Document Detail


Arterial catheters as a source of bloodstream infection: a systematic review and meta-analysis.
MedLine Citation:
PMID:  24413576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Catheter-related bloodstream infections are associated with significant costs and adverse consequences. Arterial catheters are commonly used in the critical care setting and are among the most heavily manipulated vascular access devices. We sought to evaluate the prevalence of arterial catheter-related bloodstream infection.
DATA SOURCES: PubMed, CinAHL, EMBASE, and Web of Science.
STUDY SELECTION: Included studies reported prevalence rate of catheter-related bloodstream infection for arterial catheters used for critical illness or postoperative monitoring. For the purposes of this study, catheter-related bloodstream infection was defined as positive blood culture collected from an arterial catheter and from the periphery with the same organism in a patient demonstrating systemic signs of sepsis.
DATA EXTRACTION: The study population, site of insertion, antiseptic preparation, catheter days, and prevalence of catheter-related bloodstream infection were abstracted. When data were not available, authors were contacted for further information.
DATA SYNTHESIS: Forty-nine studies met criteria including 222 cases of arterial catheter-related bloodstream infection in 30,841 catheters. Pooled incidence was 3.40/1,000 catheters or 0.96/1,000 catheter days. Prevalence was considerably higher in the subgroup of studies that cultured all catheters (1.26/1,000 catheter days) compared with those studies that cultured only when the arterial catheter was suspected as the source for the catheter-related bloodstream infection (0.70/1,000 catheter days). Pooled data also found a significantly increased risk of infection for femoral site of insertion compared with radial artery for arterial catheter placement (relative risk, 1.93; 95% CI, 1.32-2.84; p = 0.001) CONCLUSIONS: Arterial catheters are an underrecognized cause of catheter-related bloodstream infection. Pooled incidence when catheters were systematically cultured and correlated to blood culture results indicated a substantial burden of arterial catheter-related bloodstream infection. Selection of a radial site over a femoral site will help reduce the risk of arterial catheter-related bloodstream infection. Future studies should evaluate technologies applied to preventing central venous catheter-related bloodstream infection to arterial catheters as well.
Authors:
John C O'Horo; Dennis G Maki; Anna E Krupp; Nasia Safdar
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Critical care medicine     Volume:  42     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-05-19     Completed Date:  2014-07-10     Revised Date:  2014-10-29    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1334-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Catheter-Related Infections / epidemiology,  prevention & control*
Catheterization, Peripheral / adverse effects*
Cross Infection / epidemiology,  prevention & control*
Humans
Intensive Care Units
Practice Guidelines as Topic*
Comments/Corrections
Comment In:
Crit Care Med. 2014 Jun;42(6):1533-4   [PMID:  24836783 ]
Crit Care Med. 2014 Oct;42(10):e673   [PMID:  25226133 ]
Crit Care Med. 2014 Oct;42(10):e673-4   [PMID:  25226134 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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