Pathogenesis of catheter sepsis: a prospective study with quantitative and semiquantitative cultures of catheter hub and segments

Abstract

The purpose was to study prospectively the causes, routes of infection and frequency of catheter-related sepsis in patients on total parenteral nutrition. From Jan. 1981 to Jan. 1984, cultures of 135 subclavian catheters from 135 adult patients were done by quantitative and semiquantitative methods. Twenty patients (14.8%) had catheter-related sepsis. Fourteen episodes (70%) stemmed from a colonized hub. Skin infection (Staphylococcus aureus, 2 cases), total parenteral nutrition mixture contamination (Enterobacter cloacae, 2 cases) and hematogenous seeding of the catheter tip (Yersinia enterocolitica, 1 case, and Streptococcus faecalis, 1 case) accounted for the remaining 6 septic episodes. The catheter hub apparently is the most common site of origin of organisms causing catheter tip infection and bacteremia.