In situ management of confirmed central venous catheter-related bacteremia

Flynn, Patricia M.; Shenep, Jerry L.; Stokes, Dennis C.; Barrett, Fred F.

doi:10.1097/00006454-198708000-00007

Cited by 181 publications

(56 citation statements)

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“…Quantitative blood cultures are helpful for the diagnosis of central venous catheter (CVC) infections in patients in ICUs. The finding of a 5-to 10-fold increase in the concentration of bacteria drawn via the CVC, in comparison with the concentration of bacteria drawn via a peripheral catheter, has been suggested to indicate a CVC-related bacteremia (87). Colony counts of CNS from blood drawn from vascular access devices frequently exceed 100 CFU/ml.…”

Section: Specimen Collection and Processingmentioning

confidence: 99%

Update on clinical significance of coagulase-negative staphylococci

1994

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The clinical significance of coagulase-negative Staphylococcus species (CNS) continues to increase as strategies in medical practice lead to more invasive procedures. Hospitalized patients that are immunocompromised and/or suffering from chronic diseases are the most vulnerable to infection. Since CNS are widespread on the human body and are capable of producing very large populations, distinguishing the etiologic agent(s) from contaminating flora is a serious challenge. For this reason, culture identification should proceed to the species and strain levels. A much stronger case can be made for the identification of a CNS etiologic agent if the same strain is repeatedly isolated from a series of specimens as opposed to the isolation of different strains of one or more species. Strain identity initially can be based on colony morphology, and then one or more molecular approaches can be used to gain information on the genotype. Many of the CNS species are commonly resistant to antibiotics that are being indicated for staphylococcal infections, with the exception of vancomycin. The widespread use of antibiotics in hospitals has provided a reservoir of antibiotic-resistant genes. The main focus on mechanisms of pathogenesis has been with foreign body infections and the role of specific adhesins and slime produced by Staphylococcus epidermidis. Slime can reduce the immune response and opsonophagocytosis, thereby interfering with host defense mechanisms. As we become more aware of the various strategies used by CNS, we will be in a better position to compromise their defense mechanisms and improve treatment.

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Section: Specimen Collection and Processingmentioning

confidence: 99%

Update on clinical significance of coagulase-negative staphylococci

1994

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“…This study demonstrates that the difference in the bacterial concentration of the central and peripheral blood in patients with a positive test was at least sevenfold. Flynn (13) showed in an animal experiment that the difference in bacterial concentration in non-catheter-related bacteraemia did not exceed fivefold. It seems appropriate to conclude from our data that if the difference in identical bacterial colony counts between the two blood specimens is …”

Section: Evaluation Of Central Venous Cathetermentioning

confidence: 99%

“…(11), employing the same technique, also diagnosed 11 cases of catheter sepsis. Other workers (12)(13)(14)(15) employing different culture techniques demonstrated that catheter sepsis could be diagnosed based on a principle similar to Wing's method. However, in none of these studies (11)(12)(13)(14) were the catheters removed and subjected to microbiological study.…”

Section: Evaluation Of Central Venous Cathetermentioning

confidence: 99%

“…Other workers (12)(13)(14)(15) employing different culture techniques demonstrated that catheter sepsis could be diagnosed based on a principle similar to Wing's method. However, in none of these studies (11)(12)(13)(14) were the catheters removed and subjected to microbiological study. This study demonstrates that the difference in the bacterial concentration of the central and peripheral blood in patients with a positive test was at least sevenfold.…”

Section: Evaluation Of Central Venous Cathetermentioning

confidence: 99%

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Evaluation of central venous catheter sepsis by differential quantitative blood culture

Fan

Teoh-Chan

Lau

1989

Eur. J. Clin. Microbiol. Infect. Dis.

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The accuracy of differential quantitative blood culture in the diagnosis of central venous catheter sepsis was evaluated in 24 parenterally-fed patients in whom catheter sepsis was suspected. The pour-plate quantitative culture technique was performed immediately before removal of the catheter on blood drawn through the central venous catheter and a peripheral vein. If bacterial colonies in the catheter blood specimen were sevenfold more frequent than identical bacterial colonies in the peripheral blood specimen, the test was considered positive and indicative of catheter sepsis. Catheter-tip culture identified 9 of the 24 patients as positive for catheter sepsis. A positive differential quantitative blood culture result was found for seven of the nine infected catheters. Sensitivity of this test was 77.8%, specificity was 100%, and overall accuracy was 91.7%. It is concluded that differential quantitative blood culture is a reliable method for the exclusion of catheter sepsis.

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“…Some of these complications may sometimes become more severe than the primary disease itself. The complications related to procedure are pneumothorax, hemothorax, air embolism, arterial puncture, arrhythmia, pericardial tamponade and brachial plexus injury [4][5][6] .The short term complications after the procedure include hemoptysis, hematoma in the port implantation site, dehiscence of the incision 7,8 ; whereas late complications include catheter related infections, thrombosis of the catheter, tear and transection of the catheter, 'pinch-off' syndrome, relocation of the catheter tip, embolization due to catheter, extravasations of the given medications, slipping of the catheter, erosion and/or perforation of superior vena cava [9][10][11][12][13][14] . However, these short and late complications may be observed in both terms.…”

mentioning

confidence: 99%

Evaluation of the removal reasons of totally implantable venous devices in children: a retrospective study

Kılıç¹,

Soyer²,

Karnak³

et al. 2016

Turk J Pediatr

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Totally implantable venous access devices (TIVADs) increase the quality of life in children with hematologic and oncologic diseases or organ failures. The aim of this study is to determine the reasons for port removal. The port catheters, implanted and removed in patients between January 2000 and June 2013 were evaluated retrospectively. The patients were divided into two groups, whose port catheters were removed due to completed therapy (completed therapy group, CTG) and whose port catheters were removed because of a port catheter-related complications (complication group, CG). In the CG, the patients whose port catheters are removed for infectious reasons are investigated for whether there is a relationship with age, gender, body mass index (BMI), height and weight at the time of port implantation and removal. In total, 242 patients who underwent port implantation and removal were included in the study. The male to female ratio was 1.32/1 and the mean age of the patients was 9.4±4.9 years (0-24 year). Patients were enrolled in CTG (n=170, 70.2%), and CG (n=72, 29%). There is a positive correlation between BMI and infections (p<0.05). In the CG, patients under steroid treatment had higher incidence of non-infectious causes than infectious causes (p<0.05). Oppositely, non infectious complications were higher in steroid free patients (p<0.05). There was no catheter related mortality in the entire study group.The hematological malignancies and solid tumors are the most common underlying primary disease in patients with port removal because of complications. Infectious complications are most common cause of port removal in children and despite other microorganism, fungi should be considered as a cause of catheter related infections.

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In situ management of confirmed central venous catheter-related bacteremia

Cited by 181 publications

References 0 publications

Update on clinical significance of coagulase-negative staphylococci

Update on clinical significance of coagulase-negative staphylococci

Evaluation of central venous catheter sepsis by differential quantitative blood culture

Evaluation of the removal reasons of totally implantable venous devices in children: a retrospective study

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