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Vascular access is one of the most common medical measures in hospitals. Each year, around 300 million intravascular catheters are placed in patients in the United States alone approximately 3 million of these are central venous catheters (CVCs), which cause 90 per cent of all primary bloodstream infections (BSIs).
Most of these infections occur in patients with short-term CVCs. Depending on the type of ward/surgery, infection rates vary between 1.3 per 1 000 catheter days in inpatient medical/surgical wards to 5.6 per 1 000 catheter days in burn ICUs*.
To ensure consistent diagnosis of primary BSI for surveillance for instance the CDC case definitions are used**:
The infection meets at least one of the following criteria:
B2 Clinical primary BSI may be used only to report primary BSI in neonates and infants ? 1 year of age.
The infection risk is influenced by several factors, for example the patients immune status. Hence, it is not possible to prevent all intravascular catheter-related primary BSIs. However, compliance with evidence-based recommendations significantly contributes to reducing the infection risk.
Recommendations on preventing primary bloodstream infection
Empfehlung Prävention Gefäßkatheter-assoziierter Infektionen. (Recommendation on preventing intravascular catheter-related infections)
Kommission für Krankenhaushygiene am Robert Koch-Institut (Commission for Hospital Hygiene and Infection Prevention at the Robert Koch-Institute), 2002.
Please click here to download the PDF (in German)
*O'Grady NP, Chertow DS
Managing bloodstream infections in patients who have short-term central venous catheters. Cleveland Clinic Journal of Medicine January, 2011, 78 (1): 10-17.
** 7th edition of the definitions of nosocomial infection (CDC definitions). Robert Koch-Institute, 10 February 2011