Quantitative blood cultures in the evaluation of septicemia in children with Broviac catheters

Raucher, Harold S.; Hyatt, Alexander C.; Barzilai, Asher; Harris, Michael B.; Weiner, Michael A.; LeLeiko, Neal S.; Hodes, David S.

doi:10.1016/s0022-3476(84)80584-3

Cited by 149 publications

(43 citation statements)

References 11 publications

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“…In other studies the test was considered positive when at least tenfold (7,14) sevenfold (8) or fivefold (9, 10) differences were found. In addition, a single bacterial count > 100 cfu/ml in the quantitative culture of the catheter blood specimen in the presence of a positive peripheral blood culture of the same organism is also highly suggestive of catheter-related sepsis.…”

Section: Discussionmentioning

confidence: 99%

Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis

Capdevila

Planes

Palomar

et al. 1992

Eur. J. Clin. Microbiol. Infect. Dis.

192

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A prospective study was performed to assess the value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis when this condition is suspected on clinical grounds and to establish a reliable discriminative value for application without removal of the inserted catheter. A total of 107 central venous catheters from 64 patients were used for the study. Blood was obtained simultaneously through the suspected infected device and from a peripheral venipuncture. The catheter was removed and its tip cultured semiquantitatively. Catheter-related sepsis occurred in 17 patients. Using as cut-off value a colony count fourfold higher in blood drawn through the catheter than in simultaneously drawn peripheral blood, a sensitivity of 94%, specificity of 100% and positive predictive value of 100% were obtained. A single bacterial count greater than 100 cfu/ml in the quantitative culture of the catheter blood specimen in the presence of a positive qualitative peripheral blood culture of the same organism was also highly suggestive of catheter-related sepsis. Differential quantitative blood culture is a reliable method for the diagnosis of catheter-associated sepsis without catheter removal.

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Section: Discussionmentioning

confidence: 99%

Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis

Capdevila

Planes

Palomar

et al. 1992

Eur. J. Clin. Microbiol. Infect. Dis.

192

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“…In a second study that included 25 episodes of polymicrobic bacteremia, the Isolator system detected 21 episodes and the biphasic bottle detected only 17 (39). Blood cultures on solid media have also been shown to be superior to broth methods for diagnosis of polymicrobic bacteremia in catheter-related infections (70,72).…”

Section: Development Of Quantitative Blood Culture Methodsmentioning

confidence: 99%

Quantitative aspects of septicemia

1990

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For years, quantitative blood cultures found only limited use as aids in the diagnosis and management of septic patients because the available methods were cumbersome, labor intensive, and practical only for relatively small volumes of blood. The development and subsequent commercial availability of lysis-centrifugation direct plating methods for blood cultures have addressed many of the shortcomings of the older methods. The lysis-centrifugation method has demonstrated good performance relative to broth-based blood culture methods. As a result, quantitative blood cultures have found widespread use in clinical microbiology laboratories. Most episodes of clinical significant bacteremia in adults are characterized by low numbers of bacteria per milliliter of blood. In children, the magnitude of bacteremia is generally much higher, with the highest numbers of bacteria found in the blood of septic neonates. The magnitude of bacteremia correlates with the severity of disease in children and with mortality rates in adults, but other factors play more important roles in determining the patient's outcome. Serial quantitative blood cultures have been used to monitor the in vivo efficacy of antibiotic therapy in patients with slowly resolving sepsis, such as disseminated Mycobacterium avium-M. intracellulare complex infections. Quantitative blood culture methods were used in early studies of bacterial endocarditis, and the results significantly contributed to our understanding of the pathophysiology of this disease. Comparison of paired quantitative blood cultures obtained from a peripheral vein and the central venous catheter has been used to help identify patients with catheter-related sepsis and is the only method that does not require removal of the catheter to establish the diagnosis. Quantitation of bacteria in the blood can also help distinguish contaminated from truly positive blood cultures; however, no quantitative criteria can invariably differentiate contamination from bacteremia.

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“…Quantitative cultures may be used to compare the concentrations of bacteria in samples of blood drawn simultaneously from the catheter lumen and peripheral blood; a 5-to 10-fold higher concentration in the catheter lumen is highly suggestive of catheter-related infection (14,17). However, quantitative blood cultures are labor-intensive, expensive, and prone to contamination and therefore are not routinely performed by most microbiology laboratories.…”

mentioning

confidence: 99%

Time to Blood Culture Positivity as a Marker for Catheter-Related Candidemia

et al. 2008

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Candida spp. are important causes of nosocomial bloodstream infections. Around 80% of patients with candidemia have an indwelling central venous catheter (CVC). Determining whether the CVC is the source of candidemia has implications for patient management. We assessed whether the time to detection of Candida species in peripheral blood (time to positivity [TTP]) can serve as a marker for catheter-related candidemia. Prospective surveillance of Candida bloodstream infection was conducted in two medical centers. TTP was recorded by the BacT/Alert automated system. Sixty-four candidemia episodes were included. Fifty patients (78%) had an indwelling CVC. Thirteen patients (20.3%) had definite catheterrelated candidemia. TTP was shorter for definite catheter-related candidemia (17.3 ؎ 2 h) than that for candidemia from other sources (38.2 ؎ 3 h; P < 0.001). A TTP cutoff of 30 h was 100% sensitive and 51.4% specific for catheter-related candidemia (area under the receiver-operator characteristic curve of 0.76). We conclude that TTP in peripheral blood is a sensitive but nonspecific marker for catheter-related candidemia and that a TTP of more than 30 h can help exclude an intravascular catheter as the possible source of candidemia.

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Quantitative blood cultures in the evaluation of septicemia in children with Broviac catheters

Cited by 149 publications

References 11 publications

Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis

Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis

Quantitative aspects of septicemia

Time to Blood Culture Positivity as a Marker for Catheter-Related Candidemia

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