title: Prevention of catheter-related infections using a closed hub system in patients with pulmonary arterial hypertension.
abstract: BACKGROUND
  Most of the patients with pulmonary arterial hypertension (PAH) receiving intravenous epoprostenol have experienced catheter-related infections during long-term treatment. Catheter hub was reported to be the most important source of catheter-related infections. To prevent the catheter-related infections, we have introduced a closed hub system and compared the incidence of catheter-related infections with that in patients using a non-closed hub system.
  
  
  RESULTS
  We evaluated the results obtained on 24 occasions in 20 patients with PAH between June 1999 and December 2005. On 11 occasions, a non-closed hub system was used and on 13 cases a closed hub system. We classified the catheter-related infection into a catheter-related bloodstream infection (CRBSI) group or a tunnel infection group based on the pathway of bacteria. The CRBSI rate was 0.89 per 1,000 catheter days in the non-closed hub system group vs 0.10 per 1,000 catheter days in the closed hub system group. Kaplan-Meier analysis showed that the risk of CRBSI significantly decreased in the closed hub system group. None of the patients died as a direct consequence of catheter-related infection during the study period.
  
  
  CONCLUSIONS
  We successfully prevented CRBSI by using a closed hub system.
authors: Division of Cardiology, National Hospital Organization Okayama Medical Center, Okayama, Japan. sakagi-circ@umin.ac.jp
authors: Satoshi
authors: S
authors: Akagi
authors: Hiromi
authors: H
authors: Matsubara
authors: Aiko
authors: A
authors: Ogawa
authors: Yusuke
authors: Y
authors: Kawai
authors: Kenichi
authors: K
authors: Hisamatsu
authors: Katsumasa
authors: K
authors: Miyaji
authors: Mitsuru
authors: M
authors: Munemasa
authors: Yoshihisa
authors: Y
authors: Fujimoto
authors: Kengo Fukushima
authors: KF
authors: Kusano
authors: Tohru
authors: T
authors: Ohe
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D011464:Epoprostenol / Q000008:administration & dosage*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents; D011464:Epoprostenol