In situ management of confirmed central venous catheter-related bacteremia.
Thirty-one patients with suspected central venous catheter-related bacteremia were evaluated with comparative quantitative cultures of central venous and peripheral blood specimens. Using criteria developed from studies in bacteremic animals, 19 patients were confirmed to have catheter-related bacteremia. Antibiotic therapy was administered through the catheter (in situ therapy) in 17 of those patients to evaluate the feasibility of treating patients with true central venous catheter-related bacteremias without catheter removal. Bacteremia was successfully eradicated in 11 of 17 patients (65%), allowing 7 patients to retain their catheter a median of 157 days. This study validates the use of comparative quantitative blood cultures in the diagnosis of catheter-related bacteremia and indicates that in situ therapy is a rational alternative to catheter removal in patients with catheter-related bacteremia.
Flynn
P M
PM
Division of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38101.
Shenep
J L
JL
Stokes
D C
DC
Barrett
F F
FF
D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification; D001769:Blood / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011817:Rabbits; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents