Catheter-related Bloodstream Infections: Do We Know All of It?

Abstract

Background: Catheterrelated bloodstream infections (CRBSI) represent a lifethreaten ing complication. They are associated with high morbidity, mortality and healthcare costs. Cancer patients are at particular risk due to the nature of the dis ease and the ther apyassociated immunodeficiency. Although the incidence of catheterrelated infections decreased in the past decade, the mortality rate remains high at 12- 25%. The incidence of CRBSI differs among patients. While the incidence in ICU patients across the Europe was reported to be 0.5- 4.1 episodes per 1.000 catheterdays, the incidence in cancer patients was 1.1- 7.5 episodes per 1.000 catheterdays. One of the factors negatively influenc ing the incidence is the lack of uniformity in CRBSI definitions, etiology and risk factors for surveillance purposes. Purpose: This preview not only presents the definitions of catheterrelated infections and etiology and risk factors for develop ing CRBSI, it also it also summarizes epidemiologic data, dia gnostic techniques, and the prevention and treatment strategies for CRBSI accord ing to knowledge acquired over the last 10 years. Follow ing the implementation of the prevention strategies guidelines for CRBSI published in 2011 by Center for Dis ease Control and Prevention and Healthcare Infection Control Practices Advisory Committee, the incidence of CRBSI has decreased by more than 50%. As central venous catheters are a common part of cancer treatment, every oncologist should be aware of the risk of catheterrelated infections. The prevention and treatment guidelines with surveillance of CRBSI should be the gold standard in the care of cancer patients as well. Conclusion: Adherence to evidencebased guidelines for prevention of catheterrelated infections and surveillance of CRBSI are the basic steps required to reduce the rate of CRBSI. Implementation of these strategies in hospital healthcare policy, particularly in written form, and control of adherence and report ing of the incidence rate to higher authorities are strongly recommended. When these interventions were successfully implemented, they reduced the incidence rate under 1 episode of CRBSI per 1.000 catheterdays in Western countries. Each healthcare facility us ing central venous catheters should be advised to implement these strategies, particular when treat ing cancer patients.