Background: Central venous catheters (CVCs) are used to deliver a variety of therapies, as well
as for measurement of hemodynamic parameters. The major associated complication is
catheter-related blood stream infection (CRBSI).
Method: Review of the pertinent English-language literature.
Results: The incidence of CRBSI depends on how such infections are defined. Generally,
the term includes all BSIs in patients with CVCs when other sources can be excluded, and if
a culture of the catheter tip demonstrates a substantial number of colonies of the organism
found in the blood stream. Important pathogenic determinants of catheter-related infection
are the material of which the device is made and the intrinsic virulence of the organism. The
site at which a catheter is placed influences the risk of infection. The types of organisms that
most commonly cause hospital-acquired BSIs have changed over time. Migration of skin organisms
at the insertion site into the cutaneous catheter tract with colonization of the catheter
tip is the most common route of infection. Good hand hygiene before catheter insertion, combined
with proper aseptic technique during its manipulation, provides protection against infection;
maximal sterile barrier precautions during insertion reduce the incidence of CRBSI.
Catheters that are coated or impregnated with antimicrobial or antiseptic agents can decrease
the risk and the associated hospital costs. No studies have demonstrated that oral or parenteral
antibacterial or antifungal drugs reduce the incidence of CRBSI in adults. Use of anticoagulants
might have a role in the prevention of CRBSI. Catheter replacement at scheduled intervals
has not lowered rates of local or systemic complications.
Conclusions: Central venous catheters are used commonly to deliver a variety of therapies,
such as large amounts of fluid or blood products during surgery or in intensive care units,
chemotherapy, and parenteral nutrition, as well as for measurement of hemodynamic variables.
The major complication associated with CVCs is CRBSI.
