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Infection associated with central venous or epidural catheters: how to reduce it?

机译：与中央静脉或硬膜外导管相关的感染：如何减少？

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PURPOSE OF REVIEW: Central venous catheters are a leading source of nosocomial bloodstream infection with an estimated 10% mortality. Infection associated with epidural catheterization is an uncommon but devastating complication. Diagnosis of spinal epidural abscess requires a high index of suspicion and imaging techniques such as MRI. Early diagnosis and treatment will minimize permanent damage, but primary prevention should be the aim, which depends on proper patient evaluation and use of full aseptic precautions. RECENT FINDINGS: Recent studies suggest that epidural infection is no longer as rare a complication as once thought and may be increasing. It is not clear whether this increase is related to an increase in reporting, an overall increase in the total number of epidurals (especially extended use) being performed, or a true increase in infection rate. Implementation of multistep prevention programs has been shown to decrease central venous catheter-related bloodstream infection rate. Antiseptic or antibiotic-impregnated central venous catheters are effective in decreasing central venous catheter-related bloodstream infections. SUMMARY: Healthcare worker education and training are essential to create standardization of aseptic care. Continuous surveillance is necessary for identifying lapses in infection-control practices.
机译：审查目的：中央静脉导管是医院血液感染的主要来源，估计死亡率为10％。与硬膜外导管插入术相关的感染是一种罕见但破坏性的并发症。脊髓硬膜外脓肿的诊断需要高度怀疑和影像学检查技术，例如MRI。早期诊断和治疗将最大程度地减少永久性损害，但首要目标是预防，这取决于对患者的正确评估和充分的无菌预防措施的使用。最近的发现：最近的研究表明，硬膜外感染不再像以前想象的那样罕见，并且可能正在增加。目前尚不清楚这种增加是否与报告的增加，正在执行的硬膜外麻醉术的总数（特别是长期使用）的总体增加或感染率的真正增加有关。已经表明，实施多步骤预防计划可以降低中心静脉导管相关的血液感染率。防腐剂或抗生素浸渍的中央静脉导管可有效减少与中央静脉导管相关的血液感染。简介：医护人员的教育和培训对于建立无菌护理的标准化至关重要。持续监视对于确定感染控制措施的失误是必要的。

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