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  • Blood culture Central venous catheter Bacterial colonisation Bacteraemia  (1)
  • Catheter replacement  (1)
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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 26 (2000), S. 1373-1375 
    ISSN: 1432-1238
    Keywords: Blood culture Central venous catheter Bacterial colonisation Bacteraemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Objective: To evaluate the widespread practice of using qualitative culture of venous blood taken through central venous catheters (CVCs) as a means of diagnosing catheter colonisation in situ. Design: A prospective clinical study. Patients: Three hundred fifty-one CVCs were inserted into 228 critically ill patients. Interventions: Prior to CVC removal, blood was taken for qualitative culture from the CVC and a peripheral site. All catheter tips underwent semi-quantitative analysis of bacterial colony count [1]. Measurements and results: One hundred eighteen (33.6%) CVCs were found to be colonised on removal. A positive central blood culture had a sensitivity and specificity of 50.8% and 78.9% when compared with the 'gold standard' of catheter tip culture. This gives a positive predictive value of 47.7% and a negative predictive value of 76.5%. The sensitivity and specificity of a positive peripheral blood culture were 41.5% and 77.7% with positive and negative predictive values of 48.8% and 72.9%, respectively. When only those catheters removed because of systemic sepsis (n=139) were considered, a positive central blood culture had a sensitivity of 58.8% and a specificity of 69.3%. Conclusion: Our results indicate that the use of central blood culture confers a small advantage in sensitivity compared with peripheral blood culture. This advantage was further improved by only considering the catheters removed because of systemic sepsis but at the cost of a loss of specificity. Qualitative blood culture is a poor tool for the diagnosis of in-situ CVC colonisation.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 14 (1988), S. 227-231 
    ISSN: 1432-1238
    Keywords: Central vein catheter ; Bacteraemia ; Catheter replacement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 440 critically ill patients, the association between different central vein catheter insertion sites, the duration of catheter insertion and catheter-associated sepsis was examined. Of 780 catheter tips studied, 19% were colonized by microorganisms. The incidence of colonization varied with the different insertion sites. The lowest percentage of colonized catheters occurred with catheters inserted via the subclavian vein (15%) and the highest, at the femoral vein insertion site (34%,p〈0.01). The percentage of catheters colonized increased as the duration of insertion increased, at all insertion sites studied. Catheter colonization was closely related to the development of bacteraemia and was associated with approximately 10% of colonized catheters. Our results suggest that the subclavian site is associated with the lowest infective complication rate. To minimize catheter associated sepsis, catheters at all insertion sites should be used with parsimony and only kept in place for the minimum amount of time that their continuing use is necessary.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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