Influence of sterile protective sleeves on the sterility of pulmonary artery catheters

So, Heard; Rf, Davis; Rj, Sherertz; Ms, Mikhail; Rc, Gallagher; Layon, A. Joseph; Tj, Gallagher

doi:10.1097/00003246-198705000-00009

Cited by 28 publications

(6 citation statements)

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“…Both studies support the results of our study. Catheter-related bacteremia did not occur in the 4-day group, which is consistent with the rate of infection reported in previous studies (4,5,17,24), and there was only one patient with catheter-related bacteremia in the 7-day group. The results of Eyer et al (8) are similar to our findings.…”

Section: Discussionsupporting

confidence: 91%

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Comparison between replacement at 4 days and 7 days of the infection rate for pulmonary artery catheters in an intensive care unit*

Chen

Yen²,

Yang³

et al. 2003

Critical Care Medicine

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No statistically significant difference was found for pulmonary artery catheter-associated infection when intervals of 4 or 7 days between insertion and replacement were compared. Patients with prolonged pulmonary artery catheterization must be carefully examined for signs or symptoms of infection. The time until pulmonary artery catheter replacement can be extended to 7 days if there is no evidence of catheter-related infection.

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Section: Discussionsupporting

confidence: 91%

“…Previous studies of PA catheters have shown that the risk of infection increases with the duration of catheterization (5,11,17), although some reports have found no such association (3,8,18). Four studies have found that the incidence of infection increases with use of the same PA catheter for Ͼ4 days (19 -22).…”

Section: Discussionmentioning

confidence: 99%

Comparison between replacement at 4 days and 7 days of the infection rate for pulmonary artery catheters in an intensive care unit*

Chen

Yen²,

Yang³

et al. 2003

Critical Care Medicine

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“…In a previous prospective study of Swan-Ganz catheters, we found that the sonication method for culturing vascular catheters demonstrated an association between catheterrelated bacteremia and the number of organisms removed from Swan-Ganz catheters (7). For four of the five catheters that were associated with catheter-related bacteremia, vascular catheter cultures grew greater than 103 organisms.…”

Section: Discussionmentioning

confidence: 80%

“…369, 1984). Subsequently, we used this technique in a prospective study of Swan-Ganz catheters and found that removal of greater than 103 organisms from the catheter was associated with positive blood cultures for the same organism (P < 0.025) (7). Encouraged by these results, we began culturing all vascular catheters submitted to the clinical microbiology laboratory by using sonication in broth followed by serial dilutions and report here our 36-month experience with this method.…”

mentioning

confidence: 99%

Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory

et al. 1990

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clinical microbiology laboratory in a 36-month period. A total of 46% of the cultures were positive; the most common organisms isolated were coagulase-negative staphylococci (36.4%), Pseudomonas aeruginosa (13.9%), enterococci (10.0%), yeasts (9.2%), Staphylococcus aureus (5.8%), and Enterobacter species (4.4%). The frequencies of positive blood cultures within 48 h prior to a positive catheter culture result were as follows: Candida albicans (68.4%), S. aureus (60%), Enterobacter cloacae (42.9%), Staphylococcus epidermidis (32.1%), P. aeruginosa (27.7%), and enterococci (23.3%). The sonication method allowed quantification of the number of CFU removed from a catheter for between 102 and 107 CFU. For catheter cultures in which :102 CFU grew, a linear regression equation could be calculated: (risk of positive blood culture for the same organism) = 14

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“…Subsequently, a number of other quantitative catheter culture methods have been developed in an attempt to deal with some of the limitations of the roll plate method. Removable catheters have been cultured by flushing with broth (8), centrifugation (3), swabbing the catheter hub followed by vortexing the swab (21), vortexing (4), and sonication (19,43). Removable catheters have also been studied by Gram staining (11,12) or acridine orange staining (12,49) of catheters or Gram staining of a touch preparation from the catheter (9).…”

mentioning

confidence: 99%

Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies

1997

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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.

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Influence of sterile protective sleeves on the sterility of pulmonary artery catheters

Cited by 28 publications

References 0 publications

Comparison between replacement at 4 days and 7 days of the infection rate for pulmonary artery catheters in an intensive care unit*

Comparison between replacement at 4 days and 7 days of the infection rate for pulmonary artery catheters in an intensive care unit*

Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory

Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies

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