Diagnostic Value of Simultaneous Culture of Central Venous Catheter Blood and Peripheral Blood for Catheter-related Bloodstream Infection_Chinese Journal of Evidence-Based Medicine

Authors：

 SHENTing ¹ , YANGWei ¹ , LIChen-fang ¹ , ZHANGZhen ² ,  XIANGYun ²

1. Department of Rheumatology, the First Hospital of Wuhan, Wuhan 430022, China;
2. Department of Laboratory, Wuhan Medical and Health Center for Women and Children, Wuhan 430016, China;

Corresponding author：

XIANGYun, Email: deng13098855103@163.com

Keywords：

Central venous catheters; Catheter-related bloodstream infections; Blood culture; Catheter culture; Diagnosis

DOI：

10.7507/1672-2531.20150149

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Objective To investigate the diagnostic value of simultaneous culture of central venous catheter (CVC) blood and peripheral blood for catheter-related bloodstream infections (CRBSI). Methods Non-septic patients who were treated with CVC for 1 to 7 days were enrolled from February 2011 to February 2015 in the First Hospital of Wuhan City. Blood were collected from both peripheral vein and CVC for bacterial culture once a day. The CVCs were removed from patients who got CRBSI from the first to sixth day and who did not by the end of the seventh day for semi-quantitative catheter culture, quantitative catheter culture, CVC culture and catheter exit-site pus culture. The diagnosis of CRBSI were based on 4 methods as follows:A, both peripheral and CVC blood were positive and the time of CVC blood positive were 2 hours earlier than peripheral blood; B, the colonies of semi-quantitative catheter cultures were ≥15 CFU and the microorganisms in both CVC and peripheral blood were the same; C, the colonies ratio of CVC and peripheral blood cultures were ≥5:1; D, the microorganisms in both the peripheral blood and catheter exit-site pus were the same. The diagnostic value of the four methods was compared. Results A total of 1 086 patients were finally included. From 1 to 7 days, 64 patients were peripheral blood positive, 79 were CVC blood positive. The patients diagnosed as CRBSI using A, B, C, and D methods were 58, 55, 51, and 36, respectively. Sixty patients were diagnosed as CRBSI based on the clinical and laboratory methods. For the number of patients diagnosed with CRBSI, there was no significant difference between A and B (P>0.05), as well as A and C (P>0.05), however, significant difference was found between A and D (P<0.05). In the diagnostic value of CRBSI, A is similar to B (sensitivity:93.33% vs. 91.67%, specificity:99.81% vs. 100%, Youden index:0.93 vs. 0.92). A, B and C had almost similar specificity (all >99%), however, A had higher sensitivity (93.33% vs. 76.67%, 58.33%) and Youden index (0.93 vs. 0.76, 0.58). Conclusion Simultaneous culture of CVC blood and peripheral blood has a good diagnostic value for CRBSI.

Citation： SHENTing, YANGWei, LIChen-fang, ZHANGZhen, XIANGYun. Diagnostic Value of Simultaneous Culture of Central Venous Catheter Blood and Peripheral Blood for Catheter-related Bloodstream Infection. Chinese Journal of Evidence-Based Medicine, 2015, 15(8): 883-886. doi: 10.7507/1672-2531.20150149 Copy

