title: Detection of central venous catheter-related bloodstream infections in haematooncological patients.
abstract: BACKGROUND
  Catheter-related bloodstream infections (CRBSIs) are currently detected in patients with clinically suspicion. The aim of our study was to evaluate whether CRBSIs could be anticipated and detected in a subclinical stage by peptide nucleic acid fluorescence in situ hybridization (PNA FISH) using universal hybridization probes or acridine orange leucocyte cytospin (AOLC) tests in haematooncological patients with central venous catheters (CVCs) in situ.
  
  
  METHODS
  Peptide nucleic acid fluorescence in situ hybridization and AOLC tests using blood samples from one CVC lumen/port chamber in haematooncological patients were continuously performed. These results were compared to those obtained from routinely performed CRBSI diagnostic tests.
  
  
  RESULTS
  One hundred and eighty-two patients with 342 catheter periods were investigated. Seventeen CRBSI cases were detected in 6466 CVC days by routine measures resulting in a CRBSI rate of 2.6/1000 catheter days. Two of 17 showed positive PNA FISH tests, and five positive AOLC test results before the diagnosis were established with routine measures. The screening revealed further seven patients with positive universal PNA FISH tests and 10 positive AOLC tests without symptoms indicative for infection and were therefore considered not to have CRBSI.
  
  
  CONCLUSIONS
  Sampling of only one CVC lumen/port chamber screening for CRBSI in haematooncological patients seems not to be a useful tool for anticipative diagnosis of CRBSI. Reasons for false-negative results might include origin of CRBSIs from the other CVC lumina not sampled for screening, and false-positive results might origin from catheter colonization without subsequent spread of micro-organisms into the peripheral bloodstream.
authors.affiliation: Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Rabensteiner
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Theiler
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Duettmann
authors.affiliation: Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Ines
authors.initials: I
authors.lastname: Zollner-Schwetz
authors.affiliation: Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Hoenigl
authors.affiliation: Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Valentin
authors.affiliation: Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Leitner
authors.affiliation: Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Josefa
authors.initials: J
authors.lastname: Luxner
authors.affiliation: Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Grisold
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Angelika
authors.initials: A
authors.lastname: Valentin
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Neumeister
authors.affiliation: Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Krause
mesh_terms: D000165:Acridine Orange; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis*; D002177:Candidiasis / Q000150:complications / Q000175:diagnosis; D055499:Catheter-Related Infections / Q000150:complications / Q000175:diagnosis*; D062905:Central Venous Catheters; D015331:Cohort Studies; D004756:Enterobacteriaceae Infections / Q000150:complications / Q000175:diagnosis; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis; D005188:False Negative Reactions; D005260:Female; D005456:Fluorescent Dyes; D016469:Fungemia / Q000150:complications / Q000175:diagnosis*; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000175:diagnosis; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007710:Klebsiella Infections / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D020135:Peptide Nucleic Acids; D011552:Pseudomonas Infections / Q000150:complications / Q000175:diagnosis; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis; D020615:Stenotrophomonas maltophilia / Q000276:immunology
chemical_list: D005456:Fluorescent Dyes; D020135:Peptide Nucleic Acids; D000165:Acridine Orange
keywords: Acridine orange leucocyte cytospin; catheter-related blood stream infection; haematooncology; peptide nucleic acid fluorescence in situ hybridization; screening