Expert Review Outlines Diagnosis and Treatment of Recurrent Catheter Infections

Patients who rely on long-term intravenous catheters for chemotherapy, hemodialysis, intravenous nutrition, and other essential therapies remain at risk of catheter-related bloodstream infections. These potentially life-threatening infections can be difficult to manage when continued care depends on retaining the catheter. A new review addresses this challenge, providing guidance on preventing, diagnosing, and treating recurrent and relapsing infections while preserving vascular access whenever possible.

Brown University and Brown University Health led the review, titled “Recurrent and Relapsing Catheter-Related Bloodstream Infections in Patients Requiring Long-term Vascular Access.” Focusing on patients with cancer, kidney failure, intestinal disorders, and other serious conditions, the article examines the clinical challenges of managing infections when long-term vascular access remains essential. In these cases, the catheter may be both the source of infection and the means of delivering necessary therapy.

The review synthesizes current evidence and expert clinical experience to guide the management of recurrent and relapsing catheter-related bloodstream infections. It emphasizes individualized care based on the patient’s clinical condition, the infecting organism, and the availability of alternative access sites. As part of this assessment, diagnostic guidance calls for prompt evaluation using blood cultures drawn from both the catheter and a peripheral vein.

Management recommendations highlight collaboration among infectious disease specialists, vascular-access teams, pharmacists, and interventional radiologists. The review examines when catheter removal is necessary and when preserving vascular access may be reasonable, with antimicrobial lock therapy identified as a consideration for appropriate patients.

To reduce future infections while maintaining access to essential therapies, preventive strategies include antibiotic-impregnated catheters for high-risk patients. The authors also outline research priorities, including infection-resistant catheters, improved antimicrobial lock solutions, and emerging technologies for detecting, monitoring, and preventing catheter-related infections. Published in Clinical Infectious Diseases on October 22, 2026, the review includes contributions from colleagues at institutions across the United States and Europe.

“Patients who require long-term vascular access often present some of the most challenging infection-management decisions in medicine,” said Leonard A. Mermel, D.O., of the Division of Infectious Diseases at The Warren Alpert Medical School of Brown University and Brown University Health.

“The catheter can be both the source of infection and the means by which critical treatment is delivered. Our review provides a framework to help clinical teams make individualized decisions that prioritize patient safety while maintaining continuity of care whenever possible,” added Mermel.

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