Current Approach To Intravascular Catheter Infection

Hastanelerin riskli unitelerinde yatan hastalarda nozokomi- yal kan dolasimi infeksiyonlarinin onemli bir kismi damar ici kateter infeksiyonlarindan kaynaklanmaktadir. Kateterle iliskili kan dolasimi infeksiyonu (KIKDI), onemli bir morbidite ve mortalite nedenidir. Hastanede kalis suresi ve bakim maliyetlerini artirir. Infeksiyon siklikla kateter giris yeri ve birlesim yerinden kaynaklanmaktadir. KIKDI icin en sik etken mikroorganizmalar koagulaz-negatif stafilokok, Staphylococ- cus aureus, Enterokoklar ve Candida turleridir. Kateter ile periferik kanda ayni etkenin uremesi taninin temelini olustu- rur. Tedavide, genellikle kateter cikarilir ve sistemik antibiyo- tik baslanir. Kanita dayali stratejiler esliginde paket onlemle- rin uygulanmasi, multidisipliner egitimlerin verilmesi, geriye donuk bildirimlerin saglanmasi, infeksiyon kontrol surveyan- sinin duzgun calismasi ve kalite acisindan akreditasyonun saglanmasi KIKDI'lerin onlenmesi icin zorunludur. A great majority of nosocomial bloodstream infections in hospitalized patients in risky departments of hospitals origi- nate from an infected central venous catheter (CVC). Cathe- ter-related bloodstream infection (CRBSI) is one of the con- siderable reason for morbidity and mortality and causes an increase in both duration and cost of hospital care. CRBSI usually arises around the catheter inserion site and at the hub of the catheters. Coagulase-negative staphylococci, Staphylococcus aureus, enterococci, and Candida species are the most common causative organisms for CRBSI. Isolation of the same organism from the catheter and peripheral blood contitutes the basis for the diagnosis of CRBSI. CRBSI is usually treated by withdrawal of the catheter and using systemic antibiotics. Applying prevention bundles accompa- nied with the evidence based strategies, planning multidis- ciplinary trainings, analysing retrospective data of the cases, doing infection control surveyances properly and providing acreditation in terms of quality is compulsory to avoid from CRBSI.