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Guidelines for the Prevention of Intravascular Catheter–Related Infections

  • Naomi P. O'Grady (a1) (a2), Mary Alexander (a3), E. Patchen Dellinger (a4), Julie L. Gerberding (a5), Stephen O. Heard (a6), Dennis G. Maki (a7), Henry Masur (a1) (a8), Rita D. McCormick (a9), Leonard A. Mermel (a10), Michele L. Pearson (a5), Issam I. Raad (a11), Adrienne Randolph (a12) and Robert A. Weinstein (a13)...
Abstract
Background:

Although many catheter-related blood-stream infections (CRBSIs) are preventable, measures to reduce these infections are not uniformly implemented.

Objective:

To update an existing evidenced-based guideline that promotes strategies to prevent CRBSIs.

Data Sources:

The MEDLINE database, conference proceedings, and bibliographies of review articles and book chapters were searched for relevant articles.

Studies Included:

Laboratory-based studies, controlled clinical trials, prospective interventional trials, and epidemiologic investigations.

Outcome Measures:

Reduction in CRBSI, catheter colonization, or catheter-related infection.

Synthesis:

The recommended preventive strategies with the strongest supportive evidence are education and training of healthcare providers who insert and maintain catheters; maximal sterile barrier precautions during central venous catheter insertion; use of a 2% chlorhexidine preparation for skin antisepsis; no routine replacement of central venous catheters for prevention of infection; and use of antiseptic/antibiotic-impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (ie, education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis).

Conclusion:

Successful implementation of these evidence-based interventions can reduce the risk for serious catheter-related infection.

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