Term
| What are risk factors for catheter infections? |
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Definition
- Site of catheter
- Frequency of access
- Duration
- Patient
- Expertise
- preventative strategies |
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Term
| What is a tunneled catheter? |
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Definition
| Does not have wings - material grows into tissue to keep microbes out |
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Term
|
Definition
| Coagulase negative Staph species (CoNS) - S. epidermidis or S. hominis |
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Term
| How does a catheter infection present? |
|
Definition
- Fever, chills
- Hypotension
- Tendernes, warmth, and pain
**Leads to thrombophlebitis, IE, sepsis |
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Term
| What are criteria for a catheter infection? |
|
Definition
- Catheter in place 48 hours
- 1 + blood culture from peripheral vein
**Obtain BC PRIOR to therapy - 2+. A 3 fold increase in bacteria from catheter indicates an infection |
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Term
| What should a catheter be removed? |
|
Definition
Always remove in presence of infection
**Lock therapy for salvage, and never alone. Not for all organisms, 100-1000x MIC |
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Term
| How do you treat catheter infections empirically? |
|
Definition
- IV!
- De-escalate
- MRSA based on population
- Most commonly Vanc X5 days if catheter removed or 10-14 days with lock therapy |
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Term
| How are different types of catheter infections treated? |
|
Definition
- S. aureus - remove catheter, 14 day ONLY if meets criteria. Needs an echo after 5 days (TEE). Nafcillin or Vanc
- Enterococcus - remove catheter. Ampi or Vanc
- GNB - Removal, then Zosyn, 3rd gen cef, or a penem + AG
- Candida - removal, then Ampho or Echo. De-escalate to fluconazole |
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