Applying the science to the prevention of catheter-related infections.
BACKGROUND
Catheter-related bloodstream infection (CR-BSI) remains a leading cause of nososcomial infection, despite the fact that many CR-BSIs are preventable. Simple principles of infection control and the use of novel devices to reduce these infections are not uniformly implemented.


OBJECTIVE
To review and summarize the evidence that promotes strategies to prevent CR-BSIs.


METHODS
The Medline database and bibliographies of review articles and book chapters were searched for relevant articles.


METHODS
In vitro and in vivo laboratory-based studies, controlled clinical trials, prospective interventional trials, and epidemiologic investigations.


METHODS
Reduction in CR-BSI, catheter colonization, tunnel infection, or local site infection.


RESULTS
The recommended prevention strategies with strong supportive evidence include educating and training of health care providers who insert and maintain catheters; using full barrier precautions during central venous catheter insertion; using a 2% chlorhexidine preparation for skin antisepsis; eliminating the practice of scheduled replacement of central venous catheters for prevention of infection; and using antiseptic/antibiotic impregnated short-term central venous catheters.


CONCLUSIONS
Simple interventions can reduce the risk for serious catheter-related infection. Health care provider awareness and adherence to these prevention strategies is critical to reducing the risk for CR-BSI, improving patient safety, and promoting quality health care.
O'Grady
Naomi P
NP
Warren Magnusen Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
D000890:Anti-Infective Agents / Q000008:administration & dosage; D001458:Bandages; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D004496:Education, Continuing; D019317:Evidence-Based Medicine; D006801:Humans; D006920:Hygiene; D007362:Intensive Care Units / Q000592:standards*; D011785:Quality Assurance, Health Care; D014481:United States
D000890:Anti-Infective Agents