The catheter should not be indwelled more than 5 days. Conclusions Invasive operation, the lasting time of catheterization and using a lot of antibiotics are the susceptible factors for CRBSI. Hospital should establish suite intervention methods and operation procedures,strengthen education of the medical staff and proceed with targeted monitor for decreasing the rate of infectious.