[The subclavian vein catheter related infections (author's transl)].

Abstract

The aim of the present investigation was to study the possible means to prevent the subclavian vein catheter related infections. The tip of the catheter and the part situating at the skin puncture were cultured using the semiquantitative culture method. The growth of the micro-organisms was divided into three groups: classical pathogenic, opportunistic and non pathogenic. We did not find any growth in 64 p. cent of the catheters. The puncture site gave growth in 15 p. cent, the catheter tip in 6,5 p. cent and both of them in 14 p. cent In this study four cases (1,5 p. cent) of septicemias were found. In these cases Streptococcus fecalis was the most common microorganism. The aim of the semiquantitative culture method was to differentiate a real catheter related infection and contamination. The real infection was found only in 32 catheter tips though growth was seen in 54 catheter tips. According to this investigation it seems that the most important factor in preventing catheter related infections was strict sterility during the catheter placement as well as during the maintenance. A small dose of heparin probably reduces the formation of fibrin sleeve around the catheter tip and thus prevents infections. The time the patient is catheterized is also of importance, patients with catheter related septicemia had twice as long duration than cases without growth of catheter tip.