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Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin

BACKGROUND: Culture of catheter hubs and skin surrounding the catheter entry site has a negative predictive value for catheter tip colonization. However, manipulation of the hub for culture requires the hubs to be swabbed, introducing potential dislodging of biofilm and subsequent migration of micro...

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Autores principales: Pérez-Granda, María Jesús, Guembe, María, Cruces, Raquel, Barrio, José María, Bouza, Emilio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736709/
https://www.ncbi.nlm.nih.gov/pubmed/26838274
http://dx.doi.org/10.1186/s13054-016-1201-0
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author Pérez-Granda, María Jesús
Guembe, María
Cruces, Raquel
Barrio, José María
Bouza, Emilio
author_facet Pérez-Granda, María Jesús
Guembe, María
Cruces, Raquel
Barrio, José María
Bouza, Emilio
author_sort Pérez-Granda, María Jesús
collection PubMed
description BACKGROUND: Culture of catheter hubs and skin surrounding the catheter entry site has a negative predictive value for catheter tip colonization. However, manipulation of the hub for culture requires the hubs to be swabbed, introducing potential dislodging of biofilm and subsequent migration of microorganisms. Hubs are usually closed with needleless connectors (NCs), which are replaced regularly. Our objective was to evaluate whether culture of flushed withdrawn NCs is an alternative to hub culture when investigating central venous catheter colonization. METHODS: The study population comprised 49 intensive care unit patients whose central venous catheters had been in place for at least 7 days. Cultures of NCs and skin were obtained weekly. RESULTS: We included 82 catheters with more than 7 days’ indwelling time. The catheter tip colonization rate was 18.3 % (15/82). Analysis of skin and NC cultures revealed a 92.5 % negative predictive value for catheter colonization. Three episodes of catheter-related bloodstream infection (C-RBSI) occurred in patients with colonized catheters. CONCLUSION: Surveillance of NC and skin cultures could help to identify patients at risk for C-RBSI.
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spelling pubmed-47367092016-02-03 Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin Pérez-Granda, María Jesús Guembe, María Cruces, Raquel Barrio, José María Bouza, Emilio Crit Care Research BACKGROUND: Culture of catheter hubs and skin surrounding the catheter entry site has a negative predictive value for catheter tip colonization. However, manipulation of the hub for culture requires the hubs to be swabbed, introducing potential dislodging of biofilm and subsequent migration of microorganisms. Hubs are usually closed with needleless connectors (NCs), which are replaced regularly. Our objective was to evaluate whether culture of flushed withdrawn NCs is an alternative to hub culture when investigating central venous catheter colonization. METHODS: The study population comprised 49 intensive care unit patients whose central venous catheters had been in place for at least 7 days. Cultures of NCs and skin were obtained weekly. RESULTS: We included 82 catheters with more than 7 days’ indwelling time. The catheter tip colonization rate was 18.3 % (15/82). Analysis of skin and NC cultures revealed a 92.5 % negative predictive value for catheter colonization. Three episodes of catheter-related bloodstream infection (C-RBSI) occurred in patients with colonized catheters. CONCLUSION: Surveillance of NC and skin cultures could help to identify patients at risk for C-RBSI. BioMed Central 2016-02-02 /pmc/articles/PMC4736709/ /pubmed/26838274 http://dx.doi.org/10.1186/s13054-016-1201-0 Text en © Pérez-Granda et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Pérez-Granda, María Jesús
Guembe, María
Cruces, Raquel
Barrio, José María
Bouza, Emilio
Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin
title Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin
title_full Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin
title_fullStr Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin
title_full_unstemmed Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin
title_short Assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin
title_sort assessment of central venous catheter colonization using surveillance culture of withdrawn connectors and insertion site skin
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736709/
https://www.ncbi.nlm.nih.gov/pubmed/26838274
http://dx.doi.org/10.1186/s13054-016-1201-0
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