Guidelines for the prevention of intravascular catheter-related infections.
BACKGROUND
Although many catheter-related bloodstream infections (CR-BSIs) are preventable, measures to reduce these infections are not uniformly implemented.


OBJECTIVE
To update an existing evidenced-based guideline that promotes strategies to prevent CR-BSIs.


METHODS
The MEDLINE database, conference proceedings, and bibliographies of review articles and book chapters were searched for relevant articles.Studies Included: Laboratory-based studies, controlled clinical trials, prospective interventional trials, and epidemiological investigations.


METHODS
Reduction in CR-BSI, catheter colonization, or catheter-related infection.


RESULTS
The recommended preventive strategies with the strongest supportive evidence are education and training of healthcare providers who insert and maintain catheters; maximal sterile barrier precautions during central venous catheter insertion; use of a 2% chlorhexidine preparation for skin antisepsis; no routine replacement of central venous catheters for prevention of infection; and use of antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e. education and training, maximal sterile barrier precautions and 2% chlorhexidine for skin antisepsis).


CONCLUSIONS
Successful implementation of these evidence-based interventions can reduce the risk for serious catheter-related infection.
O'grady
Naomi P
NP
Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Alexander
Mary
M
Dellinger
E Patchen
EP
Gerberding
Julie L
JL
Heard
Stephen O
SO
Maki
Dennis G
DG
Masur
Henry
H
McCormick
Rita D
RD
Mermel
Leonard A
LA
Pearson
Michele L
ML
Raad
Issam I
II
Randolph
Adrienne
A
Weinstein
Robert A
RA
D000293:Adolescent; D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods; D002648:Child; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D004866:Equipment Contamination; D019317:Evidence-Based Medicine; D006235:Hand Disinfection; D006801:Humans; D017053:Infection Control / Q000379:methods*