Skip to Main Content


Intravascular catheters are used for a wide range of adjunctive therapies in pediatric patients, such as administering total parenteral nutrition and chemotherapy and facilitating blood drawing. For the purposes of discussing complication risks and preventive strategies, these catheters can be subdivided into short-term, intermediate-term, and long-term devices. Approaches to catheter device placement and care that prevent infection are discussed in Chapters 34 and 107.


The pathogenesis of bloodstream infections for both short-, intermediate-, and long-term devices includes migration of potential pathogens from the skin at the exit site along the external surface of the catheter to the catheter tip, intraluminal migration of organisms from the catheter hub, contaminated infusates, and rarely, seeding of the catheter hematogenously from a distant focus.1 The true incidence of bowel translocation of microorganisms with subsequent seeding of the catheter is unknown, but this is proposed as a potential mechanism of catheter-related bloodstream infections (CR-BSI) in patients with dysfunctional bowel. Short-term and intermediate-term, noncuffed, nontunneled catheters are more prone to migration of organisms along the external surface of the catheter, and as a result they are infected by a greater proportion of skin flora including coagulase negative staphylococci and Staphylococcus aureus.2-5 Long-term, cuffed, tunneled catheters are less likely to be infected by organisms along the external catheter surface because the cuff acts as a fibrotic dam to migration. The definitions of different types of catheter-related infections are presented in Table 239-1.

Table Graphic Jump Location
Table 239-1. Definitions of Catheter-Related Infections

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.