Infection Associated with Medical Devices

Reference work entry

Healthcare-associated infections (HAIs) occur worldwide and affect both developed and resource-poor countries. Infections acquired in healthcare settings are major causes of death and morbidity among hospitalized patients. They are a significant burden both for patient and for public health. The World Health Organization conducted a study in 55 hospitals of 14 countries representing four WHO Regions (Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific). This prevalence study found that on average 8.7% of hospital patients had HAIs; data from the United States of America (USA) reveal a similar prevalence. Based on these figures, at any given time, over 1.4 million people worldwide suffer from infectious complications acquired while in the hospital. In December of 2010, the Lancetpublished a review of available scientific data on HAIs in countries with limited resources. In developing countries, the number of HAIs is 15.5 per 100 patients; this is in sharp contrast with...

Keywords

Hand Hygiene Urinary Catheter Central Venous Access Asymptomatic Bacteriuria Chlorhexidine Gluconate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

References

  1. American Thoracic Society I.D.S.O.A (2005) Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir and Crit Care Med 171:388–416CrossRefGoogle Scholar
  2. Berenholtz S, Pronovost P, Lipsett P (2004) Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med 32:2014–2020PubMedCrossRefGoogle Scholar
  3. Bhutta A, Gilliam C, Honeycutt M, Schexnayder S, Green J, Moss M, Anand KJ (2007) Reduction of bloodstream infections associated with catheters in paediatric intensive care unit: stepwise approach. Brit Med J 334:362–365PubMedCrossRefGoogle Scholar
  4. Bigham MT, Amato R, Bondurrant P, Fridriksson J, Krawczeski CD, Raake J, Ryckman S, Schwartz S, Shaw J, Wells D, Brilli RJ (2009) Ventilator-associated pneumonia in the pediatric intensive care unit: characterizing the problem and implementing a sustainable solution. J Pediatr 154:582–587PubMedCrossRefGoogle Scholar
  5. Brilli RJ, Sparling KW, Lake MR, Butcher J, Myers SS, Clark MD, Helpling A, Stutler ME (2008) The business case for preventing ventilator-associated pneumonia in pediatric intensive care unit patients. Jt Comm J Qual Patient Saf 34:629–638PubMedGoogle Scholar
  6. Centers for Disease Control and Prevention (1994) Guideline for prevention of nosocomial pneumonia. Respir Care 39:1191–1236Google Scholar
  7. Centers for Disease Control and Prevention (2010) Issues in healthcare settings: CDC’s 7 healthcare safety challenges. http://www.cdc.gov/ncidod/dhqp/about_challenges.html. Accessed 26 Dec 2010
  8. Chang SL, Shortliffe LD (2006) Pediatric urinary tract infections. Pediatr Clin N Am 53:379–400CrossRefGoogle Scholar
  9. Climo MW, Sepkowitz KA, Zuccotti G, Fraser VJ, Warren DK, Perl TM, Speck K, Jernigan JA, Robles JR, Wong ES (2009) The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: results of a quasi-experimental multicenter trial. Crit Care Med 37:1858–1865PubMedCrossRefGoogle Scholar
  10. Coffin S, Klompas M, Classen D et al (2008) Strategies to prevent ventilator-associated pneumonia in acute care hospitals. Infect Control Hosp Epidemiol 29:S31–S40PubMedCrossRefGoogle Scholar
  11. Costello JM, Morrow DF, Graham DA, Potter-Bynoe G, Sandora T, Lausen PC (2008) Systematic intervention to reduce central line-associated bloodstream infection rates in a pediatric cardiac intensive care unit. Pediatrics 121:915–928PubMedCrossRefGoogle Scholar
  12. Darouiche RO, Smith JA Jr, Hanna H, Dhabuwala CB, Steiner MS, Babaian RJ, Boone TB, Scardino PT, Thornby JI, Raad II (1999) Efficacy of antimicrobial-impregnated bladder catheters in reducing catheter-associated bacteriuria: a prospective, randomized, multicenter clinical trial. Urology 54:976–981PubMedCrossRefGoogle Scholar
  13. Dato VM, Dajani AS (1990) Candidemia in children with central venous catheters: role of catheter removal and amphotericin B therapy. Pediatr Infect Dis J 9:309–314PubMedCrossRefGoogle Scholar
  14. de Mello MJ, de Albuquerque Mde F, Ximenes RA, Lacerda HR, Ferraz EJ, Byington R, Barbosa MT (2010) Factors associated with time to acquisition of bloodstream infection in a pediatric intensive care unit. Infect Control Hosp Epidemiol 31:249–255PubMedCrossRefGoogle Scholar
  15. Deutschman CS, Neligan PJ (2010) Evidence-based practice of critical care. Saunders Elsevier, PhiladelphiaGoogle Scholar
  16. Elella RA, Najm HK, Balkhy H, Bullard L, Kabbani MS (2010) Impact of bloodstream infection on the outcome of children undergoing cardiac surgery. Pediatr Cardiol 31:483–489PubMedCrossRefGoogle Scholar
  17. Elward AM (2003) Pediatric ventilator-associated pneumonia. Pediatr Infect Dis J 22:445–446PubMedGoogle Scholar
  18. Elward AM, Warren DK, Fraser VJ (2002) Ventilator-associated pneumonia in pediatric intensive care unit patients: risk factors and outcomes. Pediatrics 109:758–764PubMedCrossRefGoogle Scholar
  19. Elward AM, Hollenbeak CS, Warren DK, Fraser VJ (2005) Attributable cost of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics 115:868–872PubMedCrossRefGoogle Scholar
  20. Fernandez-Hidalgo N, Almirante B, Calleja R, Ruiz I, Planes A, Rodriguez D, Pigrau C, Pahissa A (2006) Antibiotic-lock therapy for long-term intravascular catheter-related bacteraemia: results of an open, non-comparative study. J Antimicrob Chemother 57:1172–1180PubMedCrossRefGoogle Scholar
  21. Ferrer M, Liapikou A, Valencia M, Esperatti M, Theessen A, Antonio MJ, Mensa J, Torres A (2010) Validation of the American Thoracic Society–Infectious Diseases Society of America guidelines for hospital-acquired pneumonia in the intensive care unit. Clin Infect Dis 50:945–952PubMedCrossRefGoogle Scholar
  22. Fiser DH, Graham J, Green JW, Moss M, Wankum PC, Heulitt MJ, Prince A, Schexnayder SM, Dick RM (2006) Pediatric vascular access and centese. In: Fuhrman BP, Zimmerman JJ (eds) Pediatric critical care. Mosby Elsevier, PhiladelphiaGoogle Scholar
  23. Frasca D, Dahyot-Fizelier C, Mimoz O (2010) Prevention of central venous catheter-related infection in the intensive care unit. Crit Care 14:212PubMedCrossRefGoogle Scholar
  24. Garcia-Teresa MA, Casado-Flores J, Delgado Dominguez MA, Roqueta-Mas J, Cambra-Lasaosa F, Concha-Torre A, Fernandez-Perez C (2007) Infectious complications of percutaneous central venous catheterization in pediatric patients: a Spanish multicenter study. Intensive Care Med 33:466–476PubMedCrossRefGoogle Scholar
  25. Gould C, Umscheid C, Agarwal R et al (2008) Guideline for the prevention of catheter-associated urinary tract infections 2008. Department of Health and Human Services Centers for Disease Control and Prevention, Health and Human Services, Atlanta, pp 1–47Google Scholar
  26. Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA (2010) Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 31:319–326PubMedCrossRefGoogle Scholar
