Negative catheter-tip culture and diagnosis of catheter-related bacteremia.
Negative catheter-tip culture and diagnosis of catheter-related bacteremia.
复制标题
导管尖端培养阴性和导管相关菌血症的诊断。
DOI：
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
B. Eurin
中科院分区：
文献类型：
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作者：
Douard Mc;E. Clementi;G. Arlet;O. Marie;Laurent Jacob;B. Schremmer;M. Rouveau;M. Garrouste;B. Eurin
在58例菌血症成人患者中评价了在儿科隔离器1.5 ml试管中采集的成对定量血培养（PQtBC）与中心静脉导管（CVC）节段培养（导管座和头端）诊断导管相关菌血症（CRB）的准确性。本研究的第二个目的是在PQtBC结果显著的情况下，准确说明受感染器械的头端或座（或两者）是否是菌血症的来源。58例疑似CRB的菌血症患者入组研究。在52名患者中，在CVC移除前通过PQtBC获得诊断，并通过CVC段培养证实：30名患者为CRB，22名患者为非导管相关菌血症。6例患者PQtBC未发现CRB。1)PQtBC的敏感性为83%，特异性为100%（阴性预测值为78%，阳性预测值为100%）。2)16例菌血症患者具有真实的管座相关菌血症（阳性管座培养物与阴性头端培养物相关）。当菌血症患者疑似CRB时，培养阴性不能排除CRB的诊断。在所有情况下，CVC尖端培养物必须与PQtBC或与中心培养物相关联。
The accuracy of paired quantitative blood cultures (PQtBCs) collected in pediatric Isolator 1.5-ml tubes compared to central venous catheter (CVC) segment cultures (hub and tip) to diagnose catheter-related bacteremia (CRB) was evaluated in 58 bacteremic adult patients. The second aim of this study was to state precisely whether the tip or the hub (or both) of the infected device was the source of the bacteremia in case of significant results of PQtBC. Fifty-eight bacteremic patients with suspected CRB entered the study. In 52 patients, the diagnosis was obtained before CVC removal by PQtBC and was confirmed by CVC segment cultures: CRB in 30 patients, non-catheter-related bacteremia in 22 patients. Six patients had CRB not found by PQtBC. 1) PQtBC is 83% sensitive, 100% specific (negative predictive values 78%, positive predictive values 100%). 2) Sixteen bacteremic patients had authentic hub-related bacteremia (positive hub culture associated with negative tip cultures). When CRB is suspected in bacteremic patients, a negative tip culture cannot exclude the diagnosis of CRB. In all cases, CVC tip culture must be associated either with PQtBC or with hub cultures.