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01-11-2008 | Review Article

Central venous catheter-related infections in hematology and oncology

Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

Authors: Hans-Heinrich Wolf, Malte Leithäuser, Georg Maschmeyer, Hans Salwender, Ulrike Klein, Iris Chaberny, Florian Weissinger, Dieter Buchheidt, Markus Ruhnke, Gerlinde Egerer, Oliver Cornely, Gerd Fätkenheuer, Sabine Mousset

Published in: Annals of Hematology | Issue 11/2008

Abstract

Catheter-related infections (CRI) cause considerable morbidity in hospitalized patients. The incidence does not seem to be higher in neutropenic patients than in nonneutropenic patients. Gram-positive bacteria (coagulase-negative staphylococci, Staphylococcus aureus) are the pathogens most frequently cultured, followed by Candida species. Positive blood cultures are the cornerstone in the diagnosis of CRIs, while local signs of infection are not necessarily present. Blood cultures should be taken from peripheral blood and from the venous catheter. A shorter time to positivity of catheter blood cultures as compared with peripheral blood cultures supports the diagnosis of a CRI. In many cases, a definite diagnosis requires catheter removal and microbiological analysis. The role plate method with semiquantitative cultures has been established as standard in most laboratories. Antimicrobial treatment of CRI should be directed by the in vitro susceptibility of the isolated pathogen. Primary removal of the catheter is mandatory in S. aureus and Candida infections, as well as in case of tunnel or pocket infections. Future studies will elucidate whether the rate of CRI in neutropenic patients may be reduced by catheters impregnated with antimicrobial agents.

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Title: Central venous catheter-related infections in hematology and oncology
Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)
Authors: Hans-Heinrich Wolf
Malte Leithäuser
Georg Maschmeyer
Hans Salwender
Ulrike Klein
Iris Chaberny
Florian Weissinger
Dieter Buchheidt
Markus Ruhnke
Gerlinde Egerer
Oliver Cornely
Gerd Fätkenheuer
Sabine Mousset
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: Annals of Hematology / Issue 11/2008
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-008-0509-5

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