Chapter 13.12 : Culture of Intravascular Devices

Abstract:

Intravascular catheters are used to provide continuous vascular access to permit blood sampling; to administer blood products, medications, total parenteral nutrition, and other fluids; and, in the case of pulmonary artery catheters, to permit hemodynamic monitoring of cardiac function. Because these devices penetrate the integument, they put the patient at significant risk for development of device-related infection. The insertion site becomes colonized by bacteria from the patient's own skin or by microorganisms carried on the hands of medical personnel ( 5 ). Organisms can also gain access through the lumen of the catheter following contamination of the hub ( 4 ) or infusion of contaminated fluids. Invading organisms can then colonize the intravascular catheter surfaces in the form of a biofilm and produce local infection and, in a significant number of cases, bacteremia, fungemia, suppurative phlebitis, or septic thrombosis ( 5 ). (See Appendix 13.12-1 for further discussion.)