Abstract:This prospective study evaluated semiquantitative and qualitative catheter-culture methods for diagnosis of catheter-related infection (CRI) in newborns. Catheter tips from newborns admitted to the Neonatal Unit of the University Hospital of the Botucatu Medical School, UNESP were included in the study. Catheter cultures were performed with both semiquantitative and qualitative techniques. For CRI diagnosis, microorganisms isolated from catheter cultures and from peripheral blood cultures were identified and s… Show more
“…Supplementary Table S1 shows the characteristics of the studies in our analyses. Most studies (39 out of 45) [11–26, 28–30, 33–43, 45–52] were prospective in nature, 26 studies [7, 10, 12, 16, 18–20, 24, 28–31, 34–36, 38, 40, 42, 43, 46–48, 50, 52] reported on the diagnostic accuracy of the semi-quantitative method and 30 [7, 11–15, 17, 21–23, 25–27, 29, 32–34, 37–47, 50, 51] on quantitative methods such as catheter segment, IVD-drawn or paired lysis cultures. Three studies were conducted in Australia, and the rest were from the Americas (USA and Brazil), France, Spain and the UK.…”
Section: Resultsmentioning
confidence: 99%
“…2); 18 of 45 (see note on previous page) studies [7, 10, 11, 21–24, 30, 33–36, 38, 40, 46–50] showed a high risk of bias in conduct and interpretation of the index tests. Likewise, 16 studies [16–19, 21, 27–31, 34–36, 38, 40] had high risks of bias in conduct and interpretation of reference standards; and 14 [7, 10, 13–15, 21–27, 29, 51] had high risks of bias in patient flow and interval between index tests and reference standards. Fig.…”
Catheter-related blood-stream infections (CRBSIs) are the most common healthcare-associated blood-stream infections. They can be diagnosed by either semi-quantitative or quantitative methods, which may differ in diagnostic accuracy. A meta-analysis was undertaken to compare the diagnostic accuracy of semi-quantitative and quantitative methods for CRBSI. A systematic search of Medline, Scopus, Cochrane and Embase databases up to January 2020 was performed and subjected to a QUADAS (quality assessment of diagnostic accuracy studies 2) tool to evaluate the risk of bias among studies. The pooled sensitivity and specificity of the methods were determined and heterogeneity was evaluated using the χ2 test and I2. Publication bias was assessed using a Funnel plot and the Egger's test. In total, 45 studies were analysed with data from 11 232 patients. The pooled sensitivity and specificity of semi-quantitative methods were 85% (95% CI 79–90%) and 84% (95% CI 79–88%), respectively; and for quantitative methods were 85% (95% CI 79–90%) and 95% (95% CI 91–97%). Considerable heterogeneity was statistically evident (P < 0.001) by both methods with a correspondingly symmetrical Funnel plot that was confirmed by a non-significant Deek's test. We conclude that both semi-quantitative and quantitative methods are highly useful for screening for CRBSI in patients and display high sensitivity and specificity. Quantitative methods, particularly paired quantitative cultures, had the highest sensitivity and specificity and can be used to identify CRBSI cases with a high degree of certainty.
“…Supplementary Table S1 shows the characteristics of the studies in our analyses. Most studies (39 out of 45) [11–26, 28–30, 33–43, 45–52] were prospective in nature, 26 studies [7, 10, 12, 16, 18–20, 24, 28–31, 34–36, 38, 40, 42, 43, 46–48, 50, 52] reported on the diagnostic accuracy of the semi-quantitative method and 30 [7, 11–15, 17, 21–23, 25–27, 29, 32–34, 37–47, 50, 51] on quantitative methods such as catheter segment, IVD-drawn or paired lysis cultures. Three studies were conducted in Australia, and the rest were from the Americas (USA and Brazil), France, Spain and the UK.…”
Section: Resultsmentioning
confidence: 99%
“…2); 18 of 45 (see note on previous page) studies [7, 10, 11, 21–24, 30, 33–36, 38, 40, 46–50] showed a high risk of bias in conduct and interpretation of the index tests. Likewise, 16 studies [16–19, 21, 27–31, 34–36, 38, 40] had high risks of bias in conduct and interpretation of reference standards; and 14 [7, 10, 13–15, 21–27, 29, 51] had high risks of bias in patient flow and interval between index tests and reference standards. Fig.…”
Catheter-related blood-stream infections (CRBSIs) are the most common healthcare-associated blood-stream infections. They can be diagnosed by either semi-quantitative or quantitative methods, which may differ in diagnostic accuracy. A meta-analysis was undertaken to compare the diagnostic accuracy of semi-quantitative and quantitative methods for CRBSI. A systematic search of Medline, Scopus, Cochrane and Embase databases up to January 2020 was performed and subjected to a QUADAS (quality assessment of diagnostic accuracy studies 2) tool to evaluate the risk of bias among studies. The pooled sensitivity and specificity of the methods were determined and heterogeneity was evaluated using the χ2 test and I2. Publication bias was assessed using a Funnel plot and the Egger's test. In total, 45 studies were analysed with data from 11 232 patients. The pooled sensitivity and specificity of semi-quantitative methods were 85% (95% CI 79–90%) and 84% (95% CI 79–88%), respectively; and for quantitative methods were 85% (95% CI 79–90%) and 95% (95% CI 91–97%). Considerable heterogeneity was statistically evident (P < 0.001) by both methods with a correspondingly symmetrical Funnel plot that was confirmed by a non-significant Deek's test. We conclude that both semi-quantitative and quantitative methods are highly useful for screening for CRBSI in patients and display high sensitivity and specificity. Quantitative methods, particularly paired quantitative cultures, had the highest sensitivity and specificity and can be used to identify CRBSI cases with a high degree of certainty.
