Аннотация
Катетер-ассоциированные инфекции кровотока занимают третье место среди всех нозокомиальных инфекций и первое место среди причин бактериемии, составляя до 10% от всех инфекций у госпитализированных пациентов, 20% от всех нозокомиальных инфекций и до 87% от первичных бактериемий. В Европе и США ежегодно регистрируется более 500 тыс. случаев катетер-ассоциированных инфекций, из которых 80 тыс. случаев регистрируется в ОРИТ. В статье рассматриваются вопросы эпидемиологии, этиологии и классификации катетер-ассоциированных инфекций кровотока, их клинические проявления, основные методы и критерии диагностики, а также подходы к терапии. Подробно обсуждаются возможности профилактики данной патологии.
-
1.
Seifert H., Jansen B., Widmer A.F., Farr B.M. Central-venous catheters. In: Seifert H., Jansen B., Farr B.M., editors. Catheter-related infections. 2nd ed. New York: Marcel Dekker; 2004. p. 293-315.
-
2.
Mermel L.A., Farr B.M., Sherertz R.J., et al. Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 2001; 32:1249-1272.
-
3.
McGee D., Gould M. Preventing complications of central venous catheterization. N Engl J Med 2003; 348:1123-1133.
-
4.
Collin G. Decreasing catheter colonization through the use of an anticeptic-impregnated catheter. Chest 1999; 115:1632-1640.
-
5.
Berrington A., Gould’ F. Use of antibiotic lokcs to treat colonized central venous catheters. J Antimicrob Chemoter 2001; 48:597-603.
-
6.
O’Grady N., Alexander M., Dellenger E., et al. Gudelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2002; 35:1281-1307.
-
7.
Jarvis W. The evolving world of healthcare-associated bloodstream infection surveillance and prevention: is yor system as good as you think? Infect Contr and Hosp Epidem 2002; 23:842-844.
-
8.
Rodriguez-Bano J. Selection of empiric therapy in patients with catheter-related infections. Clin Microbiol Infect 2002; 8:275-281.
-
9.
Warren D., Zack J., Elward A., et al. Nosocomial primary bloodstream infections in intensive care unit patients in a nonteaching community medical center: a 21-month prospective study. Clin Infect Dis 2001; 33:1329-1335.
-
10.
Shah C., Mittelman M., Costerton J., et al. Antimicrobial ativity of novel catheter lock solution. Antimicrob Agent Chemother 2002; 46:1674-1679.
-
11.
Yoo S., Ha M., Choi D., Pai H. Effectiveness of surveillance of central catheter-related bloodstream infection in an ICU in Korea. Infect Control Hosp Epidemiol 2001; 22:433-436.
-
12.
Digiovine B., Chenoweth C., Watts C., Higgins M. The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J Resp Crit Care Med 1999; 160:976-981.
-
13.
Charbonneau P., du Cheyron D., Daubin C. Les defenses de l’organisme en reanimation. Available from: www.infectio-lille.com
-
14.
U.S. Department of Health and Human Services, Food and Drug Administration, Center of Drug Evaluation and Researsh. Guidelines for industry catheter-related bloodstream infections – developing antimicrobial drugs for treatment, october 1999. Available from: www.fda.gov
-
15.
Saint S., Savel R., Matthay M. Enhancing the safety of critically patients by reducing urinary and central venous catheter-related infections. Am J Resp Crit Care Med 2002; 165:1475-1479.
-
16.
Renaud B., Brun-Buisson C. Outcomes of primary and catheter-related bacteremia. Am J Resp Crit Care Med 2001; 163:1584-1590.
-
17.
Richards M., Edwards J., Culver D., Gaynes R. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med 1999; 27:887-92.
-
18.
Miller D., O’Grady N. Guidelines for the prevention of intravascular catheter-related infections: recommendations relevant to interventional radiology. J Vasc Intervent Rad 2003; 14:133-136.
-
19.
Chatzinikolaou I., Zipf T., Hanna H., et al. Minocycline -ethylenediaminetetraacetate lock solution for the prevention of implantable port infections in children with cancer. Clin Infect Dis 2003; 36:116-119.
-
20.
Crnich C., Maki D. The promise of novel technology for the prevention of intravascular device-related bloodstream infection. II. Long-term devices. Clin Infect Dis 2002; 34:1362-1368.
-
21.
Rijnders B., Wijngaerden E., Wilmer A., Peetermans W. Use of full sterile barrier precautions during insertion of arterial catheters: a randomized trial. Clin Infect Dis 2003; 36:743-748.
