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Preventing Second-Generation Complications due to Staphylococcus aureus

JAMES J. RAHAL, MD
Arch Intern Med. 1989;149(3):503-504. doi:10.1001/archinte.1989.00390030009002.
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Serious hospital-acquired infections have become a major limiting factor in the rapid progress of critical care technology. Although not the most frequent of such infections, intravascular catheter-associated bacteremia (CAB) is one of the more devastating. Too often its sudden onset creates havoc in the midst of an otherwise gratifying response to multidisciplinary efforts. In such instances, constant intravascular access, required for lifesaving procedures, may exact a price that, itself, yields significant morbidity or mortality. Under the most complex circumstances, a certain minimal incidence of CAB may be inevitable. Unfortunately, this complication also occurs under less critical conditions, creating illness more severe than the primary disease. An estimated 50000 instances of CAB occur yearly in US hospitals, and approximately 25 000 of these are due to Staphylococcus aureus, an organism particularly disposed to invading heart valves and producing distant metastatic abscesses in bone, kidney, epidural space, and other vital areas.1

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