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      Catheter Salvage After Catheter-Related Bloodstream Infection During Home Parenteral Nutrition

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          Most cited references 16

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          Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association.

           ,  ,   (2010)
          Despite improvements in cardiovascular implantable electronic device (CIED) design, application of timely infection control practices, and administration of antibiotic prophylaxis at the time of device placement, CIED infections continue to occur and can be life-threatening. This has prompted the study of all aspects of CIED infections. Recognizing the recent advances in our understanding of the epidemiology, risk factors, microbiology, management, and prevention of CIED infections, the American Heart Association commissioned this scientific statement to educate clinicians about CIED infections, provide explicit recommendations for the care of patients with suspected or established CIED infections, and highlight areas of needed research.
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            PICC-associated bloodstream infections: prevalence, patterns, and predictors.

            Growing use of peripherally inserted central catheters (PICCs) has led to recognition of the risk of PICC-associated bloodstream infection. We sought to identify rates, patterns, and patient, provider, and device characteristics associated with this adverse outcome.
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              Prevention and treatment of implanted central venous catheter (CVC) - related sepsis: a report after six years of home parenteral nutrition (HPN).

              Catheter-related sepsis is a serious and common complication in patients receiving home parenteral nutrition (HPN). Prevention measures, prevalence of infections, types of agents and implanted central venous catheters (CVC), effectiveness of antibiotic therapy have been evaluated in 221 patients consecutively followed in our unit from January 1995 to December 2000. The clinical diagnosis of catheter-related infection was made using well-defined criteria. Patients were divided into two groups: A and B, receiving instructions with different modalities: standard (A) and detailed (B), respectively. Sixty CVC-related sepsis occurred in 32 (14%) patients. A multivariate analysis showed that the duration of HPN (P<0.001; OR=0.9), type of catheter (P=0.009; OR=0.12) and type of disease (P=0.033; OR=4.92) significantly influence catheter infection. The type of implanted CVC (159 port-a-cath in 153 patients and 71 tunnelled in 68) seems to affect the infection rate, this being lower in tunnelled (P=0.03). Infection rate was lower in B vs A group (P<0.001) with all types of catheters, suggesting the preventive role of very careful training. In particular, the incidence of CVC-related sepsis was 6/1000 days of HPN (i.e. 6/1000 days of catheterization) in Group A and 3/1000 in Group B. Systemic and antibiotic lock therapy was performed with an 83% successful rate. Gram-positive bacteria were the most frequent CVC infection agents, which are usually eradicated by antibiotic therapy lasting 7 days.
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                Author and article information

                Journal
                Journal of Parenteral and Enteral Nutrition
                JPEN J Parenter Enteral Nutr
                SAGE Publications
                0148-6071
                1941-2444
                February 17 2017
                March 2017
                September 29 2016
                March 2017
                : 41
                : 3
                : 481-488
                Affiliations
                [1 ]Division of General Internal Medicine
                [2 ]Second Department of Internal Medicine, Charles University Faculty of Medicine, Hradec Kralove, Czech Republic
                [3 ]Division of Infectious Diseases
                [4 ]Division of Gastroenterology and Hepatology
                [5 ]Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
                [6 ]Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Kentucky, USA
                Article
                10.1177/0148607115587018
                © 2017

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