Prevention of catheter-related infections using a closed hub system in patients with pulmonary arterial hypertension.
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.
Akagi
Satoshi
S
Division of Cardiology, National Hospital Organization Okayama Medical Center, Okayama, Japan. sakagi-circ@umin.ac.jp
Matsubara
Hiromi
H
Ogawa
Aiko
A
Kawai
Yusuke
Y
Hisamatsu
Kenichi
K
Miyaji
Katsumasa
K
Munemasa
Mitsuru
M
Fujimoto
Yoshihisa
Y
Kusano
Kengo Fukushima
KF
Ohe
Tohru
T
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
D000959:Antihypertensive Agents; D011464:Epoprostenol