Prospective, randomised study of selective versus routine culture of vascular catheter tips: patient outcome, antibiotic use and laboratory workload

Pérez-Parra, A.; Guembe, María; Martín‐Rabadán, Pablo; Muñóz, Patricia; Bouza, Emilio

doi:10.1016/j.jhin.2010.11.021

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…Our review highlighted that this depth of RCT testing is not yet present in the literature for all areas of CVAD management, with many single RCTs focusing on an intervention in one study only [25, 47, 58, 67, 70, 72, 91, 107, 108, 122, 156, 163, 168, 177, 181, 185, 187, 194, 195, 199]. The potential barriers to undertaking and publishing RCTs in vascular access are likely to be due to a lack of research knowledge, skills, and funding.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trials in central vascular access devices: A scoping review

et al. 2017

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BackgroundRandomized controlled trials evaluate the effectiveness of interventions for central venous access devices, however, high complication rates remain. Scoping reviews map the available evidence and demonstrate evidence deficiencies to focus ongoing research priorities.MethodA scoping review (January 2006–December 2015) of randomized controlled trials evaluating the effectiveness of interventions to improve central venous access device outcomes; including peripherally inserted central catheters, non-tunneled, tunneled and totally implanted venous access catheters. MeSH terms were used to undertake a systematic search with data extracted by two independent researchers, using a standardized data extraction form.ResultsIn total, 178 trials were included (78 non-tunneled [44%]; 40 peripherally inserted central catheters [22%]; 20 totally implanted [11%]; 12 tunneled [6%]; 6 non-specified [3%]; and 22 combined device trials [12%]). There were 119 trials (68%) involving adult participants only, with 18 (9%) pediatric and 20 (11%) neonatal trials. Insertion-related themes existed in 38% of trials (67 RCTs), 35 RCTs (20%) related to post-insertion patency, with fewer trials on infection prevention (15 RCTs, 8%), education (14RCTs, 8%), and dressing and securement (12 RCTs, 7%). There were 46 different study outcomes reported, with the most common being infection outcomes (161 outcomes; 37%), with divergent definitions used for catheter-related bloodstream and other infections.ConclusionMore high quality randomized trials across central venous access device management are necessary, especially in dressing and securement and patency. These can be encouraged by having more studies with multidisciplinary team involvement and consumer engagement. Additionally, there were extensive gaps within population sub-groups, particularly in tunneled devices, and in pediatrics and neonates. Finally, outcome definitions need to be unified for results to be meaningful and comparable across studies.

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Section: Discussionmentioning

confidence: 99%

Randomized controlled trials in central vascular access devices: A scoping review

et al. 2017

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“…e l s e v i e r . c o m / l o c a t e / i j i d Ekkelenkamp et al, 2008;Perez-Parra et al, 2009;Mrozek et al, 2011;Park et al, 2010;Perez-Parra et al, 2011;Munoz et al, 2012;Peacock et al, 1998;Leenders et al, 2011;van Eck van der Sluijs et al, 2012;Hetem et al, 2011). This issue remains unresolved in current clinical guidelines (Mermel et al, 2009;Mermel et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Should non-bacteraemic patients with a colonized catheter receive antimicrobial therapy?

Egea

Guembe

Rodríguez-Borlado

et al. 2017

International Journal of Infectious Diseases

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“…2 The use of the catheter-tip cooling technique in the United Kingdom resulted in a 75% reduction in catheter cultures, representing a 42% reduction in expenditure, as well as clinical acceptance by the medical staff. 5 The objective of this study was to evaluate the savings associated with the implementation of a central-catheter-tip cooling protocol for tips forwarded to the microbiology laboratory.…”

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confidence: 99%

“…In addition, a recent randomized study showed increased predictive value and decreased cost compared to direct processing 2 . The use of the catheter-tip cooling technique in the United Kingdom resulted in a 75% reduction in catheter cultures, representing a 42% reduction in expenditure, as well as clinical acceptance by the medical staff 5 …”

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confidence: 99%

“…According to the Centers for Disease Prevention (CDC), the catheter-tip culture should only be performed when catheter-related bacteremia is suspected 5 . After 6 months of adherence to the catheter screening protocol, 43.68% of all catheter tips received was processed; catheter tips were processed if there had been a culture in the prior 7 days, a positive blood culture after 7 days of catheter arrival, or at the physician’s request.…”

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confidence: 99%

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Cost Savings and Burden of an Intravascular Line Tip Culture Screening Policy

Tuon

Pacher

Moreira

et al. 2017

Infect. Control Hosp. Epidemiol.

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Prospective, randomised study of selective versus routine culture of vascular catheter tips: patient outcome, antibiotic use and laboratory workload

Cited by 7 publications

References 19 publications

Randomized controlled trials in central vascular access devices: A scoping review

Randomized controlled trials in central vascular access devices: A scoping review

Should non-bacteraemic patients with a colonized catheter receive antimicrobial therapy?

Cost Savings and Burden of an Intravascular Line Tip Culture Screening Policy

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