Treatment strategies for central venous catheter infections

Intravascular catheters are essential in most hospital units. These devices are the most common source of nosocomial bloodstream infections. Catheter-related bloodstream infections (CR-BSI) are associated with increased morbidity and mortality, prolonged hospitalization, and increased costs. CR-BSI can be diagnosed by different bacteriologic techniques, some of which can be performed in situ without withdrawing the device. Prevention strategies should aim to avoid extra- and endoluminal contamination. The management of CR-BSI includes catheter withdrawal and an appropriate antibiotic, which depends on the patient's clinical situation and on etiologic factors. Glycopeptide antibiotics are widely used for empirical treatment because of the high prevalence of staphylococcal infections. Antibiotic therapy should be reassessed when culture and sensitivity results are known.