Blood drawn through valved catheter hub connectors carries a significant risk of contamination
Infection Control became concerned when bloodstream infection (BSI) rates increased after implementing a needleless valved hub connector. During a 21-month period three different needleless catheter hub connectors were evaluated by quantitatively culturing blood drawn through hub connectors that wou...
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Published in | European journal of clinical microbiology & infectious diseases Vol. 30; no. 12; pp. 1571 - 1577 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer-Verlag
01.12.2011
Springer Springer Nature B.V |
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Abstract | Infection Control became concerned when bloodstream infection (BSI) rates increased after implementing a needleless valved hub connector. During a 21-month period three different needleless catheter hub connectors were evaluated by quantitatively culturing blood drawn through hub connectors that would have ordinarily been discarded (DBC). DBC drawn through Clearlink™ catheter hub connectors were found to be twice as likely to be positive as DBC drawn through Clave® or Q-syte™ hub connectors (
P
< 0.04). DBC grew pathogens 46% of the time and skin organisms 54% of the time. Patients with positive DBC were three times more likely to meet Centers for Disease Control (CDC) BSI criteria by DBC cultures than by physician-ordered blood cultures (CBC;
P
< 0.001). For patients growing pathogens in DBC, 64% had no CBC drawn, the average temperature was lower than for patients with pathogens in CBC (99.3 ± 1.5 ve 100.6 ± 1.9,
P
= 0.015), and 92% of discharged patients (11 out of 12) were not treated with an antibiotic active against the DBC pathogen. Drawing BC through a catheter hub connector carries a risk of false-positives that could increase BSI rates by up to 3-fold. Further work is necessary to evaluate this concern. |
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AbstractList | Infection Control became concerned when bloodstream infection (BSI) rates increased after implementing a needleless valved hub connector. During a 21-month period three different needleless catheter hub connectors were evaluated by quantitatively culturing blood drawn through hub connectors that would have ordinarily been discarded (DBC). DBC drawn through Clearlink™ catheter hub connectors were found to be twice as likely to be positive as DBC drawn through Clave® or Q-syte™ hub connectors (
P
< 0.04). DBC grew pathogens 46% of the time and skin organisms 54% of the time. Patients with positive DBC were three times more likely to meet Centers for Disease Control (CDC) BSI criteria by DBC cultures than by physician-ordered blood cultures (CBC;
P
< 0.001). For patients growing pathogens in DBC, 64% had no CBC drawn, the average temperature was lower than for patients with pathogens in CBC (99.3 ± 1.5 ve 100.6 ± 1.9,
P
= 0.015), and 92% of discharged patients (11 out of 12) were not treated with an antibiotic active against the DBC pathogen. Drawing BC through a catheter hub connector carries a risk of false-positives that could increase BSI rates by up to 3-fold. Further work is necessary to evaluate this concern. Infection Control became concerned when bloodstream infection (BSI) rates increased after implementing a needleless valved hub connector. During a 21-month period three different needleless catheter hub connectors were evaluated by quantitatively culturing blood drawn through hub connectors that would have ordinarily been discarded (DBC). DBC drawn through Clearlink(TM) catheter hub connectors were found to be twice as likely to be positive as DBC drawn through Clave® or Q-syte(TM) hub connectors (P<0.04). DBC grew pathogens 46% of the time and skin organisms 54% of the time. Patients with positive DBC were three times more likely to meet Centers for Disease Control (CDC) BSI criteria by DBC cultures than by physician-ordered blood cultures (CBC; P<0.001). For patients growing pathogens in DBC, 64% had no CBC drawn, the average temperature was lower than for patients with pathogens in CBC (99.3±1.5 ve 100.6±1.9, P=0.015), and 92% of discharged patients (11 out of 12) were not treated with an antibiotic active against the DBC pathogen. Drawing BC through a catheter hub connector carries a risk of false-positives that could increase BSI rates by up to 3-fold. Further work is necessary to evaluate this concern.[PUBLICATION ABSTRACT] Infection Control became concerned when bloodstream infection (BSI) rates increased after implementing a needleless valved hub connector. During a 21-month period three different needleless catheter hub connectors were evaluated by quantitatively culturing blood drawn through hub connectors that would have ordinarily been discarded (DBC). DBC drawn through Clearlink™ catheter hub connectors were found to be twice as likely to be positive as DBC drawn through Clave® or Q-syte™ hub connectors (P < 0.04). DBC grew pathogens 46% of the time and skin organisms 54% of the time. Patients with positive DBC were three times more likely to meet Centers for Disease Control (CDC) BSI criteria by DBC cultures than by physician-ordered blood cultures (CBC; P < 0.001). For patients growing pathogens in DBC, 64% had no CBC drawn, the average temperature was lower than for patients with pathogens in CBC (99.3 ± 1.5 ve 100.6 ± 1.9, P = 0.015), and 92% of discharged patients (11 out of 12) were not treated with an antibiotic active against the DBC pathogen. Drawing BC through a catheter hub connector carries a risk of false-positives that could increase BSI rates by up to 3-fold. Further work is necessary to evaluate this concern. |
Author | Palavecino, E. Bischoff, W. Karchmer, T. B. Sherertz, R. J. |
Author_xml | – sequence: 1 givenname: R. J. surname: Sherertz fullname: Sherertz, R. J. email: sherertz@wfubmc.edu organization: Infectious Diseases Section, Department of Medicine, Wake Forest University School of Medicine – sequence: 2 givenname: T. B. surname: Karchmer fullname: Karchmer, T. B. organization: Becton Dickinson – sequence: 3 givenname: E. surname: Palavecino fullname: Palavecino, E. organization: Pathology Department, Wake Forest University School of Medicine – sequence: 4 givenname: W. surname: Bischoff fullname: Bischoff, W. organization: Infectious Diseases Section, Department of Medicine, Wake Forest University School of Medicine |
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Keywords | Skin Organism Peripheral Blood Culture Positive Blood Culture Blood Culture Central Venous Catheter Infection Catheter Microbiology Contamination Blood Risk factor |
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SubjectTerms | Adult Aged Aged, 80 and over Antibiotics Bacteremia - diagnosis Biological and medical sciences Biomedical and Life Sciences Biomedicine Blood Blood - microbiology Catheters Catheters - microbiology Connectors Disease control Education False Positive Reactions Female Gram-negative bacteria Health surveillance Humans Infections Infectious diseases Internal Medicine Male Medical Microbiology Medical sciences Medicine Middle Aged Pathogens Patients Specimen Handling - methods Young Adult |
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Title | Blood drawn through valved catheter hub connectors carries a significant risk of contamination |
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