Cultures of Needleless Connectors Are Useful for Ruling Out Central Venous Catheter Colonization
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
Setting.
Laboratory procedures.
Definitions.
Statistical analyses.
Ethics.
RESULTS
Characteristica | Result |
---|---|
Patients (n = 49) | |
Age (mean ± SD) (yr) | 64.47 ± 14.2 |
Male/female (no./no.) | 28/21 |
Underlying condition (no. [%]) | |
Myocardial infarction | 10 (20.4) |
Congestive heart failure | 18 (36.7) |
Central nervous system (ACVA) | 2 (4.1) |
Chronic obstructive pulmonary disease | 11 (22.4) |
Diabetes mellitus | 18 (36.7) |
Peptic ulcer disease | 7 (14.3) |
Peripheral vascular disease | 5 (10.2) |
Renal dysfunction | 8 (16.3) |
EuroSCORE (mean ± SD) | 6.68 ± 3.1 |
Comorbidity index (Charlson criteria) (mean ± SD) | 2.18 ± 1.7 |
Nonfatal underlying disease (no. [%]) | 45 (91.8) |
APACHE II score at admission (mean ± SD) | 8.67 ± 3.4 |
Length of ICU stay (median [IQR]) (days) | 8.5 (5.2–13.0) |
C-RBSI episodes (no. [%]) | 3 (6.1) |
Crude mortality rate (no. [%]) | 8 (16.3) |
Attributable mortality rate (no. [%]) | 0 (0.0) |
Central venous systems (n = 75) | |
Type of catheter (no. [%]) | |
Nontunneled central venous catheter | 57 (60.0) |
Swan-Ganz catheter | 1 (1.3) |
Arterial catheter | 2 (2.7) |
Sheldon catheter | 4 (5.3) |
Introducer sheath | 11 (14.7) |
Location (no. [%]) | |
Jugular | 60 (80.0) |
Subclavian | 8 (10.7) |
Femoral | 7 (9.3) |
Total parenteral nutrition/propofol (no. [%]) | 13 (17.3) |
Reason for catheter withdrawal (no. [%]) | |
End of use | 50 (66.7) |
Suspicion of infection | 12 (16.0) |
Other | 13 (17.3) |
Catheter colonization (no. [%]) | 8 (10.7) |
Catheter colonization density (cases per 1,000 catheter-days) | 9.91 |
Culture type | Sensitivity (95% CI)a (%) | Specificity (95% CI) (%) | PPV (95% CI) (%) | NPV (95% CI) (%) | Validity index (95% CI) (%) | Prevalence (95% CI) (%) | Positive LR (95% CI) | Negative LR (95% CI) |
---|---|---|---|---|---|---|---|---|
Hub | 25.0 (0.0–61.3) | 95.5 (89.8–100) | 40.0 (0.0–92.9) | 91.4 (84.2–98.7) | 88.0 (79.9–96.0) | 10.7 (3.0–18.3) | 5.58 (1.09–28.56) | 0.79 (0.52–1.18) |
NC | 87.5 (58.3–100) | 97.0 (92.2–100) | 77.8 (45.0–100) | 98.5 (94.8–100) | 96.0 (90.9–100) | 10.7 (3.0–18.3) | 29.31 (7.30–117.68) | 0.13 (0.02–0.81) |
Sample no. | Microorganism (CFU) | ||
---|---|---|---|
Catheter tip | Hub | Connector | |
40 | Staphylococcus capitis (100) | Staphylococcus epidermidis (50) | Staphylococcus capitis (1,000) |
Staphylococcus hominis (100) | Staphylococcus hominis (100) | Staphylococcus hominis (500) | |
Klebsiella pneumoniae (30) | |||
67 | Staphylococcus epidermidis (>1,000) | Staphylococcus epidermidis (>1,000) | Staphylococcus epidermidis (1,500) |
97 | Rhodotorula mucilaginosa (>1,000) | ||
53 | Staphylococcus epidermidis (1,000) | Staphylococcus epidermidis (600) | |
Corynebacterium tuberculostearicum (1,000) | |||
36 | Staphylococcus epidermidis (100) | Staphylococcus epidermidis (1,300) | |
Enterococcus faecalis (200) | |||
Klebsiella pneumoniae (70) | |||
31 | Staphylococcus epidermidis (500) | Staphylococcus epidermidis (1,000) | |
109 | Staphylococcus aureus (5,000) | Staphylococcus aureus (300) | |
110 | Staphylococcus aureus (900) | Staphylococcus aureus (100) |
DISCUSSION
ACKNOWLEDGMENTS
REFERENCES
Information & Contributors
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