title: Guidelines for the prevention of intravascular catheter-related infections.
abstract: BACKGROUND
  Although many catheter-related bloodstream infections (CRBSIs) are preventable, measures to reduce these infections are not uniformly implemented.
  
  
  OBJECTIVE
  To update an existing evidenced-based guideline that promotes strategies to prevent CRBSIs.
  
  
  METHODS
  The MEDLINE database, conference proceedings, and bibliographies of review articles and book chapters were searched for relevant articles.
  
  
  METHODS
  Laboratory-based studies, controlled clinical trials, prospective interventional trials, and epidemiologic investigations.
  
  
  METHODS
  Reduction in CRBSI, 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 (ie, 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.
authors.affiliation: Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Naomi P
authors.initials: NP
authors.lastname: O'Grady
authors.forename: Mary
authors.initials: M
authors.lastname: Alexander
authors.forename: E Patchen
authors.initials: EP
authors.lastname: Dellinger
authors.forename: Julie L
authors.initials: JL
authors.lastname: Gerberding
authors.forename: Stephen O
authors.initials: SO
authors.lastname: Heard
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Maki
authors.forename: Henry
authors.initials: H
authors.lastname: Masur
authors.forename: Rita D
authors.initials: RD
authors.lastname: McCormick
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Mermel
authors.forename: Michele L
authors.initials: ML
authors.lastname: Pearson
authors.forename: Issam I
authors.initials: II
authors.lastname: Raad
authors.forename: Adrienne
authors.initials: A
authors.lastname: Randolph
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weinstein
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D015924:Blood Pressure Monitors; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000592:standards; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000592:standards; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000592:standards; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000592:standards; D002648:Child; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D019317:Evidence-Based Medicine / Q000592:standards*; D006761:Hospitals; D006801:Humans; D014469:Umbilical Arteries; D014481:United States