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Intravascular device-associated systemic infections: a 2 year analysis of cases in a district general hospital
1Department of Microbiology, Wycombe General Hospital, Buckinghamshire, UK.
Abstract:
The increasing use of intravascular devices (IVDs) throughout medicine has been accompanied by significant morbidity and mortality associated with catheter-related sepsis (CRS). Within the South Buckinghamshire district, 330 episodes of bacteraemia/fungaemia were recorded over the 2 year period 1992-1993. Thirty-nine episodes (12%), occurring in 37 patients, were associated with IVDs and these were divided into three groups according to the type and site of device. Six patients died with CRS contributing to mortality whilst one patient suffered serious morbidity, in the form of vertebral osteomyelitis. This analysis highlighted deficiencies in the management of IVDs which are likely to be found in similar district general hospitals in the UK. There is an urgent need for national guidelines on IVD care together with recommendations for the optimal treatment of IVD-associated infection.
Insights
Catheter-related sepsis (CRS) linked to intravascular devices (IVDs) caused deaths and serious illness. Improved IVD management and national guidelines are urgently needed to prevent these infections in hospitals.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Intravascular devices (IVDs) are increasingly used in healthcare settings.
- Catheter-related sepsis (CRS) is a significant complication associated with IVD use, leading to morbidity and mortality.
- Previous studies indicate a need for better understanding of CRS prevalence and impact in district general hospitals.
Purpose of the Study:
- To analyze the incidence and outcomes of CRS in a UK district general hospital over a two-year period.
- To identify deficiencies in the management of intravascular devices (IVDs) contributing to CRS.
- To highlight the need for national guidelines on IVD care and treatment of associated infections.
Main Methods:
- Retrospective analysis of bacteraemia/fungaemia episodes recorded between 1992-1993.
- Categorization of CRS episodes based on IVD type and site.
- Assessment of patient outcomes, including mortality and morbidity.
Main Results:
- 330 episodes of bacteraemia/fungaemia were recorded; 39 (12%) were associated with IVDs in 37 patients.
- Six patients died due to CRS, and one suffered vertebral osteomyelitis.
- Analysis revealed deficiencies in IVD management practices.
Conclusions:
- Catheter-related sepsis (CRS) poses a significant risk of mortality and morbidity in patients with intravascular devices (IVDs).
- Current management of IVDs in district general hospitals requires improvement.
- There is an urgent need for national guidelines for IVD care and treatment protocols for CRS.