The relevance of cultures of catheter-drawn blood and heparin-lock fluid to diagnose infection in hematologic patients.
The results of bacteriologic cultures of blood and heparin-lock fluid, both drawn from the central venous catheters of 54 consecutive oncohematologic patients, have been used to determine their value for the diagnosis of systemic and catheter-associated infection. In 30 patients with clinical signs of infection (bacteremia or septicemia), 74 of 1000 (7.4%) heparin-lock fluid cultures, 114 of 542 (21%) catheter-drawn blood cultures, and 36 of 134 (26%) venipuncture blood cultures became positive, whereas in 24 patients without clinical signs of infection the respective values were 5 of 700 (0.7%), one of 220 (0.4%), and none of ten cultures. Comparison of the results of cultures sampled on the same day reveals that the positive and negative predictive values for catheter-drawn blood cultures, with the venipuncture blood cultures taken as the standard for bacteremia, are 82% and 95% respectively. The results of heparin-lock fluid are indicative for clinically relevant colonization of the catheter. Three or more positive heparin-lock fluid cultures, sampled on subsequent days, were correlated with the occurrence of bacteremia or septicemia with a positive predictive value of 100%. The conclusions are supported by the results of scanning electron microscopy.
Guiot
H F
HF
Department of Infectious Diseases, University Medical Center, Leiden, The Netherlands.
Helmig-Schurter
A V
AV
van 't Noordende
J M
JM
D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis*; D001769:Blood / Q000382:microbiology; D002404:Catheterization; D002408:Catheters, Indwelling; D015169:Colony Count, Microbial; D006801:Humans; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification