2007 NJCC_05 bwerk v1.indd
ثبت نشده
چکیده
In critically ill patients, catheter-related bloodstream infections (CRBSIs) are associated with increased mortality, length of stay in the ICU and extra costs. The relative risk of infection can be best determined by analyzing rates of catheter-related bloodstream infections per 1000 catheter-days. Coagulase-negative staphylococci, Staphylococcus aureus and Candida spp are the pathogens found most commonly both on catheter tips and in blood. The commonly used definitions of intravascular catheterrelated infections are summarized in this review. Clinical signs of catheter-related infections are unreliable because of their poor sensitivity and specificity. Therefore diagnosis is mainly dependent on microbiological techniques. The available diagnostic tests can be classified as methods requiring removal of the central venous catheter and methods not requiring removal of the catheter. The reliability of the various methods is described; none of the described methods has a 100% sensitivity and specificity, and therefore diagnosing CRBSI is still problematic. Finally a diagnostic approach to catheter-related infection is proposed. Catheter-Related Infections, a Diagnostic Problem r e v i e w 2007 NJCC_05 bwerk v1.indd 260 12-10-2007 15:19:21 netherlands journal of critical care 261 neth j crit care • volume 11 • no 5 • october 2007 Table 1. Organisms isolated from catheter tip samples and blood [10,11] Total N = 168 Total N = 105 Organism Catheter tip % CRBSI* % CNS** S. aureus Candida spp Enterococcus spp Pseudomonas spp Acinetobacter spp Enterobacter spp Klebsiella spp Proteus spp Corynebacterium spp E. coli Others 49.1 11.9 7.2 5.9 4.9 4.2 4.2 3.6 2.4 2.4 1.8 3.6 34 17 9 6 6
منابع مشابه
2007 NJCC_05 bwerk v1.indd
Infection of pancreatic and peripancreatic necrosis frequently complicates the course of severe acute pancreatitis and accounts for the majority of morbidity and mortality in these patients. Late infectious complications such as pancreatic abscesses appear less dangerous to the patient, but should be treated aggressively. The use of prophylactic broad spectrum antibiotics can no longer be suppo...
متن کاملNJCC_05 bwerk v1.indd
Prolonged administration of benzodiazepines and/or opioids to children in a pae diatric intensive care unit (PICU) may induce physiological depen dence and withdrawal symptoms. We reviewed the lit erature for relevant contributions on the nature of these withdrawal symptoms and on availability of valid scoring systems to assess the extent of symptoms in children. Symptoms of benzodiazepine and ...
متن کاملNJCC_01 bwerk v1.indd
Introduction The kidney maintains blood pH by filtering metabolic acids and regenerating blood buffers such as bicarbonate. During CRRT, pH is regulated in a comparable way, metabolic acids are filtered or dialysed and buffer is replaced to correct metabolic acidosis and compensate for the bicarbonate lost by filtration or diffusion. Lactate, bicarbonate, acetate and citrate are the available b...
متن کاملNJCC_03 bwerk v1.indd
Metabolic alkalosis is a relatively common finding in the critically ill and has a varied aetiology. We outline the fundamental principles that govern both the generation and maintenance of a metabolic alkalosis. Causes are discussed with particular attention to those which predominate in the critically ill. Signs and symptoms of metabolic alkalosis are described together with both general and ...
متن کاملNJCC_01 bwerk v1.indd
The necessity of anticoagulating the extracorporeal circuit (ECC) when applying continuous venovenous haemofiltration (CVVH) in critically ill patients, implicates an increased risk of bleeding complications when using unfractionated heparin or low molecular weight heparins, especially in patients at high risk of bleeding. Regional anticoagulation of the ECC using citratebased solutions has eme...
متن کامل