Final answer:
The most common route for catheter-related bloodstream infection (CRBSI) is the contamination of the catheter tip by skin organisms during insertion. The formation of biofilms makes the infections resistant to treatment. Preventative measures include strict aseptic techniques and regular catheter assessment.
Step-by-step explanation:
The most common route for causing a catheter-related bloodstream infection (CRBSI) is catheter tip contamination due to skin organisms encountered during insertion. When a central venous catheter is inserted, the surrounding skin flora, which may include organisms such as Staphylococcus epidermidis and Staphylococcus aureus, can contaminate the catheter's tip or the insertion site. Over time, these organisms can form a biofilm, making the infection resistant to antibiotics and increasing the risk of the bacteria entering the bloodstream.
Preventing catheter-related infections is crucial, considering the high prevalence of CRBSIs and associated mortality rates. Risk can be minimized through strict adherence to aseptic techniques during catheter insertion and maintenance, regular assessment of the necessity of the catheter, and employing antimicrobial catheters or antibiotic lock solutions when appropriate.
Infections can also occur through extra-luminal routes. This involves organisms from the patient's skin migrating along the outside of the catheter into the bloodstream or from infections in another part of the body traveling to the catheter tip. However, these routes are less common compared to contamination at the time of catheter insertion.
If a patient develops signs of a CRBSI, such as fever or infection at the catheter site, it is crucial to perform blood cultures and assess the catheter. If the same microorganism grows from blood cultures and catheter cultures, the diagnosis of CRBSI can be confirmed, and the catheter usually needs to be removed. After removal, appropriate antimicrobial therapy should be initiated based on culture sensitivities.