Infectious Disease
Catheter-Associated Bloodstream Infection / Line Sepsis
Recognise CRBSI, paired peripheral + line cultures, line removal threshold, antimicrobial choice by organism.
Source: IDSA 2009; ESCMID 2018
Used in: Sepsis
Step 1 of ~3
info
Recognise
Suspect CRBSI in any patient with central venous catheter / port / haemodialysis catheter + fever / sepsis without other source. Local signs (purulence, erythema) absent in many.
• Take paired blood cultures: peripheral + each line lumen, BEFORE antibiotics, with simultaneous timing labelled.
• Differential time to positivity: line ≥2h before peripheral suggests CRBSI.
• Quantitative cultures or paired (line:peripheral) ratio ≥3:1 also diagnostic.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Unfractionated Heparin (Peripheral/Central Line Flush) · Anticoagulant flush / catheter maintenance
- Alteplase (Peripheral Arterial / DVT Use) · Thrombolytic — Catheter-Directed Thrombolysis / Peripheral Arterial Occlusion
- Dapsone · Anti-inflammatory / Antimicrobial
- Silver Sulfadiazine 1% Cream · Topical antimicrobial (silver-sulfonamide)
- Sulfadiazine silver · Topical antimicrobial (sulfonamide + silver)
- Emollient bath and shower products, antimicrobial-containing · Antimicrobial bath emollient (benzalkonium / chlorhexidine / triclosan)
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023
Decision support only. Always apply local guidelines and clinical judgement.