Management of Catheter-related Bloodstream Infection and Subsequent Recurrent Infection
| Management . | Recurrent Infection (n = 17) . | No Recurrent Infection (n = 85) . |
|---|---|---|
| Management of the infected catheter | ||
| Removal and later replacementa | 12 (71) | 61 (72) |
| Direct exchange over guidewire | 1 (6) | 9 (11) |
| Retained (line salvage) | 4 (24) | 14 (16) |
| Administration of definitive antibiotic therapy | ||
| Completed full course as inpatient | 8 (47) | 36 (42) |
| Outpatient oral antibiotics | 2 (12) | 28 (33) |
| Via OPAT with PICC | 0 (0) | 2 (2) |
| Via temporary outpatient scheduled hemodialysis | 1 (6) | 4 (5) |
| Via “scheduled” hemodialysis using the emergency-only hemodialysis systema | 6 (35) | 13 (15) |
| Adherence to IDSA guidelines for management of intravascular catheter–related infections | ||
| Appropriate antibiotic selection | 16 (94) | 71 (84) |
| Inappropriate antibiotic selection | 1 (6) | 13 (15) |
| Appropriate duration of therapy | 6 (35) | 64 (75) |
| Inappropriate duration of therapy | 11 (65) | 20 (24) |
| Appropriate catheter management | 14 (82) | 81 (95) |
| Inappropriate catheter management | 3 (18) | 3 (4) |
| Management . | Recurrent Infection (n = 17) . | No Recurrent Infection (n = 85) . |
|---|---|---|
| Management of the infected catheter | ||
| Removal and later replacementa | 12 (71) | 61 (72) |
| Direct exchange over guidewire | 1 (6) | 9 (11) |
| Retained (line salvage) | 4 (24) | 14 (16) |
| Administration of definitive antibiotic therapy | ||
| Completed full course as inpatient | 8 (47) | 36 (42) |
| Outpatient oral antibiotics | 2 (12) | 28 (33) |
| Via OPAT with PICC | 0 (0) | 2 (2) |
| Via temporary outpatient scheduled hemodialysis | 1 (6) | 4 (5) |
| Via “scheduled” hemodialysis using the emergency-only hemodialysis systema | 6 (35) | 13 (15) |
| Adherence to IDSA guidelines for management of intravascular catheter–related infections | ||
| Appropriate antibiotic selection | 16 (94) | 71 (84) |
| Inappropriate antibiotic selection | 1 (6) | 13 (15) |
| Appropriate duration of therapy | 6 (35) | 64 (75) |
| Inappropriate duration of therapy | 11 (65) | 20 (24) |
| Appropriate catheter management | 14 (82) | 81 (95) |
| Inappropriate catheter management | 3 (18) | 3 (4) |
Abbreviations: IDSA, Infectious Diseases Society of America; OPAT, outpatient parenteral antibioitic therapy; PICC, peripherally inserted central catheter.
aNew catheters were placed a median of 5 days later (range, 1–18 days); in those with longer durations, temporary hemodialysis catheters were placed as needed.
Management of Catheter-related Bloodstream Infection and Subsequent Recurrent Infection
| Management . | Recurrent Infection (n = 17) . | No Recurrent Infection (n = 85) . |
|---|---|---|
| Management of the infected catheter | ||
| Removal and later replacementa | 12 (71) | 61 (72) |
| Direct exchange over guidewire | 1 (6) | 9 (11) |
| Retained (line salvage) | 4 (24) | 14 (16) |
| Administration of definitive antibiotic therapy | ||
| Completed full course as inpatient | 8 (47) | 36 (42) |
| Outpatient oral antibiotics | 2 (12) | 28 (33) |
| Via OPAT with PICC | 0 (0) | 2 (2) |
| Via temporary outpatient scheduled hemodialysis | 1 (6) | 4 (5) |
| Via “scheduled” hemodialysis using the emergency-only hemodialysis systema | 6 (35) | 13 (15) |
| Adherence to IDSA guidelines for management of intravascular catheter–related infections | ||
| Appropriate antibiotic selection | 16 (94) | 71 (84) |
| Inappropriate antibiotic selection | 1 (6) | 13 (15) |
| Appropriate duration of therapy | 6 (35) | 64 (75) |
| Inappropriate duration of therapy | 11 (65) | 20 (24) |
| Appropriate catheter management | 14 (82) | 81 (95) |
| Inappropriate catheter management | 3 (18) | 3 (4) |
| Management . | Recurrent Infection (n = 17) . | No Recurrent Infection (n = 85) . |
|---|---|---|
| Management of the infected catheter | ||
| Removal and later replacementa | 12 (71) | 61 (72) |
| Direct exchange over guidewire | 1 (6) | 9 (11) |
| Retained (line salvage) | 4 (24) | 14 (16) |
| Administration of definitive antibiotic therapy | ||
| Completed full course as inpatient | 8 (47) | 36 (42) |
| Outpatient oral antibiotics | 2 (12) | 28 (33) |
| Via OPAT with PICC | 0 (0) | 2 (2) |
| Via temporary outpatient scheduled hemodialysis | 1 (6) | 4 (5) |
| Via “scheduled” hemodialysis using the emergency-only hemodialysis systema | 6 (35) | 13 (15) |
| Adherence to IDSA guidelines for management of intravascular catheter–related infections | ||
| Appropriate antibiotic selection | 16 (94) | 71 (84) |
| Inappropriate antibiotic selection | 1 (6) | 13 (15) |
| Appropriate duration of therapy | 6 (35) | 64 (75) |
| Inappropriate duration of therapy | 11 (65) | 20 (24) |
| Appropriate catheter management | 14 (82) | 81 (95) |
| Inappropriate catheter management | 3 (18) | 3 (4) |
Abbreviations: IDSA, Infectious Diseases Society of America; OPAT, outpatient parenteral antibioitic therapy; PICC, peripherally inserted central catheter.
aNew catheters were placed a median of 5 days later (range, 1–18 days); in those with longer durations, temporary hemodialysis catheters were placed as needed.
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