An endoluminal brush to detect the infected central venous catheter in situ: a pilot study

In situ endoluminal brushing: a safe technique for the diagnosis of catheter-related bloodstream infection

“…Indeed, the sensitivity and specificity of the modified brush technique has been shown to be comparable with other endoluminal techniques. 12,[16][17][18] Interestingly, the specificity of the modified technique (98%) 12,16 is higher than that of the original method (84%). 9 This probably reflects a more sensitive and accurate means of diagnosing peripheral bacteraemia in the latter study, i.e.…”

“…The risk of peripheral bacteraemia 1 min after brushing a colonized catheter lumen was 6% in an earlier study, although this was not associated with symptoms or adverse outcome. 17 We found no peripheral bacteraemia either 1 min or 1 h after brushing in any of the eight cases with significant endoluminal colonization (but no CRBSI). More importantly, we found that there was no significant increase in peripheral blood bacterial counts overall, using pre-and 1-min post-brushing quantitative peripheral blood cultures in 52 cases of CRBSI.…”

“…13,14 The endoluminal brush is a novel method for sampling CVCs in situ, originally developed by Marcus and Buday, 15 and does not rely on the ability to aspirate blood from the catheter. The technique has been shown to be both sensitive and specific for the diagnosis of CRBSI, 16,17 and has recently received approval from the US Food and Drug Administration (Ref. No.…”

“…17 Early descriptions of the technique involved advancing the brush through the catheter tip to sample the distal external surface. 15 However, increasing evidence suggests that the pathogenesis of CRBSI and the accuracy of culture techniques in diagnosing CRBSI are centred on the CVC lumen, thus obviating a need to brush beyond the catheter tip.…”

Evaluation of the use of the FAS endoluminal brush and 20% ethanol flushes to unblock central venous catheters used for long-term parenteral nutrition

“…The FAS endoluminal brush has been used successfully to diagnose CVC related sepsis, while the line remains in situ (7)(8)(9) . In this study, the FAS endoluminal brush is used to salvage occluded CVC's used for long-term PN.…”