Venous thrombosis in patients with short- and long-term central venous catheter-associated Staphylococcus aureus bacteremia.

Published

Journal Article

OBJECTIVE: Infection and thrombosis are important complications of intravascular catheters. The purpose of this study was to determine the incidence of thrombosis in patients with central venous catheter-associated Staphylococcus aureus bacteremia and the utility of physical examination for diagnosing upper extremity or neck venous thrombosis. DESIGN: Prospective observational cohort. SETTING: Tertiary care facility. PATIENTS: In all, 65 consecutive patients with catheter-associated S. aureus bacteremia with central venous catheters of the internal jugular, brachial, or subclavian veins were eligible for participation. INTERVENTION: From July 1999 through August 2004, enrolled patients underwent physical examination and ultrasonography independently to identify the presence of catheter-associated thrombosis. Study ultrasonograms were interpreted blindly using defined criteria. Outcomes were defined at 12-wk follow-up. MEASUREMENTS AND MAIN RESULTS: A total of 48 patients were enrolled. By ultrasonography, definite or possible thrombosis was present in 34 of 48 patients (71%) in this cohort. Death or recurrent bacteremia occurred in 11/34 (32%) infected patients with thrombosis and two of 14 (14%) infected patients without thrombosis (p = .29). Sensitivity of all physical examination findings, either alone or in combination, was low (< or = 24%). Only engorged veins upon hand elevation and the presence of multiple physical examination abnormalities were specific (100% each). CONCLUSIONS: Thrombosis is a common complication of central venous catheter-associated S. aureus bacteremia. Patients with central venous catheter-associated S. aureus bacteremia should undergo ultrasonography to detect thromboses even if the physical examination is normal.

Full Text

Duke Authors

Cited Authors

  • Crowley, AL; Peterson, GE; Benjamin, DK; Rimmer, SH; Todd, C; Cabell, CH; Reller, LB; Ryan, T; Corey, GR; Fowler, VG

Published Date

  • February 2008

Published In

Volume / Issue

  • 36 / 2

Start / End Page

  • 385 - 390

PubMed ID

  • 18091541

Pubmed Central ID

  • 18091541

Electronic International Standard Serial Number (EISSN)

  • 1530-0293

International Standard Serial Number (ISSN)

  • 0090-3493

Digital Object Identifier (DOI)

  • 10.1097/01.ccm.0b013e3181611f914

Language

  • eng