title: Which lumen is the source of catheter-related bloodstream infection in patients with multi-lumen central venous catheters?
abstract: OBJECTIVE
  Paired blood cultures, drawn from the catheter and a peripheral vein, used for calculation of the differential time to positivity (DTP), have been proposed for the detection of catheter-related bloodstream infections (CRBSIs). The most relevant catheter lumen to be sampled in multi-lumen central venous catheters (CVCs) has not been recommended.
  
  
  METHODS
  Forty-four febrile neutropaenic patients, following haematopoietic stem cell transplantation (HSCT) and with multi-lumen CVCs in place, were investigated using the DTP method of blood samples drawn from every lumen of the CVC and a peripheral vein.
  
  
  RESULTS
  Twelve of 44 patients (27 %) had CRBSIs, as determined by the DTP method. In 10 of 12 (83 %) febrile neutropaenic patients, after HSCT, CRBSIs originated from the CVC lumen used for parenteral nutrition and blood products only. 17 % had CRBSI originating from the other CVC lumen (p = 0.039).
  
  
  CONCLUSIONS
  In most patients, CRBSIs originated from the CVC lumen used for parenteral nutrition and blood products, indicating that this lumen is the main source of CRBSI. However, since 17 % of patients had CRBSIs originating from another lumen, each lumen of multi-lumen CVCs has to be considered as a potential source of CRBSI and should, ideally, be sampled in order to avoid failure in diagnostic procedures.
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 20, 8036, Graz, Austria. robert.krause@medunigraz.at
authors.forename: R
authors.initials: R
authors.lastname: Krause
authors.forename: T
authors.initials: T
authors.lastname: Valentin
authors.forename: H
authors.initials: H
authors.lastname: Salzer
authors.forename: M
authors.initials: M
authors.lastname: Hönigl
authors.forename: A
authors.initials: A
authors.lastname: Valentin
authors.forename: H
authors.initials: H
authors.lastname: Auner
authors.forename: I
authors.initials: I
authors.lastname: Zollner-Schwetz
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000175:diagnosis*; D055499:Catheter-Related Infections / Q000175:diagnosis*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia