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IOS 10 Exam 4
Catheter related infections
| Question | Answer |
|---|---|
| Risk Factors for catheter related infections | Immunocompromised patients, advanced age, type location of catheter, duration of catheter, number of manipulations, frequency, hygine of catheter |
| Pathogensis of catheter related infections | Fluids inserted into patient, The outer hub (infected), aact of actual insertion, placement of the device, secondary infectio |
| Common pathogens associated with catheter infections | Coag (-) staph, staph aureus, staph epi, enterococcus, Gram- bacilli (enteric, pseudomonias), fungi |
| Evaluate the patient for need of antibiotics therapy | Location of catheter, signs of infection, other sources of infection (UTI), patient specifics, current medication (superinfection), culutres (tip, intra-luminal) |
| Prevention of catheter related infection | Catheter placement and handeling, aseptic insertion, hygine, antibiotic locks and flushes, antibiotics impregnated cathters- (minocycline + rifampin or Chlorhexidine+ silver sulfadiazine) |
| If infection is caused by Coagulase negative Staph treat with | Vancomycin + retain catheter (10-14 days), or if remove (5-7days) |
| If infection is caused by Staphylococcus aureus treat with | Nafcillin 2 g q 4 hr (Vancomycin or Cefazolin if sensitivity known) 10-14 days |
| If patient presents with Gram -enterbacteriae treat with | Must cover pseudomonias: Pipercillin, ceftazidine, cefepime, aminoglycosides, carbapenems 10-14 days |
| If patient presents with a Fungal infection treat with | Fluconazole 400-600mg QD |
| If patient presents with Caspofungin treat with | Voriconazole, ampotercin B 14 days past last blood culture |