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Question 10#

What is FALSE regarding intravascular catheter infections?

A. Selected low-virulence infections can be treated with a prolonged course of antibiotics
B. In high-risk patients, prophylactic antibiotics infused through the catheter can reduce rate of catheter infections
C. Bacteremia with gram-negative bacteria or fungi should prompt catheter removal
D. Many patients with intravascular catheter infections are asymptomatic

Correct Answer is B

Comment:

Many patients who develop intravascular catheter infections are asymptomatic, often exhibiting solely an elevation in the WBC count. Blood cultures obtained from a peripheral site and drawn through the catheter that reveal the presence of the same organism increase the index of suspicion for the presence of a catheter infection. Obvious purulence at the exit site of the skin tunnel, severe sepsis syndrome due to any type of organism when other potential causes have been excluded, or bacteremia due to gram-negative aerobes or fungi should lead to catheter removal. Selected catheter infections due to lowvirulence microbes such as Staphylococcus epidermidis can be effectively treated in approximately 50 to 60% of patients with a 14- to 21-day course of an antibiotic, which should be considered when no other vascular access site exists. Use of systemic antibacterial or antifungal agents to prevent catheter infection is of no utility and is contraindicated.