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Central venous catheter-related bloodstream infection caused by Staphylococcus aureus: microbiology and risk factors
Sadoyma, Geraldo;Diogo Filho, Augusto;Gontijo Filho, Paulo Pinto;
Brazilian Journal of Infectious Diseases , 2006, DOI: 10.1590/S1413-86702006000200006
Abstract: although central vascular catheters (cvc) are indispensable in modern medicine, they are an important risk factor for primary bacteremias. we examined the incidence and risk factors associated with catheter-related bloodstream infection (cr-bsi) caused by staphylococcus aureus in surgical patients. a prospective study was carried out in the hospital das clínicas da universidade federal de uberlandia (hc-ufu) from september 2000 to december 2002. the skin insertion site, catheter tip, and blood were microbiologically analyzed. demographics and risk factors were recorded for each patient, and cultures were identified phenotypically. staphylococcus aureus was the most frequent pathogen, with an incidence rate of 4.9 episodes of cr-bsis per 1,000 catheter/days. based on logistic regression, the independent risk factors were: colonization on the insertion site =200 colony forming units (cfu)/20 cm2 (p=0.03; odds ratio (or) =6.89) and catheter tip (p=0.01; or=7.95). the cr-bsi rate was high; it was mainly associated with s. aureus, and skin colonization at the insertion site and on the catheter tip were important risk factors for cr-bsi.
耐甲氧西林路邓葡萄球菌致新生儿导管相关血流感染1例
Neonatal catheterrelated bloodstream infection caused by methicillinresistant Staphylococcus lugdunensis:a case report
 [PDF]

胡晓艳,周于新
HU Xiaoyan
,ZHOU Yuxin

- , 2015, DOI: 10.3969/j.issn.1671-9638.2015.04.018
Abstract: 导管相关血流感染(catheterrelated bloodstream infection,CRBSI)是新生儿重症监护室(NICU)较常见的重症感染,常导致患儿出现严重疾病状态甚至死亡。CRBSI 的主要致病菌是凝固酶阴性葡萄球菌(CNS)[1-2],路邓葡萄球菌是CNS中毒性较强的一种细菌,目前报道该细菌的耐药率不高,笔者现将 1 例耐甲氧西林路邓葡萄球菌导致的CRBSI病例报告如下
Tsukamurella catheter-related bloodstream infection in a pediatric patient with pulmonary hypertension
Kristen A. Wendorf,Claudia M. Espinosa,William D. LeBar,Jason B. Weinberg
Infectious Disease Reports , 2010, DOI: 10.4081/idr.2010.e5
Abstract: Catheter-related bloodstream infections (CR-BSI) are important complications in patients with long-term indwelling central venous catheters. In this report, we present the case of a 14-year-old male with pulmonary hypertension treated with continuous treprostinil infusion, who presented with a CR-BSI caused by a Tsukamurella species. This case highlights the potential for this unusual organism to cause infection in immunocompetent patients.
Bacillus Cereus catheter related bloodstream infection in a patient in a patient with acute lymphblastic leukemia  [cached]
Lütfiye ?ksüz,N Gurler,M Muftuoglu,FD Sargin
Mediterranean Journal of Hematology and Infectious Diseases , 2012, DOI: 10.4084/mjhid.2012.
Abstract: Bacillus cereus infection is rarely associated with actual infection and for this reason single positive blood culture is usually regarded as contamination . However it may cause a number of infections, such catheter-related blood stream infections. Significant catheter-related bloodstream infections (CRBSI) caused by Bacillus spp. are mainly due to B.cereus and have been predominantly reported in immunocompromised hosts1 . Catheter removal is generally advised for management of infection. In this report, catheter-related bacteremia caused by B.cereus in a patient with acute lymphoblast c leukemia (ALL) in Istanbul Medical Faculty was presented.A 44-year old man presented with fatigue, weight loss, epistaxis and high fever. A double-lumen Hickman–catheter (Bard 12.0 Fr, Round Dual Lumen) was inserted by surgical cut-down to access the right subclavian vein which would be necessary for allogeneic stem cell transplantation. Three weeks later the patient presented with high fever and headache. Bacillus spp. was isolated from the cathether while blood culture obtained from the peripheral vein remained negative. The bacterial identification was confirmed as B.cereus using VITEK identification system It has been reported Bacillus cereus septicemia may be fatal in immunocompromised hosts despite broad-spectrum appropriate treatment10. Catheter removal is essential for prevention of recurrent bacteremia. Long-term cathater salvage should be reserved for appropriate patient group.
