Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis.
A prospective study was performed to assess the value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis when this condition is suspected on clinical grounds and to establish a reliable discriminative value for application without removal of the inserted catheter. A total of 107 central venous catheters from 64 patients were used for the study. Blood was obtained simultaneously through the suspected infected device and from a peripheral venipuncture. The catheter was removed and its tip cultured semiquantitatively. Catheter-related sepsis occurred in 17 patients. Using as cut-off value a colony count fourfold higher in blood drawn through the catheter than in simultaneously drawn peripheral blood, a sensitivity of 94%, specificity of 100% and positive predictive value of 100% were obtained. A single bacterial count greater than 100 cfu/ml in the quantitative culture of the catheter blood specimen in the presence of a positive qualitative peripheral blood culture of the same organism was also highly suggestive of catheter-related sepsis. Differential quantitative blood culture is a reliable method for the diagnosis of catheter-associated sepsis without catheter removal.
Capdevila
J A
JA
Department of Internal Medicine-Infectious Diseases, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Spain.
Planes
A M
AM
Palomar
M
M
Gasser
I
I
Almirante
B
B
Pahissa
A
A
Crespo
E
E
Martínez-Vázquez
J M
JM
D016470:Bacteremia / Q000097:blood / Q000175:diagnosis*; D001769:Blood / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects*; D015169:Colony Count, Microbial; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000097:blood / Q000175:diagnosis*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D011446:Prospective Studies