How to manage central venous catheter-related bloodstream infections due to Gram-negative bacilli?

Current Opinion in Infectious Diseases - Tập 35 Số 6 - Trang 583-588 - 2022
Rafael San Juan1, María Ruiz‐Ruigómez1, José María Aguado1
1Unit of Infectious Diseases, Hospital Universitario ‘12 de Octubre’, Instituto de Investigación Hospital ‘12 de Octubre’ (imas12), Universidad Complutense, Madrid, Spain

Tóm tắt

Purpose of review

The aim of this study was to review recent data evaluating the management of central venous catheter-related bloodstream infection due to Gram-negative bacilli (GNB).

Recent findings

The incidence of GNB catheter-related bloodstream infection (CRBSI) has been increasing considerably in the last years, and this has raised a concern due to the high reported rate of multidrug-resistant in these infections what poses a considerable challenge for effective treatment. However, there are no specific guidelines for the management of GNB-CRBSI and optimal treatment duration has not been clearly defined. Recent studies have shown that the risk for complications is clearly different to what is stablished for Staphylococcus aureus. Therefore, a short course of antibiotic therapy might be effective once the central venous catheter (CVC) has been removed and the monitoring complications through control blood cultures or echocardiography seem to be less helpful in GNB CRBSI.

Summary

The incidence of GNB CRBSI has been increasing considerably in the last years; this has raised a concern due to the high reported rate of MDR in these infections what poses a considerable challenge for effective treatment. However, there are no specific guidelines for the management of GNB-CRBSI and optimal treatment duration has not been clearly defined. Recent studies have shown that the risk for complications is clearly different to what is stablished for S. aureus. Therefore, a short course of antibiotic therapy might be effective once the CVC has been removed and the monitoring complications through control blood cultures or echocardiography seem to be less helpful in GNB-CRBSI.

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