1887

Chapter 3.6 : Catheter Tip Cultures

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in
Zoomout

Catheter Tip Cultures, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817435/9781555815271_Chap3_6-1.gif /docserver/preview/fulltext/10.1128/9781555817435/9781555815271_Chap3_6-2.gif

Abstract:

Intravascular (intra-arterial or intravenous) catheter insertions cause a break in the skin barrier amenable to infection. Table 3.6-1 lists the most common types of vascular and hemodialysis access catheters used for patient care that the laboratory may encounter. The continued presence of this foreign body predisposes further to infection, which can result from either colonization of the catheter by the cutaneous microbiota or, less commonly, hematogenous seeding due to hub contamination. Since infected catheters are usually exposed directly to sterile spaces, there is a risk that the infection will result in bacteremia. Intravascular catheter-related infections are a major cause of morbidity and mortality in the United States. The Infectious Disease Society of America practice guidelines for management of these infections include culture of both catheters and blood ( ). Central catheter infection may manifest as infection at the skin insertion site, as cellulitis along the soft tissues overlying the tunneled portion, or as bacteremia without evidence of external infection at either of these superficial sites. Bacteremia occurs secondary to infection of the central catheter or as a manifestation of more serious complications, including septic thrombophlebitis or endocarditis. Laboratory confirmation of central catheter infection requires recovery of the same organism from a patient's blood and from cultures of the catheter tip and/or intracutaneous catheter segment. Clinical policy should instruct physicians to submit both catheter segments and blood cultures to the laboratory. The most common infecting organisms are enterococci, spp., and resident skin organisms, such as coagulase-negative staphylococci and spp. The significance of this last group of organisms is not always clear, since the catheter is removed through the skin.

Citation: Garcia L. 2010. Catheter Tip Cultures, p 192-198. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.6
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 3.6-1
Figure 3.6-1

Inoculation of catheter tip to agar plate.

Citation: Garcia L. 2010. Catheter Tip Cultures, p 192-198. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.6
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555817435.chap3.6
1. Blot, F.,, G. Nitenberg,, E. Chachaty,, B. Raynard,, N. Germann,, S. Antoun,, A. Laplanche,, C. Brun-Buisson,, and C. Tancrede. 1999. Diagnosis of catheter-related bacteremia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures. Lancet 354:10711077.
2. Brun-Buisson, C.,, F. Abrouk,, P. Legrand,, Y. Huet,, S. Larabi,, and M. Rapin. 1987. Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. Arch. Intern .Med. 147(RR-10):873877.
3.Centers for Disease Control and Prevention. 2002. Guidelines for the prevention of intravascular catheter-related infections. MMWR Morb. Mortal. Wkly. Rep. 51:126.
4.Clinical and Laboratory Standards Institute. 2004. Quality Assurance for Commercially Prepared Microbiological Culture Media, 3rd ed. Approved standard M22-A3. Clinical and Laboratory Standards Institute, Wayne, PA.
5. Dooley, D. P.,, A. Garcia,, J. W. Kelly,, R. N. Longfield,, and L. Harrison. 1996. Validation of catheter semiquantitative culture technique for nonstaphylococcal organisms. J. Clin. Microbiol. 34:409412.
6. Gutierrez, J.,, C. Leon,, R. Matamoros,, C. Nogales,, and E. Martin. 1992. Catheter-related bacteremia and fungemia. Reliability of two methods for catheter culture. Diagn. Microbiol. Infect. Dis. 15:575578.
7. Maki, D. G.,, C. E. Weise,, and H. W. Sarafin. 1977. A semiquantitative culture method for identifying intravenous catheter-related infection. N. Engl. J. Med. 296:13051309.
8. Malgrange, V. B.,, M. C. Escande,, and S. Theobald. 2001. Validity of earlier positivity of central venous blood cultures in comparison with peripheral blood cultures for diagnosing catheter-related bacteremia in cancer patients. J. Clin. Microbiol. 39:274278.
9. Mermel, L. A.,, B. M. Farr,, R. J. Sherertz,, I. I. Raad,, N. O'Grady,, J. S. Harris,, and D. E. Craven. 2001. Guidelines for the management of intravascular catheter related infections. Clin. Infect. Dis. 32:12491272.
10. Raad, I. I.,, M. F. Sabbagh,, K. H. Rand,, and R. J. Sherertz. 1992. Quantitative tip culture methods and the diagnosis of central venous catheter-related infections. Diagn. Microbiol. Infect. Dis. 15:1320.
11. Schmitt, S. K.,, C. Knapp,, G. S. Hall,, D. L. Longworth,, J. T. McMahon,, and J. A. Washington. 1996. Impact of chlorhexidinesilver sulfadiazine-impregnated central venous catheters on in vitro quantitation of catheter-associated bacteria. J. Clin. Microbiol. 34:508511.
12. Sherertz, R. J.,, S. O. Heard,, and I. I. Raad. 1997. Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies. J. Clin. Microbiol. 35:641646.
13. Sherertz, R. J.,, I. I. Raad,, A. Belani,, L. C. Koo,, K. H. Rand,, D. L. Pickett,, S. A. Straub,, and L. L. Fauerbach. 1990. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J. Clin. Microbiol. 28:7682.
14. Siegman-Igra, Y.,, A. M. Anglim,, D. E. Shapiro,, K. A. Adal,, B. A. Strain,, and B. M. Farr. 1997. Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis. J. Clin. Microbiol. 35:928936.
1. Sherertz, R. J.,, I. I. Raad,, A. Belani,, L. C. Koo,, K. H. Rand,, D. L. Pickett,, S. A. Straub,, and L. L. Fauerbach. 1990. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J. Clin. Microbiol. 28:7682.
2. Siegman-Igra, Y.,, A. M. Anglim,, D. E. Shapiro,, K. A. Adal,, B. A. Strain,, and B. M. Farr. 1997. Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis. J. Clin. Microbiol. 35:928936.

Tables

Generic image for table
Table 3.6-1

Common types of vascular and hemodialysis access catheters

ICU, intensive care unit; CVC, central venous catheter; TPN, total parenteral nutrition; PICC, peripherally inserted central catheter; IJ, internal jugular; UVC, umbilical vein catheter.

Citation: Garcia L. 2010. Catheter Tip Cultures, p 192-198. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.6

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error