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Pulmonary artery catheter infections. A prospective study
Abstract:
Despite the widespread use of the Swan-Ganz pulmonary artery catheter, the incidence of catheter tip infection is not well-established. One-hundred and seventy catheter insertions in 113 patients were examined in this prospective study. Using a semiquantitative culture technique, the incidence of positive catheter tip cultures was 5.8%. No significant risk factors for catheter infection were identified, although there was a trend toward more frequent infection in patients not receiving antibiotics (p less than 0.06). Catheter tip infection appeared to result most frequently from a distant focus of infection. Although the overall incidence of positive blood cultures was significantly higher in the positive vs. negative catheter tip groups (37.9% vs. 10.6%, p less than 0.001), blood cultures were generally not a reliable guide to the presence of a catheter tip infection. We conclude that catheter infection can be contained at an acceptable level by following a reasonable protocol for catheter management.
Insights
The incidence of Swan-Ganz pulmonary artery catheter tip infection is 5.8%, often originating from distant infections. Proper catheter management protocols can effectively control catheter infections.
Area of Science:
- Infectious Diseases
- Medical Devices
- Critical Care Medicine
Background:
- Swan-Ganz pulmonary artery catheters are widely used in critical care.
- The precise incidence and risk factors for catheter tip infections remain unclear.
Purpose of the Study:
- To prospectively determine the incidence of catheter tip infection.
- To identify potential risk factors associated with catheter tip infections.
- To evaluate the relationship between catheter tip and blood cultures.
Main Methods:
- Prospective study of 170 Swan-Ganz catheter insertions in 113 patients.
- Semiquantitative culture technique used for catheter tip analysis.
- Comparison of infection rates between patients receiving and not receiving antibiotics.
Main Results:
- A 5.8% incidence of positive catheter tip cultures was observed.
- No significant risk factors for infection were identified, though a trend suggested higher rates in non-antibiotic groups (p<0.06).
- Positive blood cultures were significantly more frequent in patients with positive catheter tips (37.9% vs. 10.6%, p<0.001), but not a reliable indicator of tip infection.
Conclusions:
- Catheter tip infections are relatively infrequent.
- Infections often originate from a distant focus.
- Adherence to a strict catheter management protocol is crucial for minimizing infection rates.