Probable: Defervescence of symptoms after antibiotic therapy with or without removal of the catheter, in the setting in which BC confirms infection, but catheter tip does not (or catheter tip does, but blood does not) in a symptomatic patient with no other apparent source of infection. Metastatic infectious complications of CRBSIs include endocarditis, osteomyelitis, spinal epidural abscess, septic arthritis, brain abscess, and septic pulmonary emboli.ĭefinite: Same organism from a semiquantitative culture of the catheter tip (>15 CFU/catheter segment) and from a BC in a symptomatic patient with no other apparent source of infection. 6 Gram-negative organisms cause 20% to 40% CRBSIs, whereas polymicrobial infections (10%-20%) and fungal infections (<5%) are less common. 2 - 5 The most common causative pathogens are gram-positive bacteria, with Staphylococcus aureus and coagulase-negative staphylococci accounting for 40% to 80% of CRBSIs. Catheter-related bloodstream infections (BSIs) alone have a reported incidence of 1.1 to 5.5 episodes per 1000 catheter days and are associated with increased morbidity, hospitalization, and death. 1 Catheter-related bloodstream infections (CRBSIs), exit-site infections, and tunnel infections are common complications related to hemodialysis central venous catheter use. Hemodialysis patients with a catheter have a 2- to 3-fold increased risk of hospitalization for infection and death compared with patients with an arteriovenous fistula or graft. Infections are common complications among patients on chronic hemodialysis.
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