Management of septicemia in rhesus monkeys with chronic indwelling venous catheters.

Twenty venous-catheterized, septicemic rhesus monkeys from two laboratories were studied. The most common isolates from the bloodstream were Klebsiella oxytoca from the monkeys in one laboratory and Staphylococcus aureus from those in the other. Five septicemic monkeys from the two laboratories, each with a central venous catheter, received repeated courses of antibiotics to which the infecting organisms were sensitive. Their catheters, however, were not removed. All five monkeys improved clinically, permitting continued use of the catheters. However, until the catheters were removed, bacteria were isolated repeatedly from the bloodstream. Two therapeutic regimens for the management of bacterial septicemia then were compared. Under both regimens, animals with positive blood cultures were treated for 10 days with appropriate antibiotics based on bacterial sensitivity testing. In one group of 10 monkeys, the indwelling venous catheters remained in situ during treatment. In a second group of 10 monkeys, catheters were removed at the time antibiotic therapy was initiated. When catheters were not removed, septicemia recurred 3 to 5 days after antibiotics were discontinued. In contrast, when catheter removal accompanied antibiotic therapy, resolution of the septicemia occurred within 3 to 5 days. Thus, catheter removal was required for elimination of bacteria from the bloodstream of septicemic monkeys with long-term indwelling central venous catheters.