Microbiological screening for earlier detection of central venous catheter–related bloodstream infections

Abstract

The proactive anticipative strategy using microscopic examination of CVC blood samples to anticipate CRBSI in an earlier stage compared with routine measures is a new diagnostic approach in patients with CVCs and a high risk of developing CRBSI.

Detection of central venous catheter‐related bloodstream infections in haematooncological patients

“…In our previous pilot study investigating Gram/AOLC tests for CRBSI screening in patients receiving HSCT, sensitivity and specificity were 62Á5% and 98%; and the PPV and NPV were 83% and 94Á4%, respectively. The latter drawback has been excluded in another study investigating haemodialysis patients because both lumina of a double lumen CVC were investigated and a sensitivity of 100% for the PNA FISH and AOLC was calculated [11]. The latter drawback has been excluded in another study investigating haemodialysis patients because both lumina of a double lumen CVC were investigated and a sensitivity of 100% for the PNA FISH and AOLC was calculated [11].…”

“…All patients over the age of 18 with an actively used CVC or port in situ were included after obtaining informed consent. Samples were investigated by universal PNA FISH test and AOLC test as described previously [11]. Decisions for CVC or port implantation and the number of lumen/chambers of the implanted CVC/port were made by the attending haematologists and independent from our screening study.…”

“…Decisions for CVC or port implantation and the number of lumen/chambers of the implanted CVC/port were made by the attending haematologists and independent from our screening study. This procedure was requested by our local ethics committee due to the results of our previous study [11]. CRBSI was defined as the presence of signs and symptoms of bacteremia (i.e.…”

“…Unfortunately, only 15% of removed CVC from patients with clinically suspected CRBSI proved to be infected and 85% were removed unnecessarily [2]. Recently, this anticipative strategy has been applied to patients undergoing renal replacement therapy and few haematooncological patients [11]. pneumothorax).…”

What is the evidence for intraluminal colonization of hemodialysis catheters?

“…19 The two hemodialysis patients who developed coagulase-negative staphylococcal CRBSI had the identical microorganism identified by testing intraluminal blood samples 7 and 8 days before symptoms of CRBSI developed. The sensitivity, specificity, positive and negative predictive values for peptide nucleic acid fluorescence in situ hybridization or acridine-orange leucocyte cytospin testing were 100%, 96%, 50%, and 100%, respectively.…”