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Chapter 3.6 : Diagnosis of Catheter-Related Bloodstream Infection: Differential-Time-to-Positivity Cultures and Catheter Tip Cultures

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Diagnosis of Catheter-Related Bloodstream Infection: Differential-Time-to-Positivity Cultures and Catheter Tip Cultures, Page 1 of 2

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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 Diseases 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 secondarily 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 or from paired cultures drawn through the catheter lumen. Clinical policy should instruct physicians to submit blood cultures and either paired cultures from the catheter lumen or removed catheter segments to the laboratory for diagnosis of suspected catheter-related bloodstream infection. The most common infecting organisms are , enterococci, spp., , and resident skin organisms, such as coagulase-negative staphylococci and spp. The significance of the last group of organisms is not always clear, since the catheter is removed through the skin.

Citation: Miller S. 2016. Diagnosis of Catheter-Related Bloodstream Infection: Differential-Time-to-Positivity Cultures and Catheter Tip Cultures, p 3.6.1-3.6.7. In Leber A (ed), Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch3.6
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Figures

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Figure 3.6–1

Inoculation of catheter tip to agar plate.

Citation: Miller S. 2016. Diagnosis of Catheter-Related Bloodstream Infection: Differential-Time-to-Positivity Cultures and Catheter Tip Cultures, p 3.6.1-3.6.7. In Leber A (ed), Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch3.6
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References

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1. Mermel LA, Farr BM, Sherertz RJ, Raad II, O’Grady N, Harris JS, Craven DE. 2001. Guidelines for the management of intravascular catheter related infections. Clin Infect Dis 32:12491272.
2. Blot F, Nitenberg G, Chachaty E, Raynard B, Germann N, Antoun S, Laplanche A, Brun-Buisson C, Tancrede C. 1999. Diagnosis of catheter-related bacteremia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures. Lancet 354:10711077.
3. Malgrange VB, Escande MC, Theobald S. 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.
4. Siegman-Igra Y, Anglim AM, Shapiro DE, Adal KA, Strain BA, Farr BM. 1997. Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis. J Clin Microbiol 35:928936.
5. Maki DG, Weise CE, Sarafin HW. 1977. A semiquantitative culture method for identifying intravenous catheter-related infection. N Engl J Med 296:13051309.
6. Sherertz RJ, Raad II, Belani A, Koo LC, Rand KH, Pickett DL, Straub SA, Fauerbach LL. 1990. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol 28:7682.
7. Sherertz RJ, Heard SO, Raad II. 1997. Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies. J Clin Microbiol 35:641646.
8. Centers for Disease Control and Prevention. 2002. Guidelines for the prevention of intravascular catheter-related infections. MMWR Morb. Mortal. Wkly. Rep. 51(RR-10):126.
9. CLSI. 2004. Quality Assurance for Commercially Prepared Microbiological Culture Media, 3rd ed. Approved standard M22-A3. CLSI, Wayne, PA.
10. Siegman-Igra Y, Anglim AM, Shapiro DE, Adal KA, Strain BA, Farr BM. 1997. Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis. J Clin Microbiol 35:928936.
11. Brun-Buisson C, Abrouk F, Legrand P, Huet Y, Larabi S, Rapin M. 1987. Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. Arch Intern Med 147:873877.
12. Dooley DP, Garcia A, Kelly JW, Longfield RN, Harrison L. 1996. Validation of catheter semiquantitative culture technique for nonstaphylococcal organisms. J Clin Microbiol 34:409412.
13. Gutierrez J, Leon C, Matamoros R, Nogales C, Martin E. 1992. Catheter-related bacteremia and fungemia. Reliability of two methods for catheter culture. Diagn Microbiol Infect Dis 15:575578.
14. Raad II, Sabbagh MF, Rand KH, Sherertz RJ. 1992. Quantitative tip culture methods and the diagnosis of central venous catheter-related infections. Diagn Microbiol Infect Dis 15:1320.
15. Schmitt SK, Knapp C, Hall GS, Longworth DL, McMahon JT, Washington JA. 1996. Impact of chlorhexidine-silver sulfadiazine impregnated central venous catheters on in vitro quantitation of catheter-associated bacteria. J Clin Microbiol 34:508511.
1. Sherertz RJ, Raad II, Belani A, Koo LC, Rand KH, Pickett DL, Straub SA, Fauerbach LL. 1990. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol 28:7682.
2. Siegman-Igra Y, Anglim AM, Shapiro DE, Adal KA, Strain BA, Farr BM. 1997. Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis. J Clin Microbiol 35:928936.

Tables

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Table 3.6–1

Common types of vascular and hemodialysis access catheters

Citation: Miller S. 2016. Diagnosis of Catheter-Related Bloodstream Infection: Differential-Time-to-Positivity Cultures and Catheter Tip Cultures, p 3.6.1-3.6.7. In Leber A (ed), Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch3.6

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