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Central venous catheter (CVC)-related infections in neutropenic patients

Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

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Abstract

Catheter-related infections cause considerable morbidity in hospitalised patients. The incidence does not seem to be higher in neutropenic patients than in non- neutropenic patients. Gram-positive bacteria (coagulase-negative staphylococci, Staphylococcus aureus) are the most frequently cultured pathogens, followed by Candida species. In contrast, Gram-negative bacteria play only a minor role in catheter-related infections. Positive blood cultures are the cornerstone in the diagnosis of catheter-related infections, while local signs of infection are only rarely present. However, a definite diagnosis generally requires the removal of the catheter and its microbiological examination. The role plate method with semiquantitative cultures (Maki) has been established as standard in most laboratories. Other standard procedures use quantitative techniques (Sherertz, Brun-Buisson) and are more sensitive. For therapy of catheter-related infections, antibiotics are administered according to the susceptibility of the cultured organism. Routine administration of gylcopepticed antibiotics is not indicated. Removal of the catheter has to be considered in any case of suspected catheter-related infection and is obligatory in Staphylococcus aureus and Candida infections. Tunnel or pocket infection of long-term catheters is always an indication for removal. In the future, the rate of catheter-related infections in neutropenic patients may be reduced by the use of catheters coated with antimicrobial agents.

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Authors and Affiliations

  1. Klinik 1 für Innere Medizin, Klinikum der Universität zu Köln, 50924, Köln, Germany

    Gerd Fätkenheuer & Oliver A. Cornely

  2. III. Medizinische Klinik, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg, 68305, Mannheim, Germany

    Dieter Buchheidt

  3. Innere Medizin III, Dr. Horst-Schmidt-Kliniken GmbH, 65199, Wiesbaden, Germany

    Hans-Georg Fuhr

  4. Palliativmedizin am Evangelischen Johannes- Krankenhaus, 33611, Bielefeld, Germany

    Meinolf Karthaus

  5. Klinik für Innere Medizin, Medizinische Universität zu Lübeck, 23538, Lübeck, Germany

    Jens Kisro

  6. Klinik für Innere Medizin, Universität Rostock, 18057, Rostock, Germany

    Malte Leithäuser

  7. Abteilung Hämatologie/ Onkologie, Allgemeines Krankenhaus Altona, 22763, Hamburg-Altona, Germany

    Hans Salwender

  8. Medizinische Universitätsklinik der Ruhr Universität Bochum Langendreer, 44832, Bochum, Germany

    Thomas Südhoff

  9. Medizinische Klinik III, Klinikum Benjamin Franklin, Freie Universität Berlin, 12200, Berlin, Germany

    Hubert Szelényi

  10. Medizinische Poliklinik der Universität Würzburg, 97070, Würzburg, Germany

    Florian Weissinger

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  1. Gerd Fätkenheuer
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Fätkenheuer, G., Buchheidt, D., Cornely, O. et al. Central venous catheter (CVC)-related infections in neutropenic patients. Ann Hematol 82 (Suppl 2), S149–S157 (2003). https://doi.org/10.1007/s00277-003-0769-z

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