  27. Hockenhull J, Dwan K, Smith G (2009) The clinical effectiveness of central venous catheters treated with anti-infective agents in preventing catheter-related bloodstream infections: a systematic review. Crit Care Med 37:702–712PubMedCrossRefGoogle Scholar
  28. Hooton T, Bradley SF, Cardenas DD et al (2010) Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the Infectious Diseases Society of America. Clin Infect Dis 50:625PubMedCrossRefGoogle Scholar
  29. Horan TC, Andrus M, Dudeck MA (2008) CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 36:309–332PubMedCrossRefGoogle Scholar
  30. Huang WC, Wann SR, Lin SL et al (2004) Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters. Infect Control Hosp Epidemiol 25:974–978PubMedCrossRefGoogle Scholar
  31. Jeffries HE, Mason W, Brewer M et al (2009) Prevention of central venous catheter-associated bloodstream infections in pediatric intensive care units: a performance improvement collaborative. Infect Control Hosp Epidemiol 30:645–651PubMedCrossRefGoogle Scholar
  32. Kass E, Schneiderman L (1957) Entry of bacteria into the urinary tract of patients with inlying catheters. New Eng J Med 256:556–557PubMedCrossRefGoogle Scholar
  33. Kollef MH (1999) Antimicrobial therapy of ventilator-associated pneumonia: how to select an appropriate drug regimen. Chest 115:8–11PubMedCrossRefGoogle Scholar
  34. Kollef MH, Morrow LE, Niederman MS, Leeper KV, Anzueto A, Benz-Scott L, Rodino FJ (2006) Clinical characteristics and treatment patterns among patients with ventilator-associated pneumonia. Chest 129:1210–1218PubMedCrossRefGoogle Scholar
  35. Lachman P, Yuen S (2009) Using care bundles to prevent infection in neonatal and paediatric ICUs. Curr Opin Infect Dis 22:224–228PubMedCrossRefGoogle Scholar
  36. Larcombe J (2005) Urinary tract infection in children. Clin Evid 14:429–440PubMedGoogle Scholar
  37. Leroy O, Meybeck A, d’Escrivan T et al (2003) Impact of adequacy of initial antimicrobial therapy on the prognosis of patients with ventilator-associated pneumonia. Intensive Care Med 29:2170–2173PubMedCrossRefGoogle Scholar
  38. Maki DG, Stolz SM, Wheeler S, Mermel LA (1997) Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. Ann Intern Med 127:257–266PubMedCrossRefGoogle Scholar
  39. Meddings J, Rogers MA, Macy M, Saint S (2010) Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clin Infect Dis 51:550–560PubMedCrossRefGoogle Scholar
  40. Megged O, Shalit I, Yaniv I et al (2010) Outcome of antibiotic lock technique for persistent central venous catheter-associated coagulase-negative Staphylococcus bacteremia in children. Eur J Clin Microbiol Infect Dis 29:157–161PubMedCrossRefGoogle Scholar
  41. Mermel L (2000) Prevention of intravascular catheter-related infections. Ann Intern Med 132:391–402PubMedCrossRefGoogle Scholar
  42. Mermel L, Farr B, Sherertz R (2001) Guidelines for the management of intravascular catheter-related infections. Infect Control Hosp Epidemiol 22:222–242PubMedCrossRefGoogle Scholar
  43. Miller MR, Griswold M, Harris JM et al (2010) Decreasing PICU catheter-associated bloodstream infections: NACHRIs quality transformation efforts. Pediatrics 125:206–213PubMedCrossRefGoogle Scholar
  44. Nicolle L, Bradley S, Colgan R et al (2005) Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 40:643PubMedCrossRefGoogle Scholar
  45. Niel-Weise BS, van den Broek PJ (2005) Antibiotic policies for short-term catheter bladder drainage in adults. Cochrane Database Syst Rev 3:CD005428Google Scholar
  46. Pronovost P, Needham D, Berenholt S et al (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355:2725–2732PubMedCrossRefGoogle Scholar
