title: Quantitative blood cultures for diagnosis and management of catheter-related sepsis in pediatric hematology and oncology patients.
abstract: Paired quantitative blood cultures collected simultaneously via catheter and peripheral vein in Isolator 1.5 ml tubes, were performed in 50 febrile hematology children. Samples were taken to diagnose catheter-related sepsis (CRS) without catheter removal and to monitor the therapeutic efficiency of antimicrobials administered through the infected device by infusion and/or by the antibiotic lock technique (ALT). In 7 children (14%) the colony counts from catheter blood samples were 30-fold higher than the colony counts from peripheral samples, suggesting CRS; in 7 other patients (14%), identical colony counts in both samples suggested sepsis was not catheter-related. One patient (2%) had septicemia caused by E. coli found in the urinary tract; only the peripheral blood cultures were positive. In 6 patients (12%), the Isolator system was not effective for diagnosing bacteremia or CRS; in 29 patients (58%) the febrile episode was not microbiologically documented. All episodes of CRS were cured whatever the treatment was: infusion or ALT.
authors.affiliation: Département d'Anesthesiologie, Hôpital Saint-Louis, Paris, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Douard
authors.forename: G
authors.initials: G
authors.lastname: Arlet
authors.forename: G
authors.initials: G
authors.lastname: Leverger
authors.forename: R
authors.initials: R
authors.lastname: Paulien
authors.forename: C
authors.initials: C
authors.lastname: Waintrop
authors.forename: E
authors.initials: E
authors.lastname: Clementi
authors.forename: B
authors.initials: B
authors.lastname: Eurin
authors.forename: G
authors.initials: G
authors.lastname: Schaison
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001769:Blood / Q000382:microbiology*; D001800:Blood Specimen Collection / Q000379:methods / Q000592:standards; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols / Q000592:standards*; D015169:Colony Count, Microbial; D005440:Fluid Therapy / Q000009:adverse effects*; D006402:Hematologic Diseases / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous; D009369:Neoplasms / Q000628:therapy*; D018805:Sepsis / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents