首页   按字顺浏览 期刊浏览 卷期浏览 Central venous catheter removalversus in situtreatment in neonates with coagulase-negat...
Central venous catheter removalversus in situtreatment in neonates with coagulase-negative staphylococcal bacteremia

 

作者: M. KARLOWICZ,   PAUL FURIGAY,   DANIEL CROITORU,   E. BUESCHER,  

 

期刊: The Pediatric Infectious Disease Journal  (OVID Available online 2002)
卷期: Volume 21, issue 1  

页码: 22-27

 

ISSN:0891-3668

 

年代: 2002

 

出版商: OVID

 

关键词: Coagulase-negative staphylococci;central venous catheter;neonate

 

数据来源: OVID

 

摘要:

Objective.To determine how often neonates with coagulase-negative staphylococcal (CONS) bacteremia can be treated successfully without removing the central venous catheter (CVC).Methods.A cohort study of CONS bacteremia and CVCs was conducted in infants in a neonatal intensive care unit in a 5-year period (1994 through 1998). CONS bacteremia was defined as at least two positive blood cultures within 3 days of each other.Results.Fifty-six infants had early removal CVC (ER-CVC) within 3 days, and 63 infants had late removal CVC (LR-CVC) >3 days after the first positive blood culture. All cases of CONS bacteremia were treated with vancomycin. There was no significant difference between infants in the ER-CVC and LR-CVC groups in terms of recurrence of bacteremia or case fatalities. CONS bacteremia of >3 days duration was more frequent in LR-CVC patients than ER-CVC patients: 43%vs.13% (relative risk, 3.4; 95% confidence interval, 1.6 to 7.2). CONS bacteremia was successfully treated without CVC removal in 46% of LR-CVC cases. Seventy-nine percent of LR-CVC cases with CONS bacteremia lasting 1 or 2 days were treated successfully without CVC removal. The success rate decreased to 44% with a 3- to 4-day duration of bacteremia. None of 19 infants with CONS bacteremia lasting >4 days was treated successfully until CVCs were removed.Conclusions.Prolonged CONS bacteremia was avoided by early removal of CVCs. Retention of CVCs was successful in 46% of neonates with CONS bacteremia in whom it was attempted, but it was never successful if bacteremia lasted >4 days.

 

点击下载:  PDF (123KB)



返 回