CDC Updates Guidelines for the Prevention of Catheter-Related Infection

Updated guidelines for the prevention of bloodstream infections in patients with IV catheters were released by the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). These catheter-related bloodstream infections (CRBSIs) are known to be costly to the healthcare system, and sometimes are deadly for patients.

The updated "Guidelines for the Prevention of Intravascular Catheter-Related Infections" are available online at http://www.cdc.gov/ncpdcid/pdf/Draft_BSI_guideline_v15_2FR.pdf and will be published in a special supplement to the American Journal of Infection Control. The updated guidelines were developed by a working group led by the Society of Critical Care Medicine, in collaboration with the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, Surgical Infection Society, American College of Chest Physicians, American Thoracic Society, American Society of Critical Care Anesthesiologists, Association for Professionals in Infection Control and Epidemiology, Infusion Nurses Society, Oncology Nursing Society, American Society for Parenteral and Enteral Nutrition, Society of Interventional Radiology, American Academy of Pediatrics, Pediatric Infectious Diseases Society, and the CDC Healthcare Infection Control Practices Advisory Committee.

The primary change in the guidelines is the addition of recent research findings that support evidence-based practice. Major areas of clinical interest include 1) educating and training healthcare personnel who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters and chlorhexidine impregnated sponge dressings if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also emphasize performance improvement by implementing bundled strategies, documenting and reporting rates of compliance rates with all components of the bundle as benchmarks for quality assurance and performance improvement. As in previous guidelines issued by CDC and HICPAC, each recommendation is categorized on the basis of existing scientific data, theoretical rationale, applicability, and economic impact.