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Master Thesis

Évaluation de la prise en charge des bactériémies liées aux dispositifs veineux centraux : impact du suivi des recommandations sur le pronostic

Abstract : Background: Infection is a major complication associated with the use of central venous catheters. Guidelines for medical management of catheter-related bacteraemia have been published, but no study has assessed the appropriateness of physician practices. Methods: The medical practices in cases of catheter-related bacteraemia (CRB) were investigated in a university hospital over a period of 12 months and their management was evaluated. All cases of positive blood cultures based on central venous catheter sampling were analysed, and episodes of CRB were determined in this group of patients. Medical management and patient outcome were analysed independently by two physicians. Results: 187 cases of positive blood culture were recorded and 91 cases of CRB were analysed. Systemic antimicrobial therapy was optimal in 56% of the episodes. In 51 episodes, catheter salvage was attempted, for 29 with an indication in agreement with the guidelines but without antibiotic lock therapy in 20 episodes. The overall medical management was appropriate in 41.8% of the episodes. The overall cure rate was 72.5%. CRB-related death occurred in 5.5% of the episodes. Cure was associated with compliance to the guidelines (p = 0.03) and with adaptation of the systemic antimicrobial therapy (p < 0.01). Conservative treatment success was associated with compliance with the guidelines for the indication (p = 0.01). Conclusion: Medical management of CRB did not closely adhere to the international guidelines. CRB outcome was associated with the appropriateness of this management, particularly when conservative treatment was attempted.
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Master Thesis
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Submitted on : Tuesday, February 7, 2012 - 2:52:52 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Thursday, November 22, 2012 - 11:10:40 AM


  • HAL Id : dumas-00667363, version 1
  • PPN : 158259254


Claire Wintenberger-Guillet. Évaluation de la prise en charge des bactériémies liées aux dispositifs veineux centraux : impact du suivi des recommandations sur le pronostic. Human health and pathology. 2012. ⟨dumas-00667363⟩



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