Clinical evaluation of catheter-related fungemia and bacteremia.
Forty-four patients with catheter-related infection admitted to Hokusho Central Hospital between 1985 and 1991 were studied retrospectively. The rate of catheter-related fungemia or bacteremia to all corresponding cases of fungemia and bacteremia increased from 7.7% in 1985 to 28.8% in 1991. The isolated pathogens were Candida parapsilosis (8 strains), Candida tropicalis (6 strains), methicillin-resistant Staphylococcus aureus (MRSA) (6 strains), methicillin-sensitive S. aureus (MSSA) (5 strains) and Streptococcus epidermidis (3 strains). Bacteremia occurred after catheterization of the femoral vein for a mean duration of 37 days. The period was significantly shorter than that after catheterization of the subclavian vein (56 days). The major isolates from the subclavian vein were Candida spp. (14/17, 82.4%), followed by MRSA (1/17, 5.9%) and MSSA (1/17, 5.9%), while isolates from the femoral vein were Candida spp. (6/16, 37.5%), MRSA (5/16, 31.3%) and MSSA (3/16, 20.8%). Catheter removal alone did not improve the clinical condition, particularly in MRSA bacteremia; the combination of antimicrobial therapy and removal of the catheter was necessary for a better prognosis.
Inoue
Y
Y
Department of Internal Medicine, Hokusho Central Hospital, Emukae.
Kohno
S
S
Fujii
T
T
Otsubo
T
T
Mori
N
N
Ishino
T
T
Takase
T
T
Kaku
M
M
Koga
H
H
Hara
K
K
D000368:Aged; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D016469:Fungemia / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
D000900:Anti-Bacterial Agents