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Infectious Diseases

Answer 5
  1. Guidewire exchange of malfunctioning catheter if no signs of infection. Evidence-based guidelines have been published for the prevention of CVC infections.5 In general, healthcare worker education and training, surveillance for CVC infections, hand hygiene, aseptic technique during insertion, and care of the CVC form the basis of infection prevention. Routine replacement of the CVC in order to prevent infection is not recommended. The culturing of all catheter tips in the absence of features of CVC infection or bacteremia is not useful. The use of antimicrobial impregnated CVC is recommended only if all other prevention strategies fail and the CVC is likely to remain in place for more than 5 days. Guidewire exchange of infected CVC is not recommended; however, malfunctioning CVC in the absence of infection can be replaced over a guidewire.

     O’Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. MMWR Recomm Rep 2002;51(RR-10):1-29.

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