-
22.
Brun-Buisson C. New technologies and infection control practices to prevent intravascular catheter-related infections. Am J Resp Crit Care Med 2001; 164:1557-1558.
-
23.
Munoz P., Bouza E., San Juan R., et al. Clinical-epidemiological characteristics and outcome of patients with catheter-related bloodstream infections in Europe (ESGNI-006 Study). Clin Microbiol Infect 2004; 10:843-845.
-
24.
Crnich C., Maki D. The promise of novel technology for the prevention of intravascular device-related bloodstream infection. I. Pathogenesis and short-term devices. Clin Infect Dis 2002; 34:1232-1242.
-
25.
Raad I. Management of intravascular catheter-related infections. J Antimicrob Chemother 2000; 45:267-270.
-
26.
Walsh T., Rex J. All catheter-related candidemia is not the same: assessment of the balance between the risks and benefits of removal of vascular catheters. Clin Infect Dis 2002; 34:600-602.
-
27.
Farr B. Preventing vascular catheter-related infections: current сontroversies. Clin Infect Dis 2001; 33:1733-1738.
-
28.
Mermel L. Prevention of intravascular catheter-related infections. J Ann Intern Med 2000; 133:391-402.
-
29.
Sherertz R., Ely W., Westbrook D. Education of physicians-in-training can decrease the risk for vascular catheter infection. Ann Intern Med 2000; 132:641-648.
-
30.
Deshpande K., Hatem C., Ulrich H., et al. The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population. Crit Care Med 2005; 33:13-20.
-
31.
Bouza E., San Juan R., Munoz P., et al. A European perspective on intravascular catheter-related infections: report on the microbiology workload, aetiology and antimicrobial susceptibility (ESGNI-005 Study). Clin Microbiol Infect 2004; 10:838-842.
-
32.
Белобородов В.Б. Роль современных рекомендаций по профилактике инфекций, связанных с катетеризацией сосудов. Инфекции и антимикробная терапия 2002; 6:177-180.
-
33.
Под редакцией Венцель Р., Бревер Т., Бутцлер Ж-П. Руководство по инфекционному контролю в стационаре. Перевод с английского. Смоленск: МАКМАХ; 2003. стр. 18-20.
-
34.
Blot F. Diagnosis of catheter-related infections. In: Seifert H., Jansen B., Farr B.M., editors. Catheter-Related Infections. 2nd ed. New York: Marcel Dekker; 2004. p. 37-72.
-
35.
Сидоренко С.В. Инфекции, связанные с центральным венозным катетером. Инфекции и антимикробная терапия [электронная версия]. 2001; 2(3). www.consilium-medicum/media/infection.
-
36.
Safdar N., Maki D. The pathogenesis of catheter-related bloodstream infection with noncuffed short-term central venous catheters. Intensive Care Medecine 2004; 30:62-67.
-
37.
Finch R., Greenwood D., Norrby R., Whitley R., editors. Antibiotic and chemotherapy. 8th ed. Philadelphia: Churchill Livingstone; 2003. p. 588-594.
-
38.
Donlan R. Biofilm formation: a clinically relevant microbiological process. Clin Infect Dis 2001; 33:1387-1392.
-
39.
Lyte M., Freestone P., Neal C., et al. Stimulation of Staphylococcus epidermidis growth and biofilm formation by catecholamine inotropes. Lancet 2003; 361:130-135.
-
40.
Масчан А.А. Практический взгляд на проблему катетерных инфекций. Доступна на: URL: http://www.rusanesth.com/genan.
-
41.
Isenberg H. Essential procedures for clinical microbiology. ASM PRESS. Washington: ASM PRESS; 1998. p.678-683.
-
42.
Багирова Н.С. Диагностика бактериемии. Consilium-medicum. Инфекции. 2002; 1:46-53.
-
43.
Safdar N., Fine J., Maki D. Meta-analysis: methods for diagnosing intravascular device-related bloodstream infection. Ann Intern Med. 2005; 142:451-466.
-
44.
Franklin J., Gaur A., Shenep J., et al. In situ diagnosis of central venous catheter-related bloodstream infection without peripheral blood culture. Pediatr Infect Dis J 2004; 23:614-618.
-
45.
Raad I., Hanna H., Alakech B., et al. Differential time to positivity: a useful method for diagnosing catheter-related bloodstream infections. Ann Intern Med 2004; 140:18-25.
-
46.
