[Infections and sepsis from intravascular catheters]

Intravascular catheters are an indispensable part of modern medicine, but also a frequent source for bloodstream infections. The incidence of infection depends on the catheter type, type of hospital setting (intensive care unit vs ward), and underlying diseases of the patient, and the type and resources for the prevention program. Initially, a common portal of bacterial entry is the insertion site. After prolonged catheterization, the hub (the connection between the catheter and the infusing tube) becomes the predominant source of bacterial entry. Basic surveillance data guide a risk-adjusted prevention program for an individual health care institution. The guidelines issued by the Robert-Koch-Institute are still an excellent framework: In cases of suspected catheter-related bloodstream infection, the catheter can be immediately removed and submitted to the laboratory, or -- in less severe cases -- blood cultures can be simultaneously drawn by venous cut-down and cultures through the catheter. Health care education, training and monitoring or insertion, maintenance are paramount to prevent catheter-related bloodstream infection. Coated catheters are indicated for special patient populations such as burn patients or transplant patients.