Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies
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| Published in | Journal of Clinical Microbiology Vol. 35; no. 3; pp. 641 - 646 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
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Washington, DC
American Society for Microbiology
01.03.1997
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| AbstractList | In a recent clinical trial, 248 triple-lumen catheters were removed from patients in an intensive care unit, and their tip and subcutaneous segments were cultured by both the sonication and roll plate methods; for 191 of these catheters, flush cultures of all three catheter lumens were also performed. Previously published quantitative endpoints were used to define significant catheter colonization. By using a composite index as a definition of colonization (any of the seven types of cultures meeting quantitative criteria), sonication of the subcutaneous segment was the most sensitive at detecting colonization (58%), followed by sonication of the catheter tip (53%). Sonication of both the subcutaneous and tip segments was 20% more sensitive than sonication of an adjacent catheter segment by the roll plate method. The greater sensitivity of the sonication method could be attributed to its greater ability than the roll plate method to detect catheter lumen colonization. A greater number of positive catheter segment cultures were found for colonized catheters from patients with associated bacteremia than for colonized catheters from patients without bacteremia, making any culture method more likely to identify them. For catheters with significant colonization of only one site, the localization was as follows: 36.7% subcutaneous segment, 36.7% catheter lumen, and 26.6% tip segment. These findings suggest that the current practice of culturing a single segment of a central vascular catheter is inadequate and needs to be reexamined. They further suggest that initial colonization of the catheter lumen and tip segments may be more important than previously thought and may require a change in thinking of strategies designed to prevent catheter infection. In a recent clinical trial, 248 triple-lumen catheters were removed from patients in an intensive care unit, and their tip and subcutaneous segments were cultured by both the sonication and roll plate methods; for 191 of these catheters, flush cultures of all three catheter lumens were also performed. Previously published quantitative endpoints were used to define significant catheter colonization. By using a composite index as a definition of colonization (any of the seven types of cultures meeting quantitative criteria), sonication of the subcutaneous segment was the most sensitive at detecting colonization (58%), followed by sonication of the catheter tip (53%). Sonication of both the subcutaneous and tip segments was 20% more sensitive than sonication of an adjacent catheter segment by the roll plate method (P < 0.05). The greater sensitivity of the sonication method could be attributed to its greater ability than the roll plate method to detect catheter lumen colonization (82 versus 57%, respectively; P = 0.01). A greater number of positive catheter segment cultures were found for colonized catheters from patients with associated bacteremia than for colonized catheters from patients without bacteremia (57 versus 37%; P = 0.004), making any culture method more likely to identify them. For catheters with significant colonization of only one site, the localization was as follows: 36.7% subcutaneous segment, 36.7% catheter lumen, and 26.6% tip segment. These findings suggest that the current practice of culturing a single segment of a central vascular catheter is inadequate and needs to be reexamined. They further suggest that initial colonization of the catheter lumen and tip segments may be more important than previously thought and may require a change in thinking of strategies designed to prevent catheter infection. Article Usage Stats Services JCM Citing Articles Google Scholar PubMed Related Content Social Bookmarking CiteULike Delicious Digg Facebook Google+ Mendeley Reddit StumbleUpon Twitter current issue JCM About JCM Subscribers Authors Reviewers Advertisers Inquiries from the Press Permissions & Commercial Reprints ASM Journals Public Access Policy JCM RSS Feeds 1752 N Street N.W. • Washington DC 20036 202.737.3600 • 202.942.9355 fax • journals@asmusa.org Print ISSN: 0095-1137 Online ISSN: 1098-660X Copyright © 2014 by the American Society for Microbiology. For an alternate route to JCM .asm.org, visit: JCM |
| Author | I I Raad S O Heard R J Sherertz |
| AuthorAffiliation | Department of Medicine, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1042, USA |
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| Keywords | Catheter Method Staphylococcus Fungi Infection Candida Blood vessel Microorganism culture Bacteria Micrococcales Isolation Micrococcaceae Fungi Imperfecti Diagnosis Biological contamination Comparative study Thallophyta |
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Mendeley... In a recent clinical trial, 248 triple-lumen catheters were removed from patients in an intensive care unit, and their tip and subcutaneous segments were... |
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| SubjectTerms | Bacteremia - diagnosis Bacteremia - etiology Bacteremia - microbiology Bacteria - growth & development Bacteria - isolation & purification Bacterial Infections - diagnosis Bacterial Infections - microbiology Bacterial Infections - prevention & control Bacteriological methods and techniques used in bacteriology Bacteriological Techniques - statistics & numerical data Bacteriology Biological and medical sciences Catheterization, Central Venous - adverse effects Catheters, Indwelling - adverse effects Fundamental and applied biological sciences. Psychology Humans Intensive Care Units Microbiology Sensitivity and Specificity Sonication Thrombosis - etiology |
| Title | Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies |
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