Infections of vascular lines, or catheter-related infections, pose a serious risk in healthcare settings, occurring when microbes enter the bloodstream through catheter insertion sites. Symptoms include localized pain, redness, and systemic signs like fever. Prevention relies on strict aseptic procedures during catheter insertion and prompt removal of unnecessary catheters. Treatment involves targeted antibiotics, and in severe cases, removal of the infected catheter is necessary. Swift management is crucial to prevent complications and safeguard patient well-being. Vascular catheter infections, or catheter-related bloodstream infections (CRBSIs), arise when bacteria or fungi infiltrate the bloodstream through a catheter. Common pathogens include Staphylococcus species and Candida, with risks escalating in cases of prolonged catheterization, compromised immune systems, and suboptimal catheter care. Clinical manifestations involve fever, local pain, and positive blood cultures. Diagnosis hinges on blood cultures and imaging studies, while treatment necessitates prompt catheter removal and targeted antimicrobial therapy. Prevention strategies encompass strict aseptic techniques during catheter management, vigilant monitoring, and consideration of specialized catheters. Vascular catheter infections demand timely intervention to mitigate complications and safeguard patient well-being.

1. Sajid Zubair Malik
Lecturer
MSN*(UOL), MPH(GCUF), BSc. N Gen (DUHS),
IPCD (IHHN.PKLI & RC),CNI, RN, NI (NLIN)
Pakistan Kidney and Liver Institute & Research Center (PKLI & RC)
Preventing
Intravascular Catheter-related Infections

2. To reduce the
“RISK” of
infection
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3. Endogenous Infections:
•These infections arise from microorganisms that are
already present in or on the body.
•Individual’s normal flora but can become harmful under
certain conditions.
•A person’s immune system is compromised, these
normally harmless microorganisms might cause infections.
2. Exogenous Infections:
•Results from microorganisms that come from outside the
body.
•External environment, other people, or contaminated
objects.
•Respiratory infections transmitted through the air or
gastrointestinal infections caused by consuming
contaminated food or water.
3. Iatrogenic Infections:
•Result from medical interventions or treatments.
•Procedures, surgeries, or the use of medical devices.
•Hospitals and healthcare settings

4. Infection Across
Natural Interfaces
Between the body and
micro-organisms
• Skin
• Airway, sinuses and lungs
• GI tract
• Urinary tract and kidneys
4

5. Sources Of
Hospital-
acquired
Bacteraemia
5

6. Peripheral
vascular
catheter(PVCs)
are risk for BSI
• At any one time 61% of hospital
patients were found to have a
peripheral intravenous cannula
or catheter in place
•1.9% of all hospital-acquired
infections in the Uk
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7. Central Vascular
Catheter(CVCs) are
risk for BSI
•>5 million CVCs annually
•Mortality> 25%
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8. • Coagulase-negative
staphylococci (35%)
• Staphylococcus Aureus
The Second Most
Common (25%)
Organisms
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9. Blood-stream
Infection (BSI)
Approx. 20% Of Bsis Are Caused By
Hematogenous Spread From Other Body
Sites
Urinary Tract
Wound
Infection
Respiratory
Tract
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11. INTRINSIC SOURCES
(Present prior to use)
3 Stages in the life of
infusion products during
which contamination
can occur
During
Manufacture
and Packaging
Transport and Storage
Usage
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12. Prevention of
infections
INTRINSIC SOURCES
Action
Visual Inspection
A vital part
Observe for leakage:
•~ Pinhole leaks in PVC bags
•~ Cracks in glass bottles
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13. EXTRINSIC
SOURCES
(Introduced in use)
Bacterial migration from
patient’s skin/infected
sites/contaminated IV fluid
Poor asepsis/staff’s
hands/disinfectants
IV drug incompatibility/additives Line/filter
changes/insertion/manipulation
of device
Reflux of micro-
organisms/retrograde contamination
13

14. Drip Site
Infection
Hands of Health
care providers
Patient’s own skin
and flora
Hub contamination
Catheter
contamination on
insertion 14

15. How
infection
presents
itself?
Local site
infection
Inflammatio
n of the vein
(phlebitis)
Bacteraemia
and
Septicaemia
Catheter
colonisation
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16. Peripheral Intravenous Cannula Care Bundle
High Impact Intervention(HII)
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19. References Department of Health (2003) “Winning Ways” Working together to reduce Healthcare
Associated Infection in England (Report from CMO)
Emmerson, A.M. et al. The second national prevalence survey of infection in hospital:
overview of results. Journal of Hospital Infection (1996) 32: 3, 175-190.
HCA Control of Infection Manual www.infectioncontrolservices.co.uk
Maki, D.G. and Ringer, M. (1987) Evaluation of dressings regimens for prevention of
infection with peripheral venous catheters. J. Am. Med. Ass., 285, 2396-403
Weightman N.C et al (1988) Bacteraemia related to indwelling central venous catheters:
prevention diagnosis and treatment. Eur. J. of Clin. Microbiol. and Inf. Dis., 7, 125-129
Little et al. Gloves to fit the bill. Nursing Times (1999) Vol 95 No20, 57-58
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