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Journal of Pharmacy Practice, Vol. 18, No. 1, 42-52 (2005)
DOI: 10.1177/0897190004273474
© 2005 SAGE Publications

Catheter-Related Bloodstream Infections in the Intensive Care Unit Population

Krystal K. Haase, PharmD, BCPS

Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, 1300 Coulter, Room 206, Amarillo, TX 79106.

Kari A. McCracken, PharmD

Ronda L. Akins, PharmD

Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, Amarillo, Texas.

Catheter-related bloodstream infections (CRBIs) are a cause of significant morbidity and mortality in intensive care unit patients. Development of CRBIs may occur by several mechanisms. The role of fibrin and biofilm development and their impact on therapy are described. Multiple preventative strategies related to the insertion and maintenance of the catheter site have been identified. Topical antisepsis and use of antibiotic-impregnated catheters are also beneficial for reducing the incidence of CRBI. Antibiotic lock solutionsmay be effective in preventing CRBI for select patients with longterm catheter use. Treatment of CRBIs should be based on suspected organisms, whichmost commonly include staphylococci, gram-negatives, including Pseudomonas aeruginosa andCandida species. Duration of treatment and decisions regarding catheter removal are controversial. Evaluation and treatment of potential complications of CRBIs, including endocarditis, infected thrombophlebitis, osteomyelitis, and endophthalmitis, are essential.

Key Words: Catheter-related bloodstream infection • intensive care unit • catheterization • central venous catheter


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