A Longitudinal Study of Catheter-Related Infections: Challenges in Diagnosis and Management



Hajsadeghi S ; Musavian SM ; Loni S ; Mehrakizadeh A ; Mirshafiee S
Source: Iranian Heart Journal Published:2026

Abstract

Background: Central venous catheters (CVCs) are essential for vascular access but are associated with catheter-related bloodstream infections (CRBSIs), which can cause significant morbidity and mortality, particularly among hemodialysis patients. This study aimed to investigate risk factors for CVC infections, evaluate the role of echocardiography in diagnosis and prognosis, and assess outcomes of different catheter management strategies. Methods: A longitudinal study of 166 patients with confirmed CVC infections was conducted at Rasoul Akram Hospital, Tehran, Iran, from 2014 through 2022. Data included demographics, comorbidities, catheter site/duration, microbiological cultures, echocardiographic findings, and treatment outcomes. Statistical analyses included the χ2 test, the t test, ANOVA, and regression methods using SPSS, version 26. Results: Participants had a median age of 58 years (IQR, 45–67), and 54.8% were women. Fever was the most common presenting symptom (52.4%). Vegetations were detected in 52 patients (46.4%), most commonly at the catheter site. No significant difference in mortality was found between percutaneous and surgical catheter removal methods (P = 0.26). Vegetation size was not associated with mortality (P = 0.516). Patients with diabetes and transfusion history had longer hospital stays. Recurrence of infection was highest (37.9%) in those managed without catheter removal. Conclusions: Echocardiography plays a critical role in the diagnosis and prognosis of CVC infections. Catheter removal, whether percutaneous or surgical, did not influence in-hospital mortality, even in cases with large vegetations. However, failure to remove infected catheters increased the recurrence risk. (Iranian Heart Journal 2026; 27(2): 54-64). © 2026, Iranian Heart Association. All rights reserved.