How to manage central venous catheter-related bloodstream infections due to Gram-negative bacilli?

• Published in: Current opinion in infectious diseases Vol. 35; no. 6; pp. 583 - 588
• Main Authors: San-Juan, Rafael, Ruiz-Ruigómez, María, Aguado, José María
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-12-2022
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacteremia - drug therapy; Catheter-Related Infections - drug therapy; Central Venous Catheters; Gram-Negative Bacteria; Humans; Staphylococcus aureus
• ISSN: 0951-7375; 1473-6527
• DOI: 10.1097/QCO.0000000000000855

The aim of this study was to review recent data evaluating the management of central venous catheter-related bloodstream infection due to Gram-negative bacilli (GNB).
The incidence of GNB catheter-related bloodstream infection (CRBSI) has been increasing considerably in the last years, and this has raised a concern due to the high reported rate of multidrug-resistant in these infections what poses a considerable challenge for effective treatment. However, there are no specific guidelines for the management of GNB-CRBSI and optimal treatment duration has not been clearly defined. Recent studies have shown that the risk for complications is clearly different to what is stablished for Staphylococcus aureus . Therefore, a short course of antibiotic therapy might be effective once the central venous catheter (CVC) has been removed and the monitoring complications through control blood cultures or echocardiography seem to be less helpful in GNB CRBSI.
The incidence of GNB CRBSI has been increasing considerably in the last years; this has raised a concern due to the high reported rate of MDR in these infections what poses a considerable challenge for effective treatment. However, there are no specific guidelines for the management of GNB-CRBSI and optimal treatment duration has not been clearly defined. Recent studies have shown that the risk for complications is clearly different to what is stablished for S. aureus . Therefore, a short course of antibiotic therapy might be effective once the CVC has been removed and the monitoring complications through control blood cultures or echocardiography seem to be less helpful in GNB-CRBSI.