Guidelines for the prevention of intravascular catheter-related infections. |
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Authors: | Naomi P O'Grady Mary Alexander E Patchen Dellinger Julie L Gerberding Stephen O Heard Dennis G Maki Henry Masur Rita D McCormick Leonard A Mermel Michele L Pearson Issam I Raad Adrienne Randolph Robert A Weinstein |
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Affiliation: | Clinical Center, National Institutes of Health, Bethesda, Maryland, USA. |
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Abstract: | BACKGROUND: Although many catheter-related bloodstream 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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