Reviewed by Valeria Fabre, MD; Johns Hopkins University School of Medicine
This observational retrospective study evaluated the impact of early versus late reinsertion or no reinsertion among 316 patients with catheter-related bloodstream infection (CR-BSI) at 2 medical centers in Korea. CR-BSI was defined as matching cultures in peripheral and catheter tip without alternative explanation for bacteremia. Early central venous catheter (CVC) reinsertion was defined as CVC insertion within 3 days of CVC removal and delayed reinsertion as CVC reinsertion after 3 days of catheter removal. The clinical outcomes analyzed included: occurrence of persistent CRBSI, 30-day mortality, complicated infection and recurrence within 3 months of CR-BSI. Among 109 patients with catheter-related candidemia, there was a trend towards a higher rate of persistent candidemia in the early reinsertion group compared with the delayed CVC reinsertion group. Independent risk factors for persistent CR-BSI were methicillin-resistant S. aureus and presence of septic shock. These data support the current approach of late reinsertion of CVC for catheter-related candidemia and S. aureus bacteremia. The impact of timing for other bacteria could not be appropriately evaluated in this study due to sample size.
Lee Y-M, et al. (2020). Clinical impact of early reinsertion of a central venous catheter after catheter removal in patients with catheter-related bloodstream infections. Infection Control & Hospital Epidemiology, https://doi.org/10.1017/ice.2020.405