关键词: Antibiotic Antibioticoterapia Bacteremia Bacteriemia Bacteriemia relacionada con catéter Blood cultures Catheter-related bloodstream infection Guidelines Guía de práctica clínica Hemocultivos

Mesh : Anti-Bacterial Agents / therapeutic use Antifungal Agents / therapeutic use Bacteremia / diagnosis drug therapy etiology Bacterial Typing Techniques / methods standards Bacteriological Techniques / standards Biofilms / drug effects Blood Specimen Collection / methods standards Candidemia / drug therapy etiology Catheter-Related Infections / diagnosis drug therapy Catheters / adverse effects microbiology Conservative Treatment Cross Infection / diagnosis drug therapy etiology Device Removal Disease Management Drug Resistance, Multiple, Bacterial Endocarditis, Bacterial / etiology Equipment Contamination Humans Mycology / methods Thrombophlebitis / etiology

来  源:   DOI:10.1016/j.medin.2017.09.012   PDF(Sci-hub)

Abstract:
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (the Spanish Society of Infectious Diseases and Clinical Microbiology and [SEIMC] and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units [SEMICYUC]). Short-term peripheral venous catheters, non-tunneled and long-term central venous catheters, tunneled catheters and hemodialysis catheters are covered by these guidelines. The panel identified 39 key topics that were formulated in accordance with the PICO format. The strength of the recommendations and quality of the evidence were graded in accordance with ESCMID guidelines. Recommendations are made for the diagnosis of CRBSI with and without catheter removal and of tunnel infection. The document establishes the clinical situations in which a conservative diagnosis of CRBSI (diagnosis without catheter removal) is feasible. Recommendations are also made regarding empirical therapy, pathogen-specific treatment (coagulase-negative staphylococci, Staphylococcus aureus, Enterococcus spp., Gram-negative bacilli, and Candida spp.), antibiotic lock therapy, diagnosis and management of suppurative thrombophlebitis and local complications.
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