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Central catheter infections: Single- versus triple-lumen catheters

Influence of guide wires on infection rates when used for replacement of catheters
  • Eileen Hilton
    Correspondence
    Requests for reprints should be addressed to Dr. Eileen Hilton, Division of Infectious Diseases, Long Island Jewish Medical Center, New Hyde Park, New York 11042.
    Affiliations
    Division of Infectious Diseases, Department of Medicine, the Division of Microbiology, the Division of Biostatistics, and the Department of Pharmacy, Long Island Jewish Medical Center, New Hyde Park, New York, USA

    State University of New York at Stony Brook, Stony Brook, New York, USA
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  • Theresa M. Haslett
    Affiliations
    Division of Infectious Diseases, Department of Medicine, the Division of Microbiology, the Division of Biostatistics, and the Department of Pharmacy, Long Island Jewish Medical Center, New Hyde Park, New York, USA

    State University of New York at Stony Brook, Stony Brook, New York, USA
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  • Michael T. Borenstein
    Affiliations
    Division of Infectious Diseases, Department of Medicine, the Division of Microbiology, the Division of Biostatistics, and the Department of Pharmacy, Long Island Jewish Medical Center, New Hyde Park, New York, USA

    State University of New York at Stony Brook, Stony Brook, New York, USA
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  • Victor Tucci
    Affiliations
    Division of Infectious Diseases, Department of Medicine, the Division of Microbiology, the Division of Biostatistics, and the Department of Pharmacy, Long Island Jewish Medical Center, New Hyde Park, New York, USA

    State University of New York at Stony Brook, Stony Brook, New York, USA
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  • Henry D. Isenberg
    Affiliations
    Division of Infectious Diseases, Department of Medicine, the Division of Microbiology, the Division of Biostatistics, and the Department of Pharmacy, Long Island Jewish Medical Center, New Hyde Park, New York, USA

    State University of New York at Stony Brook, Stony Brook, New York, USA
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  • Carol Singer
    Affiliations
    Division of Infectious Diseases, Department of Medicine, the Division of Microbiology, the Division of Biostatistics, and the Department of Pharmacy, Long Island Jewish Medical Center, New Hyde Park, New York, USA

    State University of New York at Stony Brook, Stony Brook, New York, USA
    Search for articles by this author
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      Abstract

      A prospective study was conducted over six months to determine if triple-lumen catheters were associated with a higher rate of infection than single-lumen catheters. A total of 502 central intravascular catheters were prospectively collected from 362 consecutive patients in the adult intensive care units. Semiquantitative and broth cultures were performed on distal and proximal catheter segments, with peripheral blood culture specimens drawn in febrile patients. The overall infection rate for the 502 catheters was 11.8 percent or 2.2 infections per 100 days at risk. The infection rates were: single-lumen lines, 8 percent; triple-lumen lines, 32 percent; and triple-lumen pulmonary artery catheters, 12 percent. When corrected for time at risk, the triple-lumen lines and the triple-lumen pulmonary artery catheters had the same rate of infection, which was three times greater than that of the single-lumen catheters. After correction for confounding variables such as the presence of diabetes mellitus, the use of hyperalimentation, the degree of illness, dialysis, or ultrafiltration, and the use of a guide wire to place a replacement line over a pre-existing one, the risk of infection remained significantly higher for triple-lumen than for single-lumen catheters. The use of a guide wire to place a new line over an old one also was associated with a trend towards an increased risk of infection.
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