Systemic sepsis and intravenous devices. A prospective survey

Seventy-five episodes of bacteraemia or fungaemia related to indwelling temporary intravenous devices were assessed by the Infectious Diseases Unit of The Westmead Centre, to determine the quality of care of these devices. The estimated incidence of systemic sepsis was 1% for all central venous catheters inserted and 0.1% for all peripheral venous catheters inserted. Sepsis was a major cause of death in 14 of 17 patients who died. Despite the existence of protocols for the insertion, management and early removal of intravenous devices, factors increasing the risk of sepsis included delay in the removal of the intravenous device and the presence of thrombophlebitis. Staphylococcus aureus was the most common isolate (41%); antibiotic resistant Gram-negative rods were also common (38%). It is concluded that continued education of resident and nursing staff is essential to minimize the risk of intravenous catheter-related sepsis.