Recent advances in management of intravascular catheter related infections

Intravascular catheter-related infections are a major cause of morbidity and mortality. Coagulase-negative staphylo-cocci, Staphylo-coccus aureus, aerobic gram-negative bacilli and Candida albicans are the commonest microorganisms implicated in catheter-related infections. Management of catheter-related infections varies according to type of catheter involved. After appropriate cultures of blood and catheter samples are done, empirical intravenous antimicrobial therapy should be initiated on the basis of clinical picture, severity of the acute illness, underlying disease and the potential pathogens involved. When a catheter related infection is documented and a specific pathogen is identified, systemic antimicrobial therapy should be narrowed and consideration given for antibiotic lock therapy, if the central venous catheter or implantable device is not removed. In all cases of catheter-related bacteremia and fungemia, the catheter should be removed, if the infection is complicated with septic thrombosis, endocarditis and osteomyelitis.