EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Incidence of luminal occlusion in multi-lumen central venous catheters Implication for the diagnosis of catheter related blood-stream infection



Incidence of luminal occlusion in multi-lumen central venous catheters Implication for the diagnosis of catheter related blood-stream infection



Abstracts of the General Meeting of the American Society for Microbiology 102: 100



Background: Recently described in situ techniques for the diagnosis of CRBSI, including differential time to positivity (DTP) of central and peripheral paired blood cultures (>2hours), Gram staining and Acridine-Orange Leukocyte Cytospin (G/AOLC)(>1 cfu) tests rely on aspirated blood from the CVC lumen. Endoluminal brushing allows assessment of catheter lumens without blood aspiration. We compared catheter blood aspiration with the results of endoluminal brushing to evaluate the success rate of techniques that require luminal blood for diagnosing CRBSI. Methods: Assessment of multi-lumen CVCs used in intensive care and high dependency unit patients was carried out on suspicion of CRBSI (temperature >37degreeC, white cell count>11X109/ml). Aspiration of blood from each lumen was attempted (1ml for gram stain and AOLC and 10ml for DTP), followed by individual brushing of each lumen. Positive endoluminal brush result criteria was >100cfu/ml. Simultaneous peripheral blood was taken and cultured by an automated qualitative method (Vital). Results: The study identified 74 CVCs with suspected CRBSI (56 triple and 18 quadruple lumen CVCs, median 8.5 days dwell time (range 2-43)). Blood was successfully aspirated from 136 of the 240 lumens investigated. A total of 43 lumens were positive on endoluminal brushing, 32.5% of which could not be aspirated. Of the 19 cases of CRBSI identified all were detected by endoluminal brushing, 12 by DTP and 10 by G/AOLC. Conclusion: Techniques that rely on luminal aspiration to diagnose CRBSI may fail to sample nearly half of the lumens in multi-lumen CVCs. We recommend that endoluminal brushing is the most appropriate in situ sampling technique for assessing multi-lumen CVCs for CRBSI when blood aspiration cannot be achieved.

(PDF emailed within 1 workday: $29.90)

Accession: 035114396

Download citation: RISBibTeXText



Related references

Which lumen is the source of catheter-related bloodstream infection in patients with multi-lumen central venous catheters?. Infection 41(1): 49-52, 2013

Intensivist supervision of resident-placed central venous catheters decreases the incidence of catheter-related blood stream infections. Patient Safety in Surgery 2: 11-11, 2008

Do multi-lumen catheters increase central venous catheter sepsis compared to single-lumen catheters?. Journal of Trauma 28(10): 1472-1475, 1988

Effectiveness of impregnated central venous catheters for catheter related blood stream infection: a systematic review. Current Opinion in Infectious Diseases 21(3): 235-245, 2008

Influence of triple-lumen central venous catheters coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia. Archives of Internal Medicine 158(1): 81-87, 1998

Five-Lumen Antibiotic-Impregnated Femoral Central Venous Catheters in Severely Burned Patients: An Investigation of Device Utility and Catheter-Related Bloodstream Infection Rates. Journal of Burn Care & Research 36(4): 493-499, 2016

Effectiveness of silver-impregnated central venous catheters for preventing catheter-related blood stream infections: a meta-analysis. International Journal of Infectious Diseases 29(): 279-286, 2015

A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies. International Journal of Hematology 100(6): 592-598, 2015

Usefulness of blood cultures from central venous catheters in the diagnosis of infection of the catheter tip. Enfermedades Infecciosas Y Microbiologia Clinica 9(7): 416-419, 1991

Effect of heparin-bonded central venous catheters on the incidence of catheter-related thrombosis and infection in children and adults. Anaesthesia and Intensive Care 34(4): 481-484, 2006

Central venous catheter-related blood stream infections: incidence and an analysis of risk factors. Medical Journal of Malaysia 62(5): 370-374, 2008

Peripherally inserted central catheters may lower the incidence of catheter-related blood stream infections in patients in surgical intensive care units. Surgical Infections 12(4): 279-282, 2011

Central venous catheter-related blood stream infections: incidence, risk factors, outcome, and associated pathogens. Journal of Cardiothoracic and Vascular Anesthesia 18(3): 304-308, 2004

Diagnosis of central-venous catheter-related infection Comparison of the roll-plate and sonication technique in 1000 catheters. Abstracts Of The Interscience Conference On Antimicrobial Agents & Chemotherapy. 43: 398, 2003

Sonication for diagnosis of catheter-related infection is not better than traditional roll-plate culture: a prospective cohort study with 975 central venous catheters. Clinical Infectious Diseases 59(4): 541-544, 2015