Chicago Journals - Clinical Infectious Diseases

Clinical Infectious Diseases 2010;51:335–341
This article is in the public domain, and no copyright is claimed.
1058-4838/2010/5103-0014
DOI: 10.1086/653942
HEALTHCARE EPIDEMIOLOGY
INVITED ARTICLE Preventing Catheter‐Related Bloodstream Infections outside the Intensive Care Unit: Expanding Prevention to New Settings
Alexander J. Kallen,1
Priti R. Patel,1 and
Naomi P. O’Grady2

1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and 2Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland

With the growing recognition of the preventability of catheter‐related bloodstream infections (CRBSIs), reducing the number of CRBSIs acquired in health care facilities has become an important patient safety goal. To date, most prevention efforts have been conducted in intensive care units (ICUs); however, many central venous catheters (CVCs) are found outside the ICU, and rates of catheter‐associated bloodstream infections in these settings appear to be similar to rates of these infections in ICUs. CVCs are also used in patients who primarily receive their care as outpatients, including those requiring hemodialysis, undergoing treatment for malignancies, and receiving parenteral nutrition. In some of these patients, CVCs might be used for extended periods, prolonging the patient’s time at risk for CRBSIs and highlighting the potential need to look beyond insertion‐based interventions to prevent infections. To meet the goal of reducing the number of all CRBSIs associated with health care, further attention on CRBSIs occurring outside the ICU is needed; however, this effort will require a better understanding of the epidemiology and prevention of these infections.

Received 29 January 2010; accepted 20 April 2010; electronically published 23 June 2010.

Reprints or correspondence: Alexander J. Kallen, 1600 Clifton Rd, MS A‐35, Atlanta, GA 30333 (AKallen@cdc.gov).
Robert A. Weinstein, Section Editor

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Chicago Journals - Clinical Infectious Diseases


1 August 2010
Volume 51, Issue 3
On the cover: "A Traveling Medicine Vendor," etching 1635. Rembandt Harmenszoon van Rijn. Wellcome Library, London. Reproduced with permission. In 17th-century Europe, treatment for infectious diseases was provided by a variety of practitioners, including university-trained physicians, barber-surgeons, apothecaries, and peddlers selling their wares. The remedies hawked on the street would have included lotions, potions, and plants, both domestic and exotic. Examples of plants favored as remedies during the 17th century may be seen in the book, The English Physitian, by Nicholas Culpeper (1616 - 1654), in which the author describes a contemporary, early 1600s selection of defenses against disease, including the mixture of water horsetail, with the leaves of another plant called adder's tongue, "as a singular remedy for all manner of wounds." The unidentified object held in the fingers of this peddler may be just about anything, but his sale likely depended on his power to convince the buyer of the purported efficacy of the product. Rembrandt (1606 - 1669), widely considered a giant in the history of art, was known for his oil paintings, sketches, and etchings on a wide range of subjects. While painting in both Leiden and Amsterdam, he received numerous commissions for portraits, as well as for paintings of religious subjects, and lived the life of a wealthy, respected citizen of his community. During the 1630s and 1640s, he completed most of his quieter studies of landscapes and of genre figures, such as that of this street vendor, which must have been a common sight in his day. (Mary and Michael Grizzard, cover-art editors)