title: Microbiology difference between colonized catheters and catheter-related bloodstream infections.
abstract: OBJECTIVE
  Central vein catheters for patients receiving total parenteral nutrition have a high incidence of colonized catheters and catheter-related bloodstream infections. However, the actual incidence and bacterial pattern have not been well studied. This study was undertaken to investigate the difference in bacteriology between colonized catheters and catheter-related bloodstream infections.
  
  
  METHODS
  From January 1997 to March 1998, 354 patients receiving total parenteral nutrition were included in this study. The patients ranged in age from 49 to 80 years, 151 women and 203 men. Colonized catheters and catheter-related bloodstream infections were defined.
  
  
  RESULTS
  The culture was performed in 249 catheter tips (249 of 614, 40.6%). Sixty tips were found to have organisms. The organisms cultured from colonized catheters were Gram(+) aerobic bacteria (34, 56.7%), fungi (14, 23.3%), and Gram(-) aerobic bacteria (12, 20%). The organisms cultured from catheter-related bloodstream infections were fungi (16, 64%), Gram(-) aerobic bacteria (5, 20%), and Gram(+) aerobic bacteria (4, 16%). Dermatogenic infection in colonized catheters should be stressed, but systemic fungal infection in catheter-related bloodstream infections should be emphasized.
  
  
  CONCLUSIONS
  A striking difference exists in bacterial species between colonized catheters and catheter-related bloodstream infections. Further studies on different treatment strategy for colonized catheters and catheter-related bloodstream infections should be undertaken. The combined approach of a total parenteral nutrition team, sterile protocols, and early diagnosis of fungemia should be advocated for the total parenteral nutrition patients.
authors.affiliation: Department of Surgery, National Taiwan University, Taipei, Taiwan.
authors.forename: Che
authors.initials: C
authors.lastname: Lin
authors.forename: Ming-Tsan
authors.initials: MT
authors.lastname: Lin
authors.forename: Der-Yirng
authors.initials: DY
authors.lastname: Hsieh
authors.forename: Yann-Fen C
authors.initials: YF
authors.lastname: Chao
authors.forename: Sung-Ling
authors.initials: SL
authors.lastname: Yeh
authors.forename: Ming Shiang
authors.initials: MS
authors.lastname: Wu
authors.forename: Jaw-Tong
authors.initials: JT
authors.lastname: Lin
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
authors.forename: King-Jen
authors.initials: KJ
authors.lastname: Chang
authors.forename: Wei-Jao
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology*; D002175:Candida / Q000302:isolation & purification; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000382:microbiology*; D003428:Cross Infection / Q000175:diagnosis / Q000382:microbiology*; D003937:Diagnosis, Differential; D005260:Female; D016469:Fungemia / Q000175:diagnosis / Q000382:microbiology*; D006088:Gram-Negative Aerobic Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000295:instrumentation*