Genome sequence of Staphylococcus epidermidis strain AU12-03, isolated from an intravascular catheter

In recent years, Staphylococcus epidermidis has become a major nosocomial pathogen and the most common cause of intravascular catheter-related bacteremia, which can increase morbidity and mortality and significantly affect patient recovery. We report a draft genome sequence of Staphylococcus epidermidis AU12-03, isolated from an intravascular catheter tip

Diagnosis of intravascular catheter infection

PURPOSE OF REVIEW: To review the distinction between catheter-related and catheter-associated infections and to report the recent advances in the methods used for their diagnosis. RECENT FINDINGS: The distinction between device-associated and device-related infections affects the effective benchmarking of the rates of both types of infection. Numerous microbiological methods have been described to diagnose these infections. Studies comparing the performance of microbiological methods that avoid the removal of the intravascular device have recently suggested that they may be effective in daily life. SUMMARY: The present review summarizes recent advances in the methods currently available to diagnose intravascular catheter-related infections and their performance at the bedside

Prevention of intravascular catheter infection

PURPOSE OF REVIEW: To review recent evidence supporting the guidelines for preventing catheter-related and catheter-associated infections. RECENT FINDINGS: A series of studies has confirmed, over the past few years, that education-based preventive programmes can reduce these infections by one half to two thirds. The evidence supporting some specific measures has increased for the optimal timing for set replacement, for catheter-site dressing with chlorhexidine-impregnated devices, and for the use of some coated or impregnated intravascular devices. SUMMARY: Catheter-related and associated infections are largely preventable and should not be viewed as an unaffordable tribute to technical medicine. Improvements in existing techniques and new technologies should all be integrated into a structured process of continuous improvement in the quality of care

Bacteremic complications of intravascular catheter tip colonization with Gram-negative micro-organisms in patients without preceding bacteremia

Although Gram-negative micro-organisms are frequently associated with catheter-related bloodstream infections, the prognostic value and clinical implication of a positive catheter tip culture with Gram-negative micro-organisms without preceding bacteremia remains unclear. We determined the outcomes of patients with intravascular catheters colonized with these micro-organisms, without preceding positive blood cultures, and identified risk factors for the development of subsequent Gram-negative bacteremia. All patients with positive intravascular catheter tip cultures with Gram-negative micro-organisms at the University Medical Center, Utrecht, The Netherlands, between 2005 and 2009, were retrospectively studied. Patients with Gram-negative bacteremia within 48 h before catheter removal were excluded. The main outcome measure was bacteremia with Gram-negative micro-organisms. Other endpoints were length of the hospital stay, in-hospital mortality, secondary complications of Gram-negative bacteremia, and duration of intensive care admission. A total of 280 catheters from 248 patients were colonized with Gram-negative micro-organisms. Sixty-seven cases were excluded because of preceding positive blood cultures, leaving 213 catheter tips from 181 patients for analysis. In 40 (19%) cases, subsequent Gram-negative bacteremia developed. In multivariate analysis, arterial catheters were independently associated with subsequent Gram-negative bacteremia (odds ratio [OR] = 5.00, 95% confidence interval [CI]: 1.20–20.92), as was selective decontamination of the digestive tract (SDD) (OR = 2.47, 95% CI: 1.07–5.69). Gram-negative bacteremia in patients who received SDD was predominantly caused by cefotaxime (part of the SDD)-resistant organisms. Mortality was significantly higher in the group with subsequent Gram-negative bacteremia (35% versus 20%, OR = 2.12, 95% CI: 1.00–4.49). Patients with a catheter tip colonized with Gram-negative micro-organisms had a high chance of subsequent Gram-negative bacteremia from any cause. This may be clinically relevant, as starting antibiotic treatment pre-emptively in high-risk patients with Gram-negative micro-organisms cultured from arterial intravenous catheters may be beneficial

Infecção urinária em recém-nascido de termo: análise de fatores de risco

OBJETIVOS: Analisar a contribuição dos fatores de risco para a ocorrência de infecção urinária em recém-nascidos de termo. CASUÍSTICA E METODOLOGIA: Estudo retrospectivo (1997), incluindo recém-nascidos de termo com urocultura positiva por saco coletor. A indicação desta coleta foi baseada em: hipertermia (T>;37,8ºC), perda de peso>;10% do peso de nascimento, alterações do estado geral (recusa alimentar, ganho insuficiente de peso e hipoatividade) ou presença de malformações nefro-urológicas. Nesses recém-nascidos foi realizada punção suprapúbica para confirmação diagnóstica. Os recém-nascidos foram divididos em dois grupos, segundo o resultado das uroculturas: Grupo I (diagnóstico presuntivo de infecção urinária) e Grupo II (diagnóstico confirmado de infecção urinária), para avaliação dos fatores de risco pela análise do risco relativo. RESULTADOS: Foram estudadas 61 crianças (5,1% dos recém-nascidos de termo) - Grupo I n=42 (68,9%) e Grupo II n=19 (31,1%). Os fatores de risco avaliados (patologias infecciosas associadas, uso prévio de antibióticos, malformações nefro-urológicas, ventilação mecânica, nutrição parenteral e o uso de cateteres) foram mais freqüentes no Grupo II (pOBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss >; 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (

Acinetobacter bacteremia in Hong Kong: Prospective study and review

The epidemiological characteristics of 18 patients with acinetobacter bacteremia were analyzed. Patients (mean age, 55.5 years) developed bacteremia after an average of 14.1 days of hospitalization. Fifteen of 16 patients survived bacteremia caused by Acinetobacter baumannii. Cultures of blood from the remaining two patients yielded Acinetobacter Iwoffii. Most patients (78%) resided in the general ward, while four patients (22%) were under intensive care. Genotyping by arbitrarily primed polymerase chain reaction analysis and the temporal sequence of isolation were more useful than phenotyping by antimicrobial susceptibility in the determination of the source of bacteremia, and the intravascular catheter was the leading infection source (39% of cases). The possibility of an association of glucose with the pathogenesis of acinetobacter infection was raised.published_or_final_versio

Risk factors for central venous catheter-related infections in surgical and intensive care units. The Central Venous Catheter-Related Infections Study Group.

To identify avoidable risk factors for central venous catheter (CVC) infections in patients undergoing short-term catheterization