title: Diagnosis of venous access port colonization requires cultures from multiple sites: should guidelines be amended?
abstract: Data on microbiological management of withdrawn venous access ports (VAPs) are scarce. The aim of our study was to assess the validity of Gram stain and culture performed on VAPs to detect colonization and VAP-related bloodstream infection (VAP-RBSI). We prospectively performed cultures of the following: catheter tip (roll-plate and sonication), port content aspirate before and after sonication, port sonication fluid (PSF), and port internal surface biofilm (ISB). The gold standard of VAP colonization was positivity of at least 1 of the cultures mentioned above. We collected 223 VAPs in which no single culture had validity values reliable enough to predict colonization and VAP-RBSI. The best validity values were those obtained when cultures of catheter tip (roll-plate), PSF, and port ISB were combined. Cultures from several areas on the VAP are necessary to ensure suitable assessment of colonization and VAP-RBSI.
authors: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Department of Medicine, Universidad Complutense, Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), RD06/0008/1025, Madrid, Spain. Electronic address: ebouza@microb.net.
authors: Emilio
authors: E
authors: Bouza
authors: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Department of Medicine, Universidad Complutense, Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), RD06/0008/1025, Madrid, Spain.
authors: Pablo
authors: P
authors: Martín-Rabadán
authors: Department of Vascular Interventional Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors: Antonio
authors: A
authors: Echenagusia
authors: Department of Vascular Interventional Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors: Fernando
authors: F
authors: Camúñez
authors: Department of Vascular Interventional Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors: Gracia
authors: G
authors: Rodríguez-Rosales
authors: Department of Vascular Interventional Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors: Gonzalo
authors: G
authors: Simó
authors: Department of Vascular Interventional Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors: Miguel
authors: M
authors: Echenagusia
authors: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Department of Medicine, Universidad Complutense, Madrid, Spain. Electronic address: mariaguembe@hotmail.com.
authors: María
authors: M
authors: Guembe
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000175:diagnosis* / Q000209:etiology; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D015373:Bacterial Typing Techniques; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Catheter-related bloodstream infection; Colonization; Diagnosis; Port reservoir