a; Mary Alexander, BSb; E.Patchen Dellinger, MDc; Julie L. Gerberding, MD, MPHd; Stephen O. Heard, MDe; Dennis G. Maki, MDf; Henry Masur, MDa; Rita D. McCormick, RNg; Leonard A. Mermel, DOh; Michele L. Pearson, MDd; Issam I. Raad, MDi; Adrienne Randolph, MD, MScj; Robert A. Weinstein, MDk; The Healthcare Infection Control Practices Advisory Committee*">
Guidelines for the prevention of intravascular catheter-related infections☆☆☆
Abstract
Background: Although many catheter-related bloodstream infections (CR-BSIs) are preventable, measures to reduce these infections are not uniformly implemented. Objective: To update an existing evidenced-based guideline that promotes strategies to prevent CR-BSIs. Data Sources: The MEDLINE database, conference proceedings, and bibliographies of review articles and book chapters were searched for relevant articles. Studies Included: Laboratory-based studies, controlled clinical trials, prospective interventional trials, and epidemiological investigations. Outcome Measures: Reduction in CR-BSI, catheter colonization, or catheter-related infection. Synthesis: The recommended preventive strategies with the strongest supportive evidence are education and training of healthcare providers who insert and maintain catheters; maximal sterile barrier precautions during central venous catheter insertion; use of a 2% chlorhexidine preparation for skin antisepsis; no routine replacement of central venous catheters for prevention of infection; and use of antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e. education and training, maximal sterile barrier precautions and 2% chlorhexidine for skin antisepsis). Conclusion: Successful implementation of these evidence-based interventions can reduce the risk for serious catheter-related infection. (Am J Infect Control 2002;30:476-89.)
From the Clinical Center, National Institutes of Health, Bethesda, representing Society of Critical Care Medicine (SCCM) and Infectious Diseases Society of America (IDSA)a; Infusion Nurses Society (INS), Cambridgeb; Department of Surgery, University of Washington, Seattle, representing Surgical Infection Society (SIS) and SCCMc; Division of Healthcare Quality Promotion, National Center for Infectious Disease, CDC, Atlantad; Department of Anesthesiology, University of Massachusetts Medical School, Worcester, representing American College of Chest Physicians (ACCP) and American Society of Critical Care Anesthesiologists (ASCCA)e; Infectious Diseases Section, University of Wisconsin Medical School, Madisonf; University of Wisconsin Hospital and Clinics, Madison, representing Association for Professionals in Infection Control and Epidemiology (APIC)g; Division of Infectious Diseases, Rhode Island Hospital, and Brown University School of Medicine, Providenceh; Department of Medical Specialties, MD Anderson Cancer Center, Houstoni; Departments of Anesthesia and Pediatrics, the Children's Hospital, Bostonj; Division of Infectious Disease, Cook County Hospital and Rush Medical College, Chicago, representing Society for Healthcare Epidemiology of America (SHEA).k
☆☆ This article is being published simultaneously in American Journal of Infection Control and Infection Control and Hospital Epidemiology . The full text of the Guidelines for the Prevention of Intravascular Catheter-Related Infections was published in the Morbidity and Mortality Weekly Report 2002; 51 (No. RR-10) and can be accessed at www.cdc.gov/ncidod/hip/default.htm .
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