Central venous catheter-related bloodstream infections: an analysis of incidence and risk factors in a cohort of 400 patients

Gowardman, John; Montgomery, Carmel; Thirlwell, Sarah; Shewan, Jane; Idema, Albert J. S.; Larsen, Peter; Havill, J. H.

doi:10.1007/s001340050712

Cited by 58 publications

(32 citation statements)

References 25 publications

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“…More recently, Tighe 27 have demonstrated that a policy of selective removal of catheters based on the AOLC test was safe, feasible, and cost effective. In contrast, Gowardman et al 28 in a cohort of 400 patients, demonstrated that in the 12 patients with CRBI the AOLC test was negative in all cases. They concluded that the AOLC test used alone was unhelpful as a method of diagnosing in situ CVC infection, consistent with the findings of Tighe et al, 26 but in sharp contrast to those reported by Rushforth et al 25 Recently, Farina et al 29 showed in a pediatric population that the AOLC test did not aid diagnosis of CRBI.…”

Section: Discussionmentioning

confidence: 85%

“…Seven studies 16,[25][26][27][28][29][30] have been performed to assess the validity of the Gram stain-AOLC test for the diagnosis of CRBI in non-neutropenic patients. Rushforth et al, 25 in an infant population, found the test 87% sensitive and 94% specific in the diagnosis of central catheter-related sepsis, as defined by quantitative blood culture.…”

Section: Discussionmentioning

confidence: 99%

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Detection of catheter-related bloodstream infections by the Gram stain–acridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients

Abdelkefi¹,

Achour²,

Torjman³

et al. 2006

Bone Marrow Transplant

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In patients with central venous catheters (CVCs), catheter-related bloodstream infections (CRBI) are a prominent cause of morbidity, excess hospital costs, and in some cases mortality. The aim of this prospective study was to assess the validity of the Gram stain-acridine orange leukocyte cytospin (AOLC) test for the diagnosis of CRBI in hematopoietic stem cell transplant (HSCT) recipients with nontunnelled CVCs, using the differentialtime-to-positivity (DTP)/clinical criteria as the criterion standard to define CRBIs. CVCs were externalized, nontunnelled, polyurethane double lumen catheters (Arrows, Readings, USA). All CVCs were placed in the subclavian vein by the infraclavicular approach, in the operating room. Catheters were inserted percutaneously, using the Seldinger technique. Study catheters were not exchanged over guidewires. Between May 2002 and December 2004, a total of 245 consecutive patients were included. Twenty-six of the 245 patients (10.6%) had CRBI as determined by the DTP method. The Gram stain-AOLC was positive in only two patients (7.6%) with a CRBI. Our results suggest that the Gram stain-AOLC test is not useful for the diagnosis of catheterrelated bloodstream infection in HSCT recipients.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Detection of catheter-related bloodstream infections by the Gram stain–acridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients

Abdelkefi¹,

Achour²,

Torjman³

et al. 2006

Bone Marrow Transplant

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“…These included blood samples from a healthy individual with and without spiking with bacteria. An extraction control of blood spiked with 10 3 CFUs of Staphylococcus epidermidis/µl was found to yield DNA levels close to the lower limit of detection. Bacterial DNA controls containing known amounts of bacterial DNA extracted from Enterococcus faecalis (100 pg to 100 fg) and a negative control (with no DNA in the reaction) to detect reagent contamination), were also included in each run.…”

Section: Molecular Methodsmentioning

confidence: 85%

“…10,11 Discrimination between the CVC and other sources of bloodstream infection is important because treatment strategies differ. In addition to systemic antibiotics, CVC-associated infection requires either antibiotic treatment that is targeted at microbial colonisation of the CVC lumen by being left in the CVC lumen, or instilled slowly, or removal of the CVC.…”

Section: Fundingmentioning

confidence: 99%

“…An alternative method for quantifying organisms when there are large numbers of bacteria in blood drawn through a CVC is to use visualisation techniques such as acridine orange leucocyte cytospin staining, and this technique can provide a rapid diagnosis. 10,20 All these techniques for assessing the differential organism load are appropriate for CVCs that have been inserted for several weeks, in which CVC-associated infection is likely to be intraluminal, but less effective for detecting CVC-associated infection soon after insertion, when organisms may be colonising the outside of the catheter. 2.…”

Section: Fundingmentioning

confidence: 99%

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Accuracy of bacterial DNA testing for central venous catheter-associated bloodstream infection in children with cancer

Millar

Zhou²,

Skinner³

et al. 2011

Health Technol Assess

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Interventions aimed at improving professional adherence to guidelines for prevention of device-related infections

Conterno¹,

Mayhew²,

Pereira³

2007

Cochrane Database of Systematic Reviews

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Central venous catheter-related bloodstream infections: an analysis of incidence and risk factors in a cohort of 400 patients

Cited by 58 publications

References 25 publications

Detection of catheter-related bloodstream infections by the Gram stain–acridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients

Detection of catheter-related bloodstream infections by the Gram stain–acridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients

Accuracy of bacterial DNA testing for central venous catheter-associated bloodstream infection in children with cancer

Interventions aimed at improving professional adherence to guidelines for prevention of device-related infections

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