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Infection Control and Hospital Epidemiology Publication Info

Article DOI: 10.1086/502455
Stable URL: http://www.jstor.org/stable/10.1086/502455
Central Venous Catheter–Related Bacteremia Due to Gram‐Negative Bacilli: Significance of Catheter Removal in Preventing Relapse • 
Hend Hanna , MD, MPH, Claude Afif , MD, Badie Alakech , MD, Maha Boktour , MD, Jeffrey Tarrand , MD, Ray Hachem , MD and Issam Raad , MD
Infection Control and Hospital Epidemiology , Vol. 25, No. 8 (August 2004), pp. 646-649
Article DOI: 10.1086/502455
Article Stable URL: http://www.jstor.org/stable/10.1086/502455
Original Articles

Central Venous Catheter–Related Bacteremia Due to Gram‐Negative Bacilli: Significance of Catheter Removal in Preventing Relapse

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Abstract(back to top)

OBJECTIVE. To study the characteristics of catheterrelated, gram‐negative bacteremia (GNB) and the role of central venous catheter (CVC) removal.

DESIGN. This retrospective study involved a search of the microbiological department records of CVC and blood cultures and patients’ medical records.

SETTING. University of Texas M. D. Anderson Cancer Center, a tertiary‐care hospital in Houston, Texas.

PATIENTS. Patients with cancer who had catheter‐related GNB, defined as (1) a positive catheter tip culture with at least 15 colony‐forming units semiquantitatively, (2) isolation of the same organism from the tip and peripheral blood cultures, (3) no other source for bacteremia except the CVC, and (4) clinical manifestations of infection (fever or chills).

RESULTS. Between January 1990 and December 1996, 72 cases of catheter‐related GNB were available for review. Most of the patients (67; 93%) had their CVCs removed in response to the bacteremia. Few patients (5; 7%) retained their CVCs and were treated with appropriate antibiotics. When CVCs were removed, only 1 patient (1%) relapsed with the same organism, whereas all 5 patients with retained CVCs relapsed after having responded (P < .001). The most commonly isolated organisms were Enterobacter, Klebsiella, Stenotrophomonas, Pseudomonas, and Acinetobacter species. Catheter removal within 72 hours of the onset of the catheter‐related GNB was the only independent protective factor against relapse of the infection (odds ratio, 0.13; 95% confidence interval, 0.02–0.75; P = .02).

CONCLUSION. In patients with documented catheterrelated GNB, CVCs should be removed within 48 to 72 hours to prevent relapse (Infect Control Hosp Epidemiol 2004;25:646‐649.)

Bibliographic Information(back to top)

  • Central Venous Catheter–Related Bacteremia Due to Gram‐Negative Bacilli: Significance of Catheter Removal in Preventing Relapse
  • Hend Hanna , MD, MPH, Claude Afif , MD, Badie Alakech , MD, Maha Boktour , MD, Jeffrey Tarrand , MD, Ray Hachem , MD and Issam Raad , MD
  • Infection Control and Hospital Epidemiology
  • Vol. 25, No. 8 (August 2004) (pp. 646-649)

Author Information(back to top)

Hend Hanna , MD, MPH; Claude Afif , MD; Badie Alakech , MD; Maha Boktour , MD; Jeffrey Tarrand , MD; Ray Hachem , MD; Issam Raad , MD

Notes and References(back to top)

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Notes

Drs. Hanna, Hachem, Boktour, and Raad are from the Department of Infectious Diseases and Dr. Tarrand is from the Department of Laboratory Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. Dr. Afif is from the University of Balamand, Beirut, Lebanon. Dr. Alakech is from Texas Tech University Health Science Center, Lubbock, Texas.Address reprint requests to Hend A. Hanna, MD, MPH, The University of Texas M. D. Anderson Cancer Center, Department of Infectious Diseases, Infection Control and Employee Health (Unit 402), 1515 Holcombe Blvd., Houston, TX 77030.Presented in part at the 41st Annual Meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy; December 15‐19, 2001; Chicago, IL.

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© 2004 by The Society for Healthcare Epidemiology of America. All rights reserved.