Prevention of central venous catheter-related blood stream infection

Abstract

In 2006, Pronovost et al recommended five bundle approaches to prevent catheter-related blood stream infection (CRBSI). These include 1) hand hygiene before catheter insertion, 2) maximal sterile barrier precautions (MSBP) when inserting the central venous catheter (CVC), 3) skin hygiene using 2% chlorhexidine before CVC insertion, 4) avoid the femoral vein for CVC insertion, and 5) remove catheters when unnecessary. These approaches have been strongly advocated in the United States of America. However, our randomized controlled trial conducted in Japan did not reveal the efficacy of MSBP. Evidence regarding prevention of CRBSI remains controversial. This review focuses on multifarious aspects of the evidence regarding the prevention of CRBSI.