protocol : Catheter Related Bloodstream Infection
CLABSI.pdf
-
content:
Definitions: Infection that originates from or is related to a central venous catheter.
Microbiology testing: Paired blood cultures, drawn from the catheter and a peripheral vein should be obtained prior to initiation of antimicrobial therapy. The line should be removed and catheter cultures should be performed when a catheter is removed for suspected CRBSI but should not otherwise be obtained routinely.
Location Common microbiology Preferred empiric therapy Potential alternatives Comments All inpatient settings S. aureus
coagulase-negative staphylococci
Enterobacterales
Klebsiella spp.
E. coli
Enterobacter spp.Pseudomonas aeruginosa
Enterococci
*Candida spp.cefepime 2g IV Q8H
PLUS
vancomycin
meropenem 1g IV Q8H
PLUS
vancomycin
*Empiric therapy targeting catheter-related candidemia may be appropriate for select patients with suspected line-associated sepsis and any of the following risk factors:
• TPN
• Prolonged broad-spectrum antibiotics
• Hematologic malignancy or SCT
• Solid organ transplant
• Femoral catheterization
• Candida colonization at multiple sitesSuggest discussion with ID (PIC 1369 or 1205) or Antimicrobial Stewardship (PIC 1337).
CONSIDER:
*micafungin 100mg IV Q24HDosing recommendations in renal insufficiency.
More detailed guidance can be found in practice guidelines from the IDSA.