Guidelines for the prevention of intravascular catheter-related infections.
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.
O'Grady
Naomi P
NP
Clinical Center, National Institutes of Health, Bethesda, Maryland, 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
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