TITLE

Central venous blood culture: a useful test for catheter colonisation?

AUTHOR(S)
Juste, R. N.; Hannan, M.; Glendenning, A.; Azadian, B.; Soni, N.
PUB. DATE
September 2000
SOURCE
Intensive Care Medicine;Sep2000, Vol. 26 Issue 9, p1373
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Objective: To evaluate the widespread practice of using qualitative culture of venous blood taken through central venous catheters (CVCs) as a means of diagnosing catheter colonisation in situ.Design: A prospective clinical study.Patients: Three hundred fifty-one CVCs were inserted into 228 critically ill patients.Interventions: Prior to CVC removal, blood was taken for qualitative culture from the CVC and a peripheral site. All catheter tips underwent semi-quantitative analysis of bacterial colony count [1].Measurements and Results: One hundred eighteen (33.6%) CVCs were found to be colonised on removal. A positive central blood culture had a sensitivity and specificity of 50.8% and 78.9% when compared with the 'gold standard' of catheter tip culture. This gives a positive predictive value of 47.7% and a negative predictive value of 76.5%. The sensitivity and specificity of a positive peripheral blood culture were 41.5% and 77.7% with positive and negative predictive values of 48.8% and 72.9%, respectively. When only those catheters removed because of systemic sepsis (n = 139) were considered, a positive central blood culture had a sensitivity of 58.8% and a specificity of 69.3%.Conclusion: Our results indicate that the use of central blood culture confers a small advantage in sensitivity compared with peripheral blood culture. This advantage was further improved by only considering the catheters removed because of systemic sepsis but at the cost of a loss of specificity. Qualitative blood culture is a poor tool for the diagnosis of in-situ CVC colonisation.
ACCESSION #
15729128

 

Related Articles

  • Endotoxaemia in patients with severe sepsis or septic shock. Venet, C.; Zeni, F.; Viallon, A.; Ross, A.; Pain, P.; Gery, P.; Page, D.; Vermesch, R.; Bertrand, M.; Rancon, F.; Bertrand, J. C. // Intensive Care Medicine;May2000, Vol. 26 Issue 5, p538 

    Objective: To examine the incidence and the bacteriological and clinical significance of endotoxaemia in ICU patients with severe sepsis or septic shock.Design: Prospective review.Setting: A 15-bed general ICU in a university hospital.Patients:...

  • Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients. Khalifa, Raphael; Dahyot-Fizelier, Claire; Laksiri, Leila; Ragot, Stéphanie; Petitpas, Franck; Nanadoumgar, Hodanou; Debaene, Bertrand; Mimoz, Olivier // Intensive Care Medicine;Oct2008, Vol. 34 Issue 10, p1820 

    Despite the lack of evidence to support routine scheduled replacement of peripheral arterial catheters this practice continues to be widely used in many intensive care units (ICU). This study evaluated whether additional risks of catheter colonization are incurred with a conservative attitude in...

  • Hub qualitative blood culture is useful for diagnosis of catheter-related infections in critically ill patients. Tanguy, Michèle; Seguin, Philippe; Laviolle, Bruno; Desbordes, Laurent; Mallédant, Yannick; Tanguy, Michèle; Mallédant, Yannick // Intensive Care Medicine;May2005, Vol. 31 Issue 5, p645 

    Objective: To assess clinical safety and accuracy of qualitative blood culture drawn through the hub for ruling out catheter-related infection (CRI).Design and Setting: Prospective observational study in a surgical intensive care unit.Patients: All patients...

  • Is continuous infusion ceftriaxone better than once-a-day dosing in intensive care? A randomized controlled pilot study. Jason A. Roberts; Rob Boots; Claire M. Rickard; Peter Thomas; Jo Quinn; Darren M. Roberts; Brent Richards; Jeffrey Lipman // Journal of Antimicrobial Chemotherapy (JAC);Feb2007, Vol. 59 Issue 2, p285 

    Objectives: To compare the clinical and bacteriological outcome of critically ill patients with sepsis treated by ceftriaxone administered as a once-a-day intermittent bolus dose or by 24 h continuous infusion. Patients and methods: We conducted an open-label, randomized...

  • Detection of bacteraemia in critically ill patients using 16S rDNA polymerase chain reaction and DNA sequencing. Sleigh, James; Cursons, Ray; La Pine, Mary; Sleigh, J; Cursons, R; La Pine, M // Intensive Care Medicine;Aug2001, Vol. 27 Issue 8, p1269 

    Objective: To confirm the sensitivity of the polymerase chain reaction (PCR) technique (versus blood cultures) and to gain a better understanding of the incidence of true- and false-positive results when using this technique.Design: Observational study.Setting:...

  • The use of the arterial line as a source for blood cultures. Levin, Phillip D.; Hersch, Moshe; Rudensky, Bernard; Yinnon, Amos M.; Levin, P D; Hersch, M; Rudensky, B; Yinnon, A M // Intensive Care Medicine;Sep2000, Vol. 26 Issue 9, p1350 

    Objective: To determine the reliability of blood cultures obtained through indwelling arterial lines as compared to that of blood cultures obtained by venipuncture.Design: A prospective observational study.Setting: Six-bed mixed medical surgical intensive...

  • Presepsin (soluble CD14 subtype) and procalcitonin levels for mortality prediction in sepsis: data from the Albumin Italian Outcome Sepsis trial. Masson, Serge; Caironi, Pietro; Spanuth, Eberhard; Thomae, Ralf; Panigada, Mauro; Sangiorgi, Gabriela; Fumagalli, Roberto; Mauri, Tommaso; Isgrò, Stefano; Fanizza, Caterina; Romero, Marilena; Tognoni, Gianni; Latini, Roberto; Gattinoni, Luciano // Critical Care;2014, Vol. 18 Issue 1, p1 

    Introduction Sepsis, a leading cause of death in critically ill patients, is the result of complex interactions between the infecting microorganisms and the host responses that influence clinical outcomes. We evaluated the prognostic value of presepsin (sCD14-ST), a novel biomarker of bacterial...

  • Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Alberti, Corinne; Brun-Buisson, Christian; Burchardi, Hilmar; Martin, Claudio; Goodman, Sergey; Artigas, Antonio; Sicignano, Alberto; Palazzo, Mark; Moreno, Rui; Boulmé, Ronan; Lepage, Eric; Le Gall, Jean Roger // Intensive Care Medicine;Feb2002, Vol. 28 Issue 2, p108 

    Objectives: To examine the incidence of infections and to describe them and their outcome in intensive care unit (ICU) patients. Design and setting: International prospective cohort study in which all patients admitted to the 28 participating units in eight countries between May 1997 and May...

  • Sequential evaluation of prognostic models in the early diagnosis of acute kidney injury in the intensive care unit. e Silva, Verônica Torres Costa; de Castro, Isac; Liaño, Fernando; Muriel, Alfonso; Rodríguez-Palomares, Jose R.; Yu, Luis // Kidney International;May2009, Vol. 75 Issue 9, p982 

    General and specific severity scores for patients with acute kidney injury have significant limitations due in part to the diversity of methods that have been used. Here we prospectively validated five general (APACHE II, SAPS II, SOFA, LODS, and OSF) and three specific (SHARF, Liaño, and...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics