**2.8 Indwelling devices**

Indwelling devices such as urinary catheters, ports, pacers, and long-term intravenous access are associated with an increased risk of infection. Examination of these devices is an important part of the physical examination of the septic patient. Erythema or purulence at the exit site is specific for infection but these signs of not sensitive for the presence of device-associated infection. In fact, less than 5% of dialysis line-associated bacteremia was found to have associated purulent exit site drainage [39]. Because physical examination findings are often absent, it is important to keep device-associated infection in the differential in septic patients. If infection is suspected, the device should be removed as soon as clinically possible and cultured [39–41].
