title: Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis.
abstract: 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.
authors.affiliation: Department of Internal Medicine-Infectious Diseases, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Capdevila
authors.forename: A M
authors.initials: AM
authors.lastname: Planes
authors.forename: M
authors.initials: M
authors.lastname: Palomar
authors.forename: I
authors.initials: I
authors.lastname: Gasser
authors.forename: B
authors.initials: B
authors.lastname: Almirante
authors.forename: A
authors.initials: A
authors.lastname: Pahissa
authors.forename: E
authors.initials: E
authors.lastname: Crespo
authors.forename: J M
authors.initials: JM
authors.lastname: Martínez-Vázquez
mesh_terms: 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