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Intravenous line infections

B A Cunha1

  • 1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, USA.

Critical Care Clinics
|April 30, 1998
PubMed
Summary

Central intravenous (IV) line infections are a common cause of unexplained fever in critical care units. Diagnosis requires ruling out other causes, with risk increasing with catheter duration, and treatment involves line removal and targeted antibiotics.

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Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Central intravenous (IV) lines are frequently used in critical care units.
  • IV line infections often present as unexplained fever without local signs.
  • The risk of infection correlates with the duration of IV catheterization.

Purpose of the Study:

  • To highlight the significance of central IV line infections as a cause of fever in critical care.
  • To outline diagnostic considerations and common pathogens.
  • To describe current treatment strategies for IV line infections.

Main Methods:

  • Diagnosis is considered after excluding other fever etiologies.
  • Identification of pathogens typically involves semiquantitative culture of the removed catheter tip.
  • Blood cultures are essential for identifying bloodstream pathogens.

Main Results:

  • The most common pathogens are skin organisms, including Staphylococcus epidermidis and Staphylococcus aureus.
  • Fever is the primary presenting symptom, often without localized signs of infection.
  • Increased duration of IV catheterization significantly elevates the risk of infection.

Conclusions:

  • Central IV line infections are a critical consideration for unexplained fever in ICU patients.
  • Prompt removal of the IV line is the cornerstone of treatment.
  • Empiric antibiotic therapy should target common gram-positive and gram-negative organisms pending culture results.

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