Kite P., Dobbins B., Wilcox M. Rapid diagnosis of central venous catheter-related bloodstream infections without catheter removal. Lancet 1999; 354:1504-7.
-
47.
Worthington T., Lambert P., Elliott T. A novel serological test for the laboratory diagnosis of central venous catheter-associated sepsis. J Antimicrob Chemother 2000; 46:516.
-
48.
Nucci M., Anaissie E. Should vascular catheters be removed from all patients with candidemia? An evidence-based review. Clin Infect Dis 2002; 34:591-599.
-
49.
Sandoe J., Witherden I., Au-Yeung H., et al. Enterococcal intravascular catheter-related bloodstream infection: management and outcome of 61 consecutive cases. J Antimicrob Chemother 2002; 50:577-582.
-
50.
Viale P., Petrosillo N., Signorini L., et al. Should lock therapy always be avoided for central venous catheter-associated fungal bloodstream infections? Clin Infect Dis 2001; 33:1947-1948.
-
51.
Droste J., Jeraj H., MacDonald A., Farrington K. Stability and in vitro efficacy of antibiotic-heparin lock solutions potentially useful for treatment of central venous catheter-related sepsis. J Antimicrob Chemother 2003; 51:849-855.
-
52.
Poole C., Carlton D., Bimbo L., Allon M. Treatment of catheter-related bacteraemia with an antibiotic lock protocol: effect of bacterial pathogen. Nephrol Dial Transplant 2004; 19:1237-1244.
-
53.
De Gaudio A., Di Filippo A. Device-related infections in critically ill patients. Part 1: prevention of catheter-related bloodstream infections. J Chemother 2003; 5:419-427.
-
54.
Elliott T. Role of antimicrobial central venous catheters for the prevention of associated infections. J Antimicrob Chemother 1999; 43:441-446.
-
55.
Elliott T., Tebbs S. Prevention of CVC-related infection. J Hosp Infect 1998; 40:193-201.
-
56.
Gnass S., Barboza L., Bilicich D. Prevention of central venous catheter-related bloodstream infections using non-technologic strategies. Infect Control Hosp Epidemiol 2004; 25:675-677.
-
57.
Chaiyakunapruk N., Veenstra D., Lipsky B., Saint S. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta-analysis. Ann Intern Med. 2002; 136:792-801.
-
58.
Роль прозрачных пленочных наклеек «Тегадерм». http://cms.3m.com/cms/ru/ru/0-99.
-
59.
Vinjirayer A., Jefferson P., Ball D. Securing central venous catheters: a comparison of sutures with staples. Emerg Med J 2004; 21:582-583.
-
60.
O’Leary M., Bihari D. Central venous catheters-time for a change? Brit Med J 1998; 316:1918-1919.
-
61.
Veenstra D., Saint S., Saha S., et al. Efficacy of anticeptic-impregnated central venous catheters in preventing catheter-related bloodstream infection. JAMA 1999; 3:261-267.
-
62.
Darouiche R. Anti-infective efficacy of silver-coated medical prostheses. Clin Infect Dis 1999; 29: 1371-1377.
-
63.
Hanna H., Benjamin R., Chatzinikolaou., et al. Long-term silicon central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: a prospective randomized clinical trial. Journal Clinical Oncology 2004; 22:3163-3171.
-
64.
Leon C., Ruiz-Santana S., Rello J., et al. Benefits of minocycline and rifampin-impregnated central venous catheters. Intensive Care Medecine 2004; 30:1891-1899.
-
65.
Yucel N., Lefering R., Maegele M., et al. Reduced colonization and infection with miconazole-rifampicin modified central venous catheters: a randomized controlled clinical trial. J Antimicrob Chemother 2004;
-
66.
Schierholz J., Fleck C., Beuth J., Pulverer G. The antimicrobial efficacy of a new central venous catheter with long-term broad-spectrum activity. J Antimicrob Chemother 2000; 46:45-50.
-
67.
Bong J., Kite P., Wilco M., McMahon M. Prevention of catheter related infection by silver iontophoretic central venous catheters: a randomized controlled trial. J Clin Pathol 2003; 56:731-735.
-
68.
Walder B., Pittet D. Prevention of bloodstream infections with central venous catheters treated with anti-infective agents depends on catheter type and insertion time: evidence from a meta-analysis. Infect Control Hosp Epidemiol 2002; 23:748-756.
-
69.
McIntyre C., Hulme L., Taal M., Fluck R. Locking of tunneled hemodialysis catheters with gentamicin and heparin. Kidney Int 2004; 66:801-805.