Update on vascular catheter infections.
OBJECTIVE
Extensive reviews of our current understanding of vascular catheter infections have recently been published. This update highlights 22 primary research articles selected from 415 randomized clinical trials and over 2500 other articles on vascular catheter infections published between January 2002 and March 2004.


RESULTS
Full sterile barriers are not necessary for the insertion of arterial catheters. Subcutaneous tunnels may decrease the risk of femoral catheter infection. The minocycline-rifampin catheter coating still appears to be the most efficacious. Further studies demonstrating that education of MD/RN personnel reduces the risk of catheter infection now exist. A number of studies show that the method of attaching IV tubing to catheters and certain catheter flush solutions can reduce the risk of infection. Differential time to positivity looks increasingly promising as a practical method for diagnosing catheter infection. All catheters suspected of infection do not need to be removed. The management of vascular catheter infections can be improved by a simple e-mail mechanism.


CONCLUSIONS
Abundant evidence now exists that there are many interventions that can reduce the risk of vascular catheter infections. The next phase of our understanding should include determining how many of these many interventions are necessary and under what circumstances.
Sherertz
Robert J
RJ
Section on Infectious Diseases, Department of Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1042, USA. sherertz@wfubmc.edu
D016470:Bacteremia / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003428:Cross Infection / Q000517:prevention & control*; D004866:Equipment Contamination; D006801:Humans; D017053:Infection Control / Q000379:methods*; D016032:Randomized Controlled Trials as Topic