A consideration on the treatment of central venous catheter-related infection.
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Accession number;00A0333860
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| Title;A consideration on the treatment of central venous catheter-related infection. |
| Author;
HANATANI YUJI
(Teikyo Univ., Sch. of Med.)
KODAIRA SUSUMU
(Teikyo Univ., Sch. of Med.)
ASAGOE TATSUO
(Teikyo Univ., Sch. of Med.)
GIBO JUN'ICHI
(Teikyo Univ., Sch. of Med.)
TOEDA HIROYUKI
(Teikyo Univ., Sch. of Med.)
KAWAKAMI SAYOKO
(Teikyo Univ., Hosp.)
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Journal Title;Japanese Journal of Chemotherapy
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Journal Code:F0608A
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ISSN:1340-7007
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VOL.48;NO.2;PAGE.107-111(2000)
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| Figure&Table&Reference;TBL.7, REF.10 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;We examined 2,202 central venous catheters(CVCs) inserted during the past 10 years to assess the severity of CVC-related infection(CRI) and to propose the proper treatment of CRI. Febrile catheterized patiens (body temperature above 38.DEG.C.) were diagnosed as having CRI when the cultures of CVC-tips were positive or when the fever dropped immediately (within 72 hours) after removal of the CVC. Cases were defined as "severe" disease, when they showed hypotension (systolic blood pressure.LEQ.90mmHg) and/or complication such as acute renal failure, heart failure, respiratory failure, or ophthalmitis. The rate of CRI was 10.6% (233/2,202), and the rate of severe disease in CRI was 15.5% (36/233). There were no significant differences in the rate of severe disease according to age, sex, underlying disease, concurrent disease, or CVC indwelling time. The rate of severe disease was significantly higher (25.9%) among the patients whose CVCs were removed more than 72 hours after the initial febrile episode (P<0.05). The rate of severe disease was significantly higher (36.7%) in patients whose maximal body temperature was above 39.DEG.C. and whose WBC counts were more than 10,000/mm3. Of the 157 microorganisms isolated from CRI, 42.0% were gram-positive cocci(GPCs), 39.5% were fungi, and 16.6% were gram-negative rods(GNRs). Because more than a half of the GPCs and GNRs were resistant strains, blood and CVC-tips cultures were considered essential for proper choice of antimicrobials. The isolation rate of fungi decreased significantly in the final 3 years (P<0.001). The rate of severe disease in the cases in which GPCs were isolated (2.6%) was significantly lower (P<0.01) than in the cases in which GNRs (40.0%) or fungi (26.5%) were isolated. Early removal of infected CVCs was recognized as being important to prevention of deterioration of CRI.... (author abst.) |
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