Diagnosis of catheter-related bacteraemia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures
Diagnosis of catheter-related bacteraemia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures
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DOI：
10.1016/s0140-6736(98)11134-0
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发表时间：
1999-09-25
期刊：
影响因子：
168.9
通讯作者：
Tancrede, C
中科院分区：
文献类型：
--
作者：
Blot, F;Nitenberg, G;Tancrede, C
背景：一种无需取出导管即可诊断导管相关性感染（CRI）的方法将是有用的。与外周静脉血培养相比，中心静脉血培养的早期阳性可能与导管相关菌血症有关。我们前瞻性地评估了差分时间阳性（DTP）的配对血培养同时通过导管集线器和外周静脉situ.Methods在14个月的时间内，在重症监护病房的癌症转诊中心，同时集线器血液和外周血培养（平均每例患者两个），从疑似CRI的患者。根据临床标准和导管尖端的定量培养，将病例分类为CRI或其他来源的脓毒症。至少有一对集线器血液和外周血培养在48小时内获得导管取出前，我们记录了集线器血液和外周血培养物之间的DTP与一个自动装置检测的血培养positive.Findings我们分析了93导管删除，因为怀疑CRI，在28集，相同的微生物被发现在集线器血液和外周血培养。在17例中心血培养阳性患者中，有16例确诊为明确的菌血症CRI，其检测时间比外周血培养至少早2小时。这些事件中约有一半（9/17）发生在长期（>30天）器械中。DTP低于2 h的11例患者中有10例排除CRI。CRI患者的配对血培养DTP显著高于其他患者（p
Background A method of diagnosing catheter-related infection (CRI) without removing the catheter would be useful. An earlier positivity of central compared with peripheral venous-blood cultures may be associated with catheter-related bacteraemia. We evaluated prospectively the differential time to positivity (DTP) of paired blood cultures drawn simultaneously via the catheter hub and from a peripheral venous site.Methods Over a 14-month period in an intensive-care unit of a cancer referral centre, simultaneous hub-blood and peripheral-blood cultures (a mean of two per patient) were obtained from patients with a suspected CRI. According to clinical criteria and quantitative culture of the catheter tip, cases were classified as CRI or sepsis of other origin. At least one pair of hub-blood and peripheral-blood cultures was obtained within 48 h before catheter removal, and we recorded the DTP between hub-blood and peripheral-blood cultures with an automatic device for detection of blood culture positivity.Findings We analysed 93 catheters removed because of suspicion of CRI, in 28 episodes, the same micro-organisms were found in both hub-blood and peripheral-blood cultures. A diagnosis of definite bacteraemic CRI was made in 16 of the 17 patients in whom a positive hub-blood culture was detected at least 2 hours earlier than peripheral-blood culture. About half (9/17) of these episodes occurred in long-term (>30 days) devices. CRI was excluded in ten of the 11 patients with a DTP lower than 2 h. The DTP of paired blood cultures was significantly greater in patients with CRI than in others (p