1.	Sammut D, Elliot C, Kiely D, et al. Central venous catheter-related blood stream infections in patients receiving intravenous iloprost for pulmonary hypertension. Eur J Clin Microbiol Infect Dis, 2013, 32(7):883-889.
2.	Long D, Ullman A, Rickard C. Paediatric intensive care practices and nurses' knowledge of evidence based recommendations for the prevention of central venous catheter (CVC) related blood stream infections. Aust Crit Care, 2013, 26(2):94-95.
3.	Sakai T, Kohda K, Konuma Y, et al. A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies. Int J Hematol, 2014, 100(6):592-598.
4.	中华医学会重症医学分会. 血管内导管相关感染的预防与治疗指南(2007). 中华内科杂志, 2008, 47(8):691-699.
5.	蒋晓飞, 骆俊, 刘红, 等. 导管保留法诊断导管相关性血流感染的研究. 检验医学, 2012, 27(4):271-274.
6.	Cicolini G, Simonetti V, Comparcini D, et al. Nurses' knowledge of evidence-based guidelines on the prevention of peripheral venous catheter-related infections:a multicentre survey. J Clin Nurs, 2014, 23(17-18):2578-2588.
7.	叶应妩, 王毓三, 申子瑜, 主编. 全国临床检验操作规程第3版. 南京:东南大学出版社, 2006:399-460.
8.	申冬琴, 杜一, 张彩云, 等. 地塞米松预处理导管预防PICC相关静脉炎的系统评价. 中国循证医学杂志, 2014, 14(4):478-483.
9.	LeMaster CH, Hoffart N, Chafe T, et al. Implementing the Central Venous Catheter Infection Prevention Bundle in the Emergency Department:Experiences Among Early Adopters. Ann Emerg Med, 2014, 63(3):340-350.
10.	Kadowaki M, Shimono N. Candida catheter related-blood stream infection. Jpn J Antibiot, 2014, 67(1):1-14.
11.	Concannon C, Wijngaarden E, Stevens V, et al. The Effect of Multiple Concurrent Central Venous Catheters on Central Line-Associated Bloodstream Infections. Infect Control Hosp Epidemiol, 2014, 35(9):1140-1146.
12.	Alkubati SA, Ahmed NT, Mohamed ONE, et al. Health care workers' knowledge and practices regarding the prevention of central venous catheter-related infection. Am J Infect Control, 2015, 43(1):26-30.

1. Sammut D, Elliot C, Kiely D, et al. Central venous catheter-related blood stream infections in patients receiving intravenous iloprost for pulmonary hypertension. Eur J Clin Microbiol Infect Dis, 2013, 32(7):883-889.
2. Long D, Ullman A, Rickard C. Paediatric intensive care practices and nurses' knowledge of evidence based recommendations for the prevention of central venous catheter (CVC) related blood stream infections. Aust Crit Care, 2013, 26(2):94-95.
3. Sakai T, Kohda K, Konuma Y, et al. A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies. Int J Hematol, 2014, 100(6):592-598.
4. 中华医学会重症医学分会. 血管内导管相关感染的预防与治疗指南(2007). 中华内科杂志, 2008, 47(8):691-699.
5. 蒋晓飞, 骆俊, 刘红, 等. 导管保留法诊断导管相关性血流感染的研究. 检验医学, 2012, 27(4):271-274.
6. Cicolini G, Simonetti V, Comparcini D, et al. Nurses' knowledge of evidence-based guidelines on the prevention of peripheral venous catheter-related infections:a multicentre survey. J Clin Nurs, 2014, 23(17-18):2578-2588.
7. 叶应妩, 王毓三, 申子瑜, 主编. 全国临床检验操作规程第3版. 南京:东南大学出版社, 2006:399-460.
8. 申冬琴, 杜一, 张彩云, 等. 地塞米松预处理导管预防PICC相关静脉炎的系统评价. 中国循证医学杂志, 2014, 14(4):478-483.
9. LeMaster CH, Hoffart N, Chafe T, et al. Implementing the Central Venous Catheter Infection Prevention Bundle in the Emergency Department:Experiences Among Early Adopters. Ann Emerg Med, 2014, 63(3):340-350.
10. Kadowaki M, Shimono N. Candida catheter related-blood stream infection. Jpn J Antibiot, 2014, 67(1):1-14.
11. Concannon C, Wijngaarden E, Stevens V, et al. The Effect of Multiple Concurrent Central Venous Catheters on Central Line-Associated Bloodstream Infections. Infect Control Hosp Epidemiol, 2014, 35(9):1140-1146.
12. Alkubati SA, Ahmed NT, Mohamed ONE, et al. Health care workers' knowledge and practices regarding the prevention of central venous catheter-related infection. Am J Infect Control, 2015, 43(1):26-30.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of Simultaneous Culture of Central Venous Catheter Blood and Peripheral Blood for Catheter-related Bloodstream Infection

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