Do antibiotics administered at the time of central venous catheter removal interfere with the evaluation of colonization?
OBJECTIVE
Catheter colonization is commonly used as an end point in studies on central venous catheter (CVC) infections. This study aimed at comparing the rates of catheter colonization in patients according to the administration of antibiotics at removal.


METHODS
Prospective study over a 5-year period. All patients with a CVC removed without suspicion of CVC infection were included.


METHODS
An adult medical/surgical intensive care unit at a university teaching hospital.


METHODS
A total of 472 patients with CVC inserted for a mean CVC duration of 6.0 +/- 3.7 days were included.


METHODS
Antibiotics at removal was defined as antibiotics administered within 48[Symbol: see text]h before CVC removal, and CVC colonization as catheter tip culture yielding > or = 10(3) colony-forming units per milliliter.


METHODS
None.


RESULTS
Of 472 patients, 302 (64%) were receiving antibiotics at removal. The number of CVC colonizations per number of CVCs inserted was 4.7% (22 of 472) and the number of CVC colonizations per 1000 CVC days was 8.0. Administration of antibiotics at removal was associated with a lower risk of CVC colonization. Irrespective of CVC duration, CVC colonization rate differed between patients with or without antibiotics at removal (Kaplan-Meier test, p=0.04).


CONCLUSIONS
The proportion of patients with antibiotics at time of removal should be taken into account when interpreting the results of surveys and trials using the quantitative CVC tip culture to define CVC colonization as an end point.
Souweine
Bertrand
B
Université Clermont, Faculté de Médecine, 63000 Clermont-Ferrand, Cedex 1, France. bsouweine@chu-clermontferrand.fr
Heng
Anne Elisabeth
AE
Aumeran
Claire
C
Thiollière
Fabrice
F
Gazuy
Nicole
N
Deteix
Patrice
P
Traoré
Ousmane
O
D018806:APACHE; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002405:Catheterization, Central Venous; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000517:prevention & control*; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents