Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy
<b>Introduction</b>: Vascular access device (VAD)-associated infections, including catheter-related (CRBSI) and catheter-associated bloodstream infections (CABSI), present significant challenges in patient care. While multidisciplinary VAD teams (VATs) are equipped with protocols for man...
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2025-01-01
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| Online Access: | https://www.mdpi.com/2079-6382/14/1/27 |
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| author | Marta Colaneri Lucia Galli Martina Offer Fabio Borgonovo Giovanni Scaglione Camilla Genovese Rebecca Fattore Monica Schiavini Giovanni De Capitani Maria Calloni Arianna Bartoli Antonio Gidaro Chiara Cogliati Spinello Antinori Andrea Gori Antonella Foschi |
| author_facet | Marta Colaneri Lucia Galli Martina Offer Fabio Borgonovo Giovanni Scaglione Camilla Genovese Rebecca Fattore Monica Schiavini Giovanni De Capitani Maria Calloni Arianna Bartoli Antonio Gidaro Chiara Cogliati Spinello Antinori Andrea Gori Antonella Foschi |
| author_sort | Marta Colaneri |
| collection | DOAJ |
| description | <b>Introduction</b>: Vascular access device (VAD)-associated infections, including catheter-related (CRBSI) and catheter-associated bloodstream infections (CABSI), present significant challenges in patient care. While multidisciplinary VAD teams (VATs) are equipped with protocols for managing these infections, adherence to these guidelines in real-life practice is inconsistent. This study aims to evaluate the alignment between actual VAD infection management practices and VAT-recommended protocols. <b>Methods</b>: We conducted a retrospective, single-center study at Luigi Sacco Hospital (May 2021–October 2023) involving non-ICU adult patients with diagnosed CRBSI or CABSI. VAT experts independently reviewed infection management choices, which were divided into eight specific procedural options. These options included variations in VAD removal, timing of repositioning, and combinations of antimicrobial lock therapy and systemic therapy. Concordance between real-life practices and VAT recommendations was evaluated using Cohen’s kappa coefficient. <b>Results</b>: Of 2419 VAD placements, 146 (6%) developed infections (84 CABSI, 62 CRBSI). Clinicians removed VADs in 66.4% of cases compared to 62.3% per VAT recommendations, with moderate overall agreement (Cohen’s kappa = 0.58). Analysis of the eight management categories revealed moderate to low alignment (unweighted kappa = 0.44, weighted kappa = 0.30) between real-life practices and VAT guidance, with slightly improved concordance in CRBSI cases. <b>Conclusions</b>: Our findings underscore a discrepancy between real-life VAD infection management and VAT-recommended protocols, suggesting a need for clearer, more accessible guidelines and increased multidisciplinary collaboration. Enhanced VAT consultation and simplified protocol dissemination may improve consistency in infection management and ultimately lead to better patient outcomes. |
| format | Article |
| id | doaj-art-12d78b8886964f339d2c32213ccddcdd |
| institution | Kabale University |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj-art-12d78b8886964f339d2c32213ccddcdd2025-01-24T13:18:36ZengMDPI AGAntibiotics2079-63822025-01-011412710.3390/antibiotics14010027Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern ItalyMarta Colaneri0Lucia Galli1Martina Offer2Fabio Borgonovo3Giovanni Scaglione4Camilla Genovese5Rebecca Fattore6Monica Schiavini7Giovanni De Capitani8Maria Calloni9Arianna Bartoli10Antonio Gidaro11Chiara Cogliati12Spinello Antinori13Andrea Gori14Antonella Foschi15Unit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyUnit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, ItalyUnit I, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyUnit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyUnit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyUnit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyUnit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyIII Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDivision of Internal Medicine, Luigi Sacco Hospital, University of Milan, 20157 Milan, ItalyDivision of Internal Medicine, Luigi Sacco Hospital, University of Milan, 20157 Milan, ItalyDivision of Internal Medicine, Luigi Sacco Hospital, University of Milan, 20157 Milan, ItalyDepartment of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, ItalyDepartment of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, ItalyUnit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyUnit II, Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy<b>Introduction</b>: Vascular access device (VAD)-associated infections, including catheter-related (CRBSI) and catheter-associated bloodstream infections (CABSI), present significant challenges in patient care. While multidisciplinary VAD teams (VATs) are equipped with protocols for managing these infections, adherence to these guidelines in real-life practice is inconsistent. This study aims to evaluate the alignment between actual VAD infection management practices and VAT-recommended protocols. <b>Methods</b>: We conducted a retrospective, single-center study at Luigi Sacco Hospital (May 2021–October 2023) involving non-ICU adult patients with diagnosed CRBSI or CABSI. VAT experts independently reviewed infection management choices, which were divided into eight specific procedural options. These options included variations in VAD removal, timing of repositioning, and combinations of antimicrobial lock therapy and systemic therapy. Concordance between real-life practices and VAT recommendations was evaluated using Cohen’s kappa coefficient. <b>Results</b>: Of 2419 VAD placements, 146 (6%) developed infections (84 CABSI, 62 CRBSI). Clinicians removed VADs in 66.4% of cases compared to 62.3% per VAT recommendations, with moderate overall agreement (Cohen’s kappa = 0.58). Analysis of the eight management categories revealed moderate to low alignment (unweighted kappa = 0.44, weighted kappa = 0.30) between real-life practices and VAT guidance, with slightly improved concordance in CRBSI cases. <b>Conclusions</b>: Our findings underscore a discrepancy between real-life VAD infection management and VAT-recommended protocols, suggesting a need for clearer, more accessible guidelines and increased multidisciplinary collaboration. Enhanced VAT consultation and simplified protocol dissemination may improve consistency in infection management and ultimately lead to better patient outcomes.https://www.mdpi.com/2079-6382/14/1/27vascular access device (VAD)bloodstream infectionsCRBSICABSImultidisciplinary teamVAD infection management |
| spellingShingle | Marta Colaneri Lucia Galli Martina Offer Fabio Borgonovo Giovanni Scaglione Camilla Genovese Rebecca Fattore Monica Schiavini Giovanni De Capitani Maria Calloni Arianna Bartoli Antonio Gidaro Chiara Cogliati Spinello Antinori Andrea Gori Antonella Foschi Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy Antibiotics vascular access device (VAD) bloodstream infections CRBSI CABSI multidisciplinary team VAD infection management |
| title | Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy |
| title_full | Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy |
| title_fullStr | Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy |
| title_full_unstemmed | Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy |
| title_short | Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy |
| title_sort | vascular access device infections current management practices and the role of multidisciplinary teams at a large hospital in northern italy |
| topic | vascular access device (VAD) bloodstream infections CRBSI CABSI multidisciplinary team VAD infection management |
| url | https://www.mdpi.com/2079-6382/14/1/27 |
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