title: Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin.
abstract: BACKGROUND
  Culture of catheter hubs and skin surrounding the catheter entry site has a negative predictive value for catheter tip colonization. However, manipulation of the hub for culture requires the hubs to be swabbed, introducing potential dislodging of biofilm and subsequent migration of microorganisms. Hubs are usually closed with needleless connectors (NCs), which are replaced regularly. Our objective was to evaluate whether culture of flushed withdrawn NCs is an alternative to hub culture when investigating central venous catheter colonization.
  
  
  METHODS
  The study population comprised 49 intensive care unit patients whose central venous catheters had been in place for at least 7 days. Cultures of NCs and skin were obtained weekly.
  
  
  RESULTS
  We included 82 catheters with more than 7 days' indwelling time. The catheter tip colonization rate was 18.3% (15/82). Analysis of skin and NC cultures revealed a 92.5% negative predictive value for catheter colonization. Three episodes of catheter-related bloodstream infection (C-RBSI) occurred in patients with colonized catheters.
  
  
  CONCLUSIONS
  Surveillance of NC and skin cultures could help to identify patients at risk for C-RBSI.
authors.affiliation: CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain. massus@hotmail.es.|Cardiac Surgery Postoperative Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. massus@hotmail.es.|Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Dr. Esquerdo, 46, 28007, Madrid, Spain. massus@hotmail.es.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Pérez-Granda
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Dr. Esquerdo, 46, 28007, Madrid, Spain. mariaguembe@hotmail.com.|Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain. mariaguembe@hotmail.com.
authors.forename: María
authors.initials: M
authors.lastname: Guembe
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Dr. Esquerdo, 46, 28007, Madrid, Spain. rcrufer@gmail.com.|Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain. rcrufer@gmail.com.
authors.forename: Raquel
authors.initials: R
authors.lastname: Cruces
authors.affiliation: CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain. jmbarriogut@gmail.com.|Cardiac Surgery Postoperative Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. jmbarriogut@gmail.com.
authors.forename: José María
authors.initials: JM
authors.lastname: Barrio
authors.affiliation: CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain. ebouza@microb.net.|Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Dr. Esquerdo, 46, 28007, Madrid, Spain. ebouza@microb.net.|Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain. ebouza@microb.net.|Medicine Department, School of Medicine, Universidad Complutense de Madrid, Pza. Ramón y Cajal, s/n Ciudad Universitaria, 28040, Madrid, Spain. ebouza@microb.net.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000382:microbiology*; D062905:Central Venous Catheters / Q000009:adverse effects* / Q000382:microbiology*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D017053:Infection Control / Q000592:standards; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology
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