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

Anna Lisa Crowley, Gail E. Peterson, Daniel K. Benjamin, Susan H. Rimmer, Cindy Todd, Christopher H. Cabell, L. Barth Reller, Thomas Ryan, G. Ralph Corey, Vance G. Fowler

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

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 (≤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.

Original languageEnglish (US)
Pages (from-to)385-390
Number of pages6
JournalCritical Care Medicine
Volume36
Issue number2
DOIs
Publication statusPublished - Feb 2008

    Fingerprint

Keywords

  • Catheter-related Staphylococcus aureus bacteremia
  • Thrombosis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this