Diagnosis and treatment of catheter-related bloodstream infection: Clinical guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology and (SEIMC) and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)
Med Intensiva (Engl Ed). 2018 Jan-Feb;42(1):5-36.
doi: 10.1016/j.medin.2017.09.012.
[Article in
English,
Spanish]
Authors
F Chaves
1
, J Garnacho-Montero
2
, J L Del Pozo
3
, E Bouza
4
, J A Capdevila
5
, M de Cueto
6
, M Á Domínguez
7
, J Esteban
8
, N Fernández-Hidalgo
9
, M Fernández Sampedro
10
, J Fortún
11
, M Guembe
12
, L Lorente
13
, J R Paño
14
, P Ramírez
15
, M Salavert
16
, M Sánchez
17
, J Vallés
18
Affiliations
- 1 Servicio de Microbiología, Hospital Universitario 12 de Octubre, Madrid, Spain.
- 2 Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, Spain. Electronic address: jgarnachom@gmail.com.
- 3 Área de Enfermedades Infecciosas, Servicio de Microbiología, Clínica Universidad de Navarra, Pamplona, Spain.
- 4 Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid; CIBER de Enfermedades Respiratorias, CibeRes, Instituto de Salud Carlos III, Madrid; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
- 5 Servicio de Medicina Interna, Hospital de Mataró, Mataró, Barcelona, Spain.
- 6 Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Sevilla, Spain.
- 7 Servicio de Microbiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
- 8 Departamento de Microbiología Clínica, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain.
- 9 Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
- 10 Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
- 11 Unidad de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain.
- 12 Unidad de Enfermedades Infecciosas y Microbiología Clínica, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
- 13 Unidad de Cuidados Intensivos, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
- 14 Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
- 15 Unidad de Cuidados Intensivos, Hospital Universitari i Politècnic La Fe, Valencia; CIBER de Enfermedades Respiratorias (CibeRes), Instituto de Salud Carlos III, Madrid, Spain.
- 16 Unidad de Enfermedades Infecciosas, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
- 17 Servicio de Medicina Intensiva, Hospital Clínico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
- 18 Unidad de Cuidados Intensivos, Hospital Universitari Parc Taulí, Sabadell, Barcelona; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
Abstract
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (the Spanish Society of Infectious Diseases and Clinical Microbiology and [SEIMC] and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units [SEMICYUC]). Short-term peripheral venous catheters, non-tunneled and long-term central venous catheters, tunneled catheters and hemodialysis catheters are covered by these guidelines. The panel identified 39 key topics that were formulated in accordance with the PICO format. The strength of the recommendations and quality of the evidence were graded in accordance with ESCMID guidelines. Recommendations are made for the diagnosis of CRBSI with and without catheter removal and of tunnel infection. The document establishes the clinical situations in which a conservative diagnosis of CRBSI (diagnosis without catheter removal) is feasible. Recommendations are also made regarding empirical therapy, pathogen-specific treatment (coagulase-negative staphylococci, Staphylococcus aureus, Enterococcus spp., Gram-negative bacilli, and Candida spp.), antibiotic lock therapy, diagnosis and management of suppurative thrombophlebitis and local complications.
Keywords:
Antibiotic; Antibioticoterapia; Bacteremia; Bacteriemia; Bacteriemia relacionada con catéter; Blood cultures; Catheter-related bloodstream infection; Guidelines; Guía de práctica clínica; Hemocultivos.
Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
MeSH terms
-
Anti-Bacterial Agents / therapeutic use
-
Antifungal Agents / therapeutic use
-
Bacteremia / diagnosis
-
Bacteremia / drug therapy
-
Bacteremia / etiology*
-
Bacterial Typing Techniques / methods
-
Bacterial Typing Techniques / standards
-
Bacteriological Techniques / standards*
-
Biofilms / drug effects
-
Blood Specimen Collection / methods
-
Blood Specimen Collection / standards
-
Candidemia / drug therapy
-
Candidemia / etiology
-
Catheter-Related Infections / diagnosis*
-
Catheter-Related Infections / drug therapy*
-
Catheters / adverse effects
-
Catheters / microbiology
-
Conservative Treatment
-
Cross Infection / diagnosis
-
Cross Infection / drug therapy
-
Cross Infection / etiology*
-
Device Removal
-
Disease Management
-
Drug Resistance, Multiple, Bacterial
-
Endocarditis, Bacterial / etiology
-
Equipment Contamination
-
Humans
-
Mycology / methods
-
Thrombophlebitis / etiology
Substances
-
Anti-Bacterial Agents
-
Antifungal Agents