  47. Raad II, Hohn DC, GIlbreath BJ (1994) Prevention of central venous catheter related infections by using maximal barrier precautions during insertion. Infect Control Hosp Epidemiol 15:231–238PubMedCrossRefGoogle Scholar
  48. Ramritu P, Halton K, Collignon P (2008) A systematic review comparing the relative effectiveness of antimicrobial-coated catheters in intensive care units. Am J Infect Control 36:104–117PubMedCrossRefGoogle Scholar
  49. Rello J, Kollef M, Diaz E, Rodriguez A (2007) Infectious diseases in critical care, 2nd edn. Springer, GermanyCrossRefGoogle Scholar
  50. Rijnders BJVWE, Vandecasteele SJ, Stas M, Peetermans WE (2005) Treatment of long-term intravascular catheter-related bacteraemia with antibiotic lock: randomized, placebo-controlled trial. J Antimicrob Chemother 55:90–94PubMedCrossRefGoogle Scholar
  51. Rosenthal VD, Maki DG, Salomao R et al (2006) Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med 145:582–591PubMedCrossRefGoogle Scholar
  52. Saint S (2000) Clinical and economic consequences of nosocomial catheter-related bacteriuria. Am J Infect Control 28:68–75PubMedCrossRefGoogle Scholar
  53. Sanchez-Munoz JA, Lopez-Martin A et al (2005) Usefulness of antibiotic-lock technique in management of oncology patients with uncomplicated bacteremia related to tunneled catheters. Eur J Clin Microbiol Infect Dis 24:291–293PubMedCrossRefGoogle Scholar
  54. Tambyah P, Maki D (2000) Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1,497 catheterized patients. Arch Intern Med 160:2998–682CrossRefGoogle Scholar
  55. Tambyah PA, Halvorson KT, Maki DG (1999) A prospective study of pathogenesis of catheter-associated urinary tract infections. Mayo Clin Proc 74:131–136PubMedCrossRefGoogle Scholar
  56. Timsit J, Schwebel C, Bouadma L (2009) Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. J Am Med Assoc 301:1231–1241CrossRefGoogle Scholar
  57. Turck M, Goffe B, Petersdorf R (1962) The urethral catheters and urinary tract infection. J Urol 88:834–837PubMedGoogle Scholar
  58. Vernon MO, Hayden MK, Trick WE, Hayes RA, Blom DW, Weinstein RA (2006) Chlorhexidine gluconate to cleanse patients in a medical intensive care unit: the effectiveness of source control to reduce the bioburden of vancomycin-resistant enterococci. Arch Intern Med 166:306–312PubMedCrossRefGoogle Scholar
  59. Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K (2009) International study of the prevalence and outcomes of infection in intensive care units. J Am Med Assoc 302:2323–2329CrossRefGoogle Scholar
  60. Wagenlehner FM, Naber KG (2000) Hospital-acquired urinary tract infections. J Hosp Infect 46:171–181PubMedGoogle Scholar
  61. Warren J (1997) Catheter-associated urinary tract infections. Infect Dis Clin North Am 11:609–622PubMedCrossRefGoogle Scholar
  62. Weber DJ, Rutala WA, Sickbert-Bennett EE, Samsa GP, Brown V, Niederman MS (2007) Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia. Infect Control Hosp Epidemiol 28:825–831PubMedCrossRefGoogle Scholar
  63. Wylie M, Graham DA, Potter-Bynoe G et al (2010) Risk factors for central line-associated bloodstream infection in pediatric intensive care units. Infect Control Hosp Epidemiol 31:1049–1056PubMedCrossRefGoogle Scholar
  64. Yogaraj JS, Elward AM, Fraser VJ (2002) Rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics 110:481–485PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Division of Pediatric Critical Care Medicine, Seattle Children’s HospitalUniversity of Washington School of Medicine (J.E.A. and H.E.J.)SeattleUSA

Personalised recommendations