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Clinical impact of early reinsertion of a central venous catheter after catheter removal in patients with catheter-related bloodstream infections.
Lee, Yu-Mi; Ryu, Byung-Han; Hong, Sun In; Cho, Oh-Hyun; Hong, Kyung-Wook; Bae, In-Gyu; Kwack, Won Gun; Kim, Young Jin; Chung, Eun Kyoung; Kim, Dong Youn; Lee, Mi Suk; Park, Ki-Ho.
Afiliación
  • Lee YM; Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
  • Ryu BH; Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
  • Hong SI; Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
  • Cho OH; Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
  • Hong KW; Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
  • Bae IG; Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
  • Kwack WG; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.
  • Kim YJ; Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
  • Chung EK; Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea.
  • Kim DY; Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
  • Lee MS; Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
  • Park KH; Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Infect Control Hosp Epidemiol ; 42(2): 162-168, 2021 02.
Article en En | MEDLINE | ID: mdl-32900398
OBJECTIVE: Early replacement of a new central venous catheter (CVC) may pose a risk of persistent or recurrent infection in patients with a catheter-related bloodstream infection (CRBSI). We evaluated the clinical impact of early CVC reinsertion after catheter removal in patients with CRBSIs. METHODS: We conducted a retrospective chart review of adult patients with confirmed CRBSIs in 2 tertiary-care hospitals over a 7-year period. RESULTS: To treat their infections, 316 patients with CRBSIs underwent CVC removal. Among them, 130 (41.1%) underwent early CVC reinsertion (≤3 days after CVC removal), 39 (12.4%) underwent delayed reinsertion (>3 days), and 147 (46.5%) did not undergo CVC reinsertion. There were no differences in baseline characteristics among the 3 groups, except for nontunneled CVC, presence of septic shock, and reason for CVC reinsertion. The rate of persistent CRBSI in the early CVC reinsertion group (22.3%) was higher than that in the no CVC reinsertion group (7.5%; P = .002) but was similar to that in the delayed CVC reinsertion group (17.9%; P > .99). The other clinical outcomes did not differ among the 3 groups, including rates of 30-day mortality, complicated infection, and recurrence. After controlling for several confounding factors, early CVC reinsertion was not significantly associated with persistent CRBSI (OR, 1.59; P = .35) or 30-day mortality compared with delayed CVC reinsertion (OR, 0.81; P = .68). CONCLUSIONS: Early CVC reinsertion in the setting of CRBSI may be safe. Replacement of a new CVC should not be delayed in patients who still require a CVC for ongoing management.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Venoso Central / Bacteriemia / Sepsis / Infecciones Relacionadas con Catéteres / Catéteres Venosos Centrales Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Infect Control Hosp Epidemiol Asunto de la revista: DOENCAS TRANSMISSIVEIS / ENFERMAGEM / EPIDEMIOLOGIA / HOSPITAIS Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Venoso Central / Bacteriemia / Sepsis / Infecciones Relacionadas con Catéteres / Catéteres Venosos Centrales Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Infect Control Hosp Epidemiol Asunto de la revista: DOENCAS TRANSMISSIVEIS / ENFERMAGEM / EPIDEMIOLOGIA / HOSPITAIS Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos