Evaluation of central venous catheter sepsis by differential quantitative blood culture

Fan, ST; Teoh-Chan, C. H.; Lau, Ka-Hin

doi:10.1007/bf01963898

Cited by 93 publications

(27 citation statements)

References 18 publications

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“…Taking simultaneous quantitative blood cultures from the catheter and a peripheral vein may be useful for diagnosing catheter infection without having to remove a catheter (6,7), but this method is labor-intensive, time-consuming, and expensive and therefore not widely used in routine clinical practice. Given the limitations of these two methods, the measurement of the differential time to positivity (DTP) between blood cultures drawn through the CVC and a peripheral vein has been used as an important diagnostic indicator.…”

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confidence: 99%

Diagnostic Usefulness of Differential Time to Positivity for Catheter-Related Candidemia

Park

Lee

et al. 2014

J Clin Microbiol

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A differential time to positivity (DTP) of >120 min is useful for diagnosing catheter-related bacteremia, but data on diagnosing catheter-related candidemia (CRC) in this way are limited. We wished to evaluate the usefulness of the DTP for diagnosing CRC. All adult patients who had the same Candida species isolated from blood cultures drawn simultaneously from a central venous catheter (CVC) and a peripheral vein were included at a tertiary care hospital over an 18-month period. A total of 105 patients with candidemia who had positive simultaneous CVC and peripheral vein blood cultures were included in our study. Sixty-one patients (58%) had CRC (47 definite and 14 probable), and 38 (36%) had candidemia from another source (non-CRC). The remaining 6 patients (6%) with indeterminate candidemia were excluded from the final analysis. The overall sensitivity and specificity of a DTP of >120 min for diagnosing CRC were 85% (95% confidence interval [CI], 74% to 93%) and 82% (95% CI, 66% to 92%), respectively, and for neutropenic patients, they were 75% (95% CI, 19% to 99%) and 100% (95% CI, 75% to 100%), respectively. For Candida glabrata infections, the optimal DTP cutoff was >6 h, with a sensitivity of 63% (95% CI, 35% to 85%) and a specificity of 75% (95% CI, 35% to 97%). In summary, DTP is useful for diagnosing CRC, and a DTP of >120 min appears to be the optimal cutoff except for CRC caused by C. glabrata. For neutropenic patients, DTP may be useful as an adjunct test to rule in CRC and to decide whether a catheter should be removed.

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confidence: 99%

Diagnostic Usefulness of Differential Time to Positivity for Catheter-Related Candidemia

Park

Lee

et al. 2014

J Clin Microbiol

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“…3 The sensitivity of catheter tip cultures is reported to range from 78 to 97%. [16][17][18] In our case, a false-negative result may be due to failure to use techniques which would allow detection of organisms present in the internal lumen of catheter. In one report, 16 patients with catheter-related infection had negative tip culture, but were found to have positive hub culture.…”

Section: Discussionmentioning

confidence: 99%

Agrobacterium yellow group: bacteremia and possible septic arthritis following peripheral blood stem cell transplantation

Chalandon

Nantel

2000

Bone Marrow Transplant

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“…This method has been limited because of the expense and the labor-intensive process involved. 7,8 Recently, Blot et al 9,10 reported that measurement of differential time to positivity (DTP) between the peripheral and CVC blood cultures is highly sensitive and specific for the diagnosis of catheter-related bloodstream infection (CRBI) in patients with long-term catheters. DTP was defined as the difference in the time it took for a blood culture drawn through the CVC and a culture drawn from a peripheral vein to become positive.…”

Section: Related Bloodstream Infection; Hematopoietic Stem Cell Transmentioning

confidence: 99%

Difference in time to positivity is useful for the diagnosis of catheter-related bloodstream infection in hematopoietic stem cell transplant recipients

Abdelkefi¹,

Achour²,

Othman³

et al. 2005

Bone Marrow Transplant

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Summary:Catheter-related bloodstream infections are associated with recognized morbidity and mortality. Accurate diagnosis of such infections results in proper management of patients and in reducing unnecessary removal of catheters. We carried out a prospective study in a bone marrow transplant unit to assess the validity of a test based on the earlier positivity of central venous blood cultures in comparison with peripheral blood cultures for predicting catheter-related bacteremia. Between May 2002 and June 2004, 38 bloodstream infections with positive simultaneous central venous catheter and peripheral vein blood cultures were included. A total of 22 patients had catheter-related bacteremias and 16 had noncatheter-related bacteremias, using the catheter-tip culture/clinical criteria as the criterion standard to define catheter-related bacteremia. Differential time to positivity of 120 min or more was associated with 86% sensitivity and 87% specificity. In conclusion, differential time to positivity of 120 min or more is sensitive and specific for catheter-related bacteremia in hematopoietic stem cell transplant recipients who have nontunnelled short-term catheters.

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Evaluation of central venous catheter sepsis by differential quantitative blood culture

Cited by 93 publications

References 18 publications

Diagnostic Usefulness of Differential Time to Positivity for Catheter-Related Candidemia

Diagnostic Usefulness of Differential Time to Positivity for Catheter-Related Candidemia

Agrobacterium yellow group: bacteremia and possible septic arthritis following peripheral blood stem cell transplantation

Difference in time to positivity is useful for the diagnosis of catheter-related bloodstream infection in hematopoietic stem cell transplant recipients

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