PREVENTION OF CENTRAL VENOUS CATHETER-RELATED INFECTION

Infections associated with central venous catheters continue to be a m ajor source of sepsis, particularly in hospitalized patients. In devel oping a strategy for the prevention of these infections; the source an d route of invasion of the causative micro-organisms need to be consid ered. The main source of micro-organisms is the patient's skin. They c an gain access to a catheter at the time of insertion, as well as via the external or internal catheter surfaces. Attempts to reduce the inc idence of infections range from the type of skin preparation selected, to care of the insertion site post-catheterization. Improvements in c atheter design have also reduced the likelihood of infection and inclu de the development of non-leachable smooth catheters with anti-adhesiv e coatings. More recently, catheters containing antimicrobial agents h ave become available and preliminary studies have demonstrated a reduc tion in microbial colonization and associated sepsis. Future preventat ive strategies may include the application of low voltage electric cur rent in combination with antimicrobials.