Central venous catheter: Infectious complications

Catheter infection, the most frequent complication of central venous catheters (CVC) use, is associated with increased morbidity, mortality, and duration of hospital stay. Risk factors in the development of catheter colonisation and bloodstream infection include patient factors (increased risk associated with malignancy, neutropenia, and shock) and treatment-related factors (increased risk associated with total parenteral nutrition, intensive care unit (ICU) admission for any reason, and endotracheal intubation). Other risk factors are prolonged catheter indwelling time, lack of sepsis during CVC insertion, and frequent manipulation of the catheter. The most important factor is catheter care after placement. Thrombus formation around the CVC tip increases the risk of infection; low-dose anticoagulants may decrease this risk. In our ICU, CVCs are used with implementation of strict guidelines and protocols for catheter insertion, care, and maintenance with positive central venous catheter tip culture in 4.4% patients with positive blood culture.