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Defining intravascular catheter-related infections: a plea for uniformity
1Department of Medicine, Brown University School of Medicine, Providence, Rhode Island, USA.
Abstract:
This article defines the complex interaction between catheterized patients and invading microbial pathogens. Catheter colonization reflects significant growth of a microbe on a catheter component. Localized intravascular catheter-related infection denotes infection at the exit site, tunnel tract, or pocket, in the absence of bloodstream infection. Systemic intravascular catheter-related infection is a complication of colonization or localized infection, usually documented by invasion of the bloodstream. Catheter sepsis is a systemic infection that is difficult to define because symptoms associated with bloodstream infection caused by the most common pathogens to infect catheterized patients, coagulase-negative staphylococci, may not meet the previously published criteria of sepsis. It is hoped that the information contained here will lead to greater uniformity in the definitions used by the many investigators in this fascinating field.
Insights
This article clarifies definitions for microbial infections in catheterized patients, distinguishing between colonization, localized, and systemic infections. Improved definitions aim for consistent research in catheter-related infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Definitions
Background:
- Catheterized patients face risks from microbial pathogens.
- Current definitions of catheter-related infections lack uniformity.
- Inconsistent definitions hinder research and clinical practice.
Purpose of the Study:
- To define and differentiate types of catheter-related microbial infections.
- To establish clear criteria for catheter colonization, localized infection, and systemic infection.
- To promote uniformity in the investigation of catheter-related infections.
Main Methods:
- Literature review and synthesis of existing definitions.
- Analysis of microbial interaction with catheter components.
- Comparison of clinical manifestations and diagnostic criteria.
Main Results:
- Catheter colonization is defined as significant microbial growth on the catheter.
- Localized infection involves the exit site or tunnel without bloodstream invasion.
- Systemic infection results from colonization or localized infection, often with bloodstream invasion.
Conclusions:
- Clearer definitions are proposed for catheter colonization and infection.
- Distinguishing between localized and systemic intravascular catheter-related infections is crucial.
- Standardized definitions are needed to advance research on catheter-related sepsis.