Incidence of bloodstream infection among patients on hemodialysis by central venous catheter
Grothe, Cibele;Belasco, Angélica Gon?alves da Silva;Bittencourt, Ana Rita de Cássia;Vianna, Lucila Amaral Carneiro;Sesso, Ricardo de Castro Cintra;Barbosa, Dulce Aparecida;
Revista Latino-Americana de Enfermagem , 2010, DOI: 10.1590/S0104-11692010000100012
Abstract: this study evaluated the incidence and risk factors of bloodstream infection (bsi) among patients with a double-lumen central venous catheter (cvc) for hemodialysis (hd) and identified the microorganisms isolated from the bloodstream. a follow-up included all patients (n=156) who underwent hemodialysis by double-lumen cvc at the federal university of s?o paulo - unifesp, brazil, over a one-year period. from the group of patients, 94 presented bsi, of whom 39 had positive cultures at the central venous catheter insertion location. of the 128 microorganisms isolated from the bloodstream, 53 were s. aureus, 30 were methicillin-sensitive and 23 were methicillin-resistant. complications related to bsi included 35 cases of septicemia and 27 cases of endocarditis, of which 15 cases progressed to death. the incidence of bsi among these patients was shown to be very high, and this bsi progressed rapidly to the condition of severe infection with a high mortality rate.
Risk factors for nosocomial bloodstream infection caused by multidrug resistant gram-negative bacilli in pediatrics
Arnoni, Mariana V.;Berezin, Eitan N.;Martino, Marinês D.V.;
Brazilian Journal of Infectious Diseases , 2007, DOI: 10.1590/S1413-86702007000200020
Abstract: the aim of this study was to identify the risk factors for nosocomial bloodstream infections by multidrug resistant gram-negative bacilli. from november 2001 to december 2003, in the pediatric department of the santa casa de s?o paulo, a retrospective case-control study was developed concerning patients who had nosocomial bloodstream infection caused by gram-negative bacilli. patients with multidrug resistant infections were designated as case patients, and control patients were those with an infection that did not meet the criteria for multidrug resistance. previous use of central venous catheter and previous use of vancomycin plus third generation cephalosporins were associated to a higher chance of infections by multidrug resistant gram-negative bacilli (odds ratio - 5.8 and 5.2, respectively). regarding sensitivity of the isolated agents, 47.8% were multidrug resistant, 54.2% were klebsiella spp. esbl producers and 36.4% were imipenem resistant pseudomonas aeruginosa. the lethality rate was 36.9% in the studied cases and this rate was significantly higher in the group of patients with multidrug resistant infections (p=0.013). risk factor identification as well as the knowledge of the susceptibility of the nosocomial infectious agents gave us the possibility to perform preventive and control strategies to reduce the costs and mortality related to these infections.
Central venous catheter-related bloodstream infection and Cryptococcus neoformans
Tuon, Felipe F.;Morales, Hugo M. P.;Penteado-Filho, Sergio R.;da-Silva, Margarete M.;Quadros, Isabel de;El Hamoui, Amina;
Brazilian Journal of Infectious Diseases , 2009, DOI: 10.1590/S1413-86702009000400016
Abstract: this is the first case reported of central venous catheter-related fungemia due to c. neoformans. a patient with chronic renal failure developed a fungemia during the treatment of a dialysis-associated bacteremia. cryptococcus neoformans grew in the catheter tip and blood culture. we addressed questions about this catheter-related fungemia.
