The prevention and management of device-related infection in infusion therapy.

Thirty-three nosocomial outbreaks of infusion-related septicemia since 1965 have dramatically pointed up the microbiologic hazards of infusion therapy. At least 25,000 patients develop device-related septicemia in the United States each year, but the source of many of these bacteremias is never recognized. Most infusion-related septicemias, including those in hyperalimentation, originate from the device used for vascular access. Epidemics stem from infusate contaminated by Klebsielleae species or pseudomonads, either from a source in the hospital or in the manufacturing plant. Device-related infection in infusion therapy can be greatly prevented by scrupulous attention to local asepsis and by limiting the duration of cannulation of peripheral veins (less than or equal to 3 days) and arteries (less than or equal to 4 days).