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Differential time to positivity of blood cultures: A valid method for diagnosing catheter-related bloodstream infections in the intensive care unit

García, X ; Sabatier, C ; Ferrer, R ; Fontanals, D ; Duarte, M ; Colomina, M ; Artigas, A ; Vallés, J

Medicina intensiva, 2012-04, Vol.36 (3), p.169-176 [Periódico revisado por pares]

Spain: Elsevier Espana

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Título:
Differential time to positivity of blood cultures: A valid method for diagnosing catheter-related bloodstream infections in the intensive care unit
Autor: García, X ; Sabatier, C ; Ferrer, R ; Fontanals, D ; Duarte, M ; Colomina, M ; Artigas, A ; Vallés, J
Assuntos: Adult ; Aged ; Bacteremia - diagnosis ; Bacteremia - etiology ; Cateterización venosa central ; Catheter-related infections ; Catheter-Related Infections - blood ; Catheter-Related Infections - diagnosis ; Catheters - microbiology ; Central venous catheterization ; Critical Care ; Critical Care - methods ; Cross Infection - blood ; Cross Infection - diagnosis ; Cuidados intensivos ; Diagnosis ; Diagnóstico ; Equipment Contamination ; Female ; Humans ; Infección asociada a catéter ; Intensive Care Units ; Male ; Middle Aged ; Predictive Value of Tests ; ROC Curve ; Sensitivity and Specificity ; Time Factors ; Unnecessary Procedures ; Veins
É parte de: Medicina intensiva, 2012-04, Vol.36 (3), p.169-176
Descrição: Abstract Purpose The validation in critical patients with short-term catheters of a method for diagnosing catheter-related bloodstream infection (CR-BSI), based on the differential time to positivity (DTP) of blood cultures. Methods Patients suspected of having CR-BSI were included. Two peripheral vein blood cultures and a catheter hub blood culture were simultaneously carried out. The responsible catheter was removed and tip cultured. Times to positivity of all blood cultures were automatically registered. CR-BSI was diagnosed when all the cultures were positive for the same microorganism and DTP ≥ 120 min. This diagnosis was compared with the one obtained using the standard method. Results 226 cases suspected of CR-BSI were analyzed during a 20-month period. A total of 19 removed catheters were associated with CR-BSI. Seven cases of polymicrobial cultures (4 with CR-BSI) were discarded from the final analysis due to the impossibility of determining the time to positivity for each individual microorganism. Using the DTP method, 12 out of 15 CR-BSI cases were diagnosed (sensitivity 80%, specificity 99%, PPV 92%, NPV 98%). In a ROC curve, we found a cut-off value of 17.7 h in positivity of hub blood cultures that may be useful for diagnosing CR-BSI. Conclusion DTP can be a valid method for CR-BSI diagnosis in critically ill patients, avoiding unnecessary catheter withdrawal.
Editor: Spain: Elsevier Espana
Idioma: Inglês;Português

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Differential time to positivity of blood cultures: A valid method for diagnosing catheter-related bloodstream infections in the intensive care unit

García, X ; Sabatier, C ; Ferrer, R ; Fontanals, D ; Duarte, M ; Colomina, M ; Artigas, A ; Vallés, J

Spain: Elsevier Espana

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