Microbiology difference between colonized catheters and catheter-related bloodstream infections.
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.
Lin
Che
C
Department of Surgery, National Taiwan University, Taipei, Taiwan.
Lin
Ming-Tsan
MT
Hsieh
Der-Yirng
DY
Chao
Yann-Fen C
YF
Yeh
Sung-Ling
SL
Wu
Ming Shiang
MS
Lin
Jaw-Tong
JT
Lee
Po-Huang
PH
Chang
King-Jen
KJ
Chen
Wei-Jao
WJ
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*