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Catheter-Related Bloodstream Infection

Central line-associated bacteremia, biofilm, paired blood cultures, catheter salvage versus removal

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Catheter-Related Bloodstream Infection?

Catheter-related bloodstream infection complicates central venous catheters, peripherally inserted central catheters, dialysis catheters, and totally implantable ports. Pathogens form biofilms on catheter surfaces, releasing organisms intermittently into the circulation. Coagulase-negative staphylococci, Staphylococcus aureus, Candida, Enterococcus, and gram-negative bacteria predominate.

Clinical presentation ranges from fever without obvious source to sepsis, septic shock, or metastatic infection (endocarditis, osteomyelitis, ocular abscess). Diagnosis requires paired peripheral and catheter-drawn blood cultures: catheter cultures positive 120 minutes earlier than peripheral or with greater than threefold colony count suggest catheter source.

Management depends on pathogen, catheter type, and patient. Catheter removal is mandatory for Staphylococcus aureus, Candida, Pseudomonas, mycobacteria, septic complications, hemodynamic instability, or persistent bacteremia. Salvage with antibiotic lock therapy plus systemic antibiotics may be attempted for coagulase-negative staphylococci in tunneled catheters. Antibiotic duration is 14 days for Staphylococcus aureus, longer if endocarditis.

Symptoms

Fever and chills with central line
Hypotension and sepsis
Erythema or pus at exit site
Bacteremia in catheterized patient
Septic emboli or endocarditis

Risk Factors

Long-term central venous catheter
Hemodialysis catheter
Total parenteral nutrition
Immunosuppression
Multiple catheter manipulations

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For fever in patient with central line
  • For sepsis with no obvious source
  • For positive blood culture and catheter
  • For exit-site or tunnel infection
  • For metastatic infectious complication

Treatment Methods

01
Paired peripheral and catheter blood cultures
02
Empirical broad-spectrum antibiotics
03
Catheter removal if Staph aureus or Candida
04
Antibiotic lock therapy for salvage
05
Echocardiogram if S. aureus bacteremia
06
14 to 28 days antibiotic duration

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.