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You are here: Home / 09. Medical/Surgical / infectious disease / Catheter Bloodstream Infection

Catheter Bloodstream Infection

July 14, 2011 by CrashMaster

 

Meta-analysis of diagnostic techniques (Ann Intern Med 2005;142:451-466)

 

Differential Time to Positivity

Take cultures from line and peripherally within 10 minutes from each other. If both are positive and cath cultures turned positive >2 hours earlier, then it is cath infection.

 

Quantitative segment culture

segment immersed in broth, any growth is positive

>103 is positive

 

Semi-Quantitative culture

roll catheter piece in agar

>15 CFU is positive or semi

 

if same organism in blood cultures from cath and peripheral, need 5-10 times greater number of colonies in cath. sample in order to call it line sepsis

 

 

 

 

 

In short term devices, use quant or semi-quant segment culture combined with one perc and one line blood cx

 

in long term devices, use paired quant blood cx or differential time to Positivity

 

Catheter-related Infections

Protocol for not pulling in mild to moderate symptomotology

Intensive Care Medicine Issue: Volume 30, Number 6 June 2004

 

 

coag-neg staph can be treated by device removal alone if you give antibiotics, then the device does not need to be removed, though 1/5 of the patients will have a recurrence s. aureus should get a minimum of 7-10 days

 

SR of central line infections show SC better than IJ better than Femoral (Critical Care 2005, 9:R631-R635)

 

Coag neg staph-remove catheter and 5-7 days of Rx

S. Aureus-2 weeks and consider echo

Candida-2 weeks from time of negative culture

 

 

 

 

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Filed Under: infectious disease


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