[Infections related to central venous catheters]

Central venous catheters (CVC) are a major source of nosocomial bacteraemia. The majority of cases are due to Staphylococcus aureus and coagulase-negative staphylococci. Severe complications, in particular septic shock, develop in 30% of all CVC-associated septicaemia cases and are usually caused by S. aureus. Some patients develop metastatic suppurative complications. Risk factors include prolonged catheterization, localization of catheter to the groin, the number of times the system is entered, use for parenteral nutrition and for dialysis, immunosuppresion and loss of skin integrity especially in burns. Important measures to decrease the rate of CVC-related infections include aseptic technique during insertion, changing transparent semipermeable dressing at least every 48 hours and replacement of the entire delivery system every 72 h. Technological advances such as bonding antimicrobial agents to the intravascular device may reduce the risk of infection. Treatment of CVC-related infections usually requires catheter removal.