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Catheter related Blood stream infection
🧾 About
- 🧪 The decision to urgently remove an intravascular catheter depends on clinical judgment, balancing severity of sepsis and the likelihood of catheter-related infection (Mermel et al., 2001).
- 📊 Use the Visual Infusion Phlebitis (VIP) score to guide treatment decisions. A high score warrants prompt action.
🩺 Clinical Assessment
- Check for systemic infection: fever, chills, rigors ❄️🤒.
- Inspect catheter site for:
- 🔴 Redness, swelling, tenderness
- 💧 Discharge or pus → local infection
- 🩸 Thrombus formation or vein inflammation
- Look for severe sepsis/septic shock features:
- ⬇️ Hypotension
- ❤️ Tachycardia
- 🧠 Altered mental status, oliguria, organ dysfunction
🔎 Investigations
- Blood Cultures:
- Take 2 sets — 1 from the catheter, 1 from peripheral vein
- Compare growth times & colony counts → confirms CRBSI
- Catheter Tip Culture: Send if catheter is removed.
- Full Blood Count (FBC): 📈 Leukocytosis / neutrophilia.
- Inflammatory Markers: CRP, procalcitonin for severity.
- Imaging: 🖼️ Ultrasound or CT if abscess/thrombophlebitis suspected.
💊 Management
- Suspected Infection:
- Take swab of site + blood cultures before antibiotics 🧫.
- Empirical Antibiotics:
- ✅ First-Line: Flucloxacillin 500 mg PO QDS
- ⚠️ Penicillin allergy: Discuss alternatives with Microbiology
- 🧬 MRSA suspected: Vancomycin 1 g IV 12-hourly (adjust for renal function)
- Severe Sepsis / Septic Shock 🚨:
- Immediate Microbiology consult
- Broad-spectrum IV antibiotics
- Supportive measures: fluids, oxygen, vasopressors 💉
💡 Key Point: Always reassess: if infection control is not achieved with antibiotics, catheter removal is often essential.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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