Diagnosis of catheter-related bloodstream infection

Abstract

Catheter-related bloodstream infection is a potentially serious condition with a mortality rate of 12% to 25%. Catheter-related bacteremia is difficult to diagnose, and clinical manifestations of the condition have proved to be unspecific and often inconclusive. Microbiologic techniques to diagnose catheter-related bloodstream infection have been developed, some of which require catheter removal whereas others do not. Differential time to positivity has demonstrated marked accuracy and practicality as it allows the catheter to remain in place. Many other methods, such as skin or hub cultures, show less remarkable results, and some, such as intraluminal brushing, may produce adverse effects. Once a catheter-related bloodstream infection is diagnosed, it is classified as either complicated or uncomplicated and treated accordingly.

Central venous access device‐related infections in patients with haemophilia

“…Infection remains the most common complication associated with CVAD use in haemophilia. Diagnosis of an infection as catheter‐related, however, can be difficult; the dilemma in diagnosis lies in the non‐specific manifestation and inconsistent clinical course of a CVAD‐related infection in an immuno‐competent child . In addition, negative blood cultures and full blood examination may not provide helpful information in aiding diagnosis.…”

Leaving More Than Your Fingerprint on the Intravenous Line

“…13 When blood drawn for quantitative culture from the catheter luminal hub or from peripheral venipuncture contains 4 to 10 times more than 15 CFU/ml, a catheter-related bloodstream infection is confirmed. 14 Thus, we considered any IV stopcock dead space bacterial counts above 120 CFU/mL as a significant bacterial burden. Considering the dynamic nature of bacteria’s natural system, we selected an effect size of 50 CFU/mL to ensure an adequate difference at lower counts.…”

Central Venous Catheter (CVC) related infections: a local retrospective study

“…Si può presumibilmente parlare di infezioni catetere correlate quando lo stesso patogeno viene isolato sia dal CVC che dal sangue (5,9). Se confrontiamo le percentuali degli isolati da CVC con quelle dei microrganismi isolati contemporanea- …”

“…Esistono varie modalità di rilevare un'infezione ematica correlata al catetere e tra queste è compresa quella che tiene conto dell'isolamento del medesimo microorganismo sia dal sangue periferico (emocoltura) che dal catetere. Le colture semi-quantitative o quantitative della punta del catetere, poiché presentano una maggiore specificità rispetto a quelle qualitative, sono le metodologie più frequentemente utilizzate per questo tipo di indagine diagnostica (4)(5)9). I principali agenti eziologici delle infezioni CVCcorrelate sono i cocchi Gram-positivi che costituiscono circa i due terzi degli isolati, con prevalenza relativa degli stafilococchi coagulasi-negativi (SCN).…”