患儿导管相关性放射根瘤菌血流感染实验室诊断方法探讨
Evaluation on laboratory diagnosis of catheterrelated bloodstream infection due to Rhizobium radiobacter in pediatric patients
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常勇杰,续华东,徐红炜,胡波,张振
CHANG Yongjie
, XU Huadong, XU Hongwei, HU Bo, ZHANG Zhen

- , 2015, DOI: 10.3969/j.issn.1671-9638.2015.02.003
Abstract: 目的探讨患儿导管相关性放射根瘤菌血流感染的诊断方法和感染因素。方法收集某院2012年2月—2014年2月1 014例使用各类中心静脉导管的患儿资料,检测放射根瘤菌感染患儿导管半定量培养,导管与静脉血菌落数比,以及静脉血与导管培养时间差;分析放射根瘤菌感染危险因素。结果1 014例使用各类中心静脉导管的患儿,导管和静脉血标本分别培养出放射根瘤菌32例和28例,27例患儿导管血和静脉血均为阳性。导管半定量培养菌落数≥15 CFU者27例,<15 CFU者5例;导管与静脉血菌落数比≥5∶1者22例,<5∶1者6例;静脉血与导管培养时间差≥2 h者26例,<2 h者2例。危险因素分析结果显示,患儿年龄、导管留置时间各组比较差异有统计学意义 (均P<0.05)。结论导管半定量培养、导管与静脉血菌落数比值及静脉与导管血培养时间差均是判断导管相关性放射根瘤菌血流感染的重要诊断依据;患儿年龄<2岁、导管留置时间>5 d是导管相关性放射根瘤菌血流感染的危险因素
Catheter Related Bloodstream Infection (CR-BSI) in ICU Patients: Making the Decision to Remove or Not to Remove the Central Venous Catheter  [PDF]
Rodrigo Octávio Deliberato, Alexandre R. Marra, Thiago Domingos Corrêa, Marinês Dalla Vale Martino, Luci Correa, Oscar Fernando Pav?o dos Santos, Michael B. Edmond
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0032687
Abstract: Background Approximately 150 million central venous catheters (CVC) are used each year in the United States. Catheter-related bloodstream infections (CR-BSI) are one of the most important complications of the central venous catheters (CVCs). Our objective was to compare the in-hospital mortality when the catheter is removed or not removed in patients with CR-BSI. Methods We reviewed all episodes of CR-BSI that occurred in our intensive care unit (ICU) from January 2000 to December 2008. The standard method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and a positive semi quantitative (>15 CFU) culture of a catheter segment from where the same organism was isolated. The conservative method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and one of the following: (1) differential time period of CVC culture versus peripheral culture positivity of more than 2 hours, or (2) simultaneous quantitative blood culture with 5:1 ratio (CVC versus peripheral). Results 53 CR-BSI (37 diagnosed by the standard method and 16 by the conservative method) were diagnosed during the study period. There was a no statistically significant difference in the in-hospital mortality for the standard versus the conservative method (57% vs. 75%, p = 0.208) in ICU patients. Conclusion In our study there was a no statistically significant difference between the standard and conservative methods in-hospital mortality.
Risk factors for catheter-related bloodstream infection: a prospective multicenter study in Brazilian intensive care units
Bicudo, Daniela;Batista, Ruth;Furtado, Guilherme Henrique;Sola, Angela;Medeiros, Eduardo Alexandrino Servolo de;
Brazilian Journal of Infectious Diseases , 2011, DOI: 10.1590/S1413-86702011000400005
Abstract: introduction: central venous catheters (cvc) are devices of great importance in health care. the advantages gained from the use of catheters outweigh the complications that might result from their use, among which bloodstream infections (bsi). in spite of its importance, few national studies have addressed this issue. objective: the aim this study was to determine the incidence of bsi in patients with cvc, hospitalized in icu, as well as the variables associated with this complication. methods: multicentric cohort study carried out at icus of three hospitals at universidade federal de s?o paulo complex. results: a total of 118 cases of bsi in 11.546 catheters day were observed: 10.22 bsi per 1,000 catheters day. on average, bsi was associated to seven additional days of hospital stay in our study (p < 0.001), with a significant difference between types of catheters. concerning the place of insertion, there was no statistical difference in bsi rates. conclusion: we concluded that a patient who uses a catheter for longer than 13 days presents a progressive risk for infection of approximately three times higher in relation to a patient who uses the catheter for less than 13 days (p < 0.001). the median duration of catheter use was 14 days among patients with bsi and 9 days in patients without infection (p < 0.001). there was higher prevalence of gram-negative infections. the risk factors for bsi were utilization of multiple-lumen catheters, duration of catheterization and icu length of stay.
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