“…But, by semiquantitative culture lower sensitivity (85%) and higher specificity (82%) was noted. In a study done by Marconi et al 32 in 2008 they concluded that the semiquantitative culture is a rapid and efficient technique for diagnosing catheter-related infection. Still, it requires a careful interpretation and its results need to be interpreted carefully for diagnosis and specific treatment.…”
Introduction: Diagnosing Central line associated bloodstream infection (CLABSI) and Central line Related local infections (CRLI) involves doing central line tip culture. The routine method which is followed in every laboratory is the semiquantitative roll plate method. However, the use of a quantitative flush method will add a further advantage, as it may detect endoluminal microorganisms more easily which helps in diagnosing blood stream infections due to central line. Materials and Methods: A prospective study was carried out in MICU of tertiary care hospital. Semiquantitative roll over technique and quantitative flush technique was followed to process central line catheter in patients suspected of CRLI and CLABSI. Results: Of 210 samples processed from patients forty seven patients (47) were diagnosed with CRLI and seven (7) with CLABSI. Semiquantitative technique had superiority in diagnosing local infections whereas flush technique had superiority in diagnosing blood stream infections. Conclusion: Both Semiquantitative and flush techniques are recommended for processing central line catheters for diagnosing CRLI and CLABSI. Early CLABSI can be missed sometimes in samples from ICU patients who have associated comorbid conditions. Thus those laboratories where only semiquantitative roll over technique is followed, quantitative flush technique is recommended which aids in diagnosing CLABSI which can be missed by roll over technique.
“…The microbiological diagnosis of catheter related infection is very important, because therapy varies based on the microorganism isolated and its resistance pattern. S. epidermidis and other coagulase-negative Staphylococci usually adhere to the surfaces of the catheters to form slime/glycocalyx after catheter insertion into the vascular system ( 10 ). Colonization of microorganisms at the catheter insertion site was an independent risk factor, showing the importance of skin as a reservoir for catheter tip colonization ( 9 ).…”
Background:Catheter Related Blood stream Infections (CRBSI) are prevalent and a potentially fatal complication pertaining to cardiovascular implant devices. There have been no major studies on bacterial colonization of catheters in cardiovascular patients in Iran.Objectives:To evaluate the incidence of catheter colonization of bacteria in the largest Iranian cardiovascular center.Patients and Methods:March 2011 to 2012, Cauterization procedures performed on 60 patients hospitalized in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran, with arterial or venous catheterization, inserted 48 hours or more, catheter evaluations done by culture methods. Blood cultures were also obtained simultaneously.Results:Forty-four out of 60 catheters (73.3%) were positive with a significant colony count. Of 44 positive cases, 11 patients had positive blood culture. Three most frequently isolated microorganisms were Staph Albus [14 (32%)], Entrococcu [12 (27%)] and Acinetobacter [5 (11%)]. gram-positive cocci were sensitive to Vancomycin and Linezolid and gram-negative bacilli were sensitive to Amikacin, Gentamicin, Tobramycin and Imipenem.Conclusions:The study findings revealed that the catheter infection in our patients had sources other than normal skin flora. These results will assist in determining the possible source of the infections, furthermore, how they are transmitted, moreover aid in controlling and preventing these dangerous in- infections.
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