Rapid Diagnosis of Intravascular Catheter-Associated Infection by Direct Gram Staining of Catheter Segments

Abstract

We conducted a study to determine the usefulness of the Gram stain in the detection of intravascular catheter-associated infection. A total of 330 intravascular catheters were prospectively collected from adults and children suspected of having such an infection. Semiquantitative solid-agar cultures of the distal catheter tip were correlated with blood cultures. Catheter-associated bacteremia occurred in 34 per cent of cases in which catheter tips were colonized (greater than or equal to 15 colonies per agar plate). There were no cases of catheter-associated bacteremia in patients with uncolonized catheters. Immediately after culture, whole catheter segments were stained by the Gram technique. Gram-negative and gram-positive bacteria and yeast were easily identifiable under oil immersion (X 1000), located