Differential quantitative blood cultures in the diagnosis of catheter-related sepsis in intensive care units.
The aim of this prospective study was to compare differential blood cultures and quantitative catheter tip cultures for the diagnosis of catheter-related sepsis. Over a period of 2 years, 283 central venous catheters were inserted in 190 adult patients. Catheters were removed when they were no longer needed or when infection was suspected. Immediately before removal of the central venous catheters, blood cultures were performed, with blood drawn simultaneously from the catheter and the peripheral vein. After removal, quantitative catheter culture was performed according to the Brun-Buisson modified Cleri technique. Fifty-five quantitative catheter cultures were positive. They were classified as contaminated (n = 18), colonized (n = 23), or infected (n = 14). Differential blood cultures correctly identified 13 infections. With a catheter/peripheral cfu ratio of 8, differential blood cultures had a sensitivity of 92.8% and a specificity of 98.8%. When the catheters were removed because of suspected infection, differential blood cultures had a sensitivity of 92.8% and a specificity of 100%. Differential blood culture, a technique that does not necessitate catheter removal, seems effective in the diagnosis of catheter-related sepsis in patients in the intensive care unit.
Quilici
N
N
Department of Anesthesia and Surgical Intensive Care, Hôpital Central and University of Nancy, France.
Audibert
G
G
Conroy
M C
MC
Bollaert
P E
PE
Guillemin
F
F
Welfringer
P
P
Garric
J
J
Weber
M
M
Laxenaire
M C
MC
D000328:Adult; D001431:Bacteriological Techniques; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007362:Intensive Care Units; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D018805:Sepsis / Q000175:diagnosis* / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification