Diagnosis and prevention of catheter-related infections.
OBJECTIVE
To highlight the major advances in diagnosing and preventing catheter-related infections published in research articles published between March 2004 and May 2007.


RESULTS
The challenge remains to make the diagnosis of catheter-related infection with good accuracy without catheter removal. The differential time to obtain positive qualitative blood culture appeared to be the most accurate available technique. Many catheter-related bloodstream infections are preventable. Simple interventions are often useful and multimodal programs are very efficacious, particularly in the intensive care setting. For long-term catheter-related bloodstream infection prevention, patient education appeared promising. Interesting evidence suggested that anticoagulant, by decreasing the biofilm formation, could decrease the risk of infection. For short-term central venous catheter-related infections research is ongoing on antiseptic dressings. Antiseptic lock appeared promising for preventing long-term central venous catheter bloodstream infections.


CONCLUSIONS
Nowadays, multimodal programs of catheter infection prevention are efficacious. Levels of catheter-related bloodstream infection of more than one or two per 1000 catheter-days are usually only found in the intensive care unit. It is a prerequisite to evaluate the cost-effectiveness of new techniques of prevention. As catheter-related bloodstream infections become rarer, strategies limiting unnecessary removal of catheters need to be developed and tested.
Timsit
Jean-François
JF
Medical ICU, Hôpital Albert Michallon, Grenoble, France. jftimsit@chu-grenoble.fr
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001431:Bacteriological Techniques; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D002408:Catheters, Indwelling / Q000382:microbiology; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D005343:Fibrinolytic Agents