Iranian Heart Association Iranian Heart Journal 27 2 2026 04 01 A Longitudinal Study of Catheter-Related Infections: Challenges in Diagnosis and Management 54 64 242140 EN Shokoufeh Hajsadeghi Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, IR Iran. 0000-0002-5805-5173 Seyed Masoud Musavian Department of Cardiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, IR Iran. Shima Loni Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, IR Iran. 0009-0003-5747-4709 Ali Mehrakizadeh Department of Cardiology, Tehran University of Medical Sciences, Tehran, IR Iran. Shayan Mirshafiee Department of Cardiology, Tehran University of Medical Sciences, Tehran, IR Iran. 0000-0003-2139-5956 Journal Article 2025 05 13 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)

https://journal.iha.org.ir/article_242140_fb73dd4f377ad8213682750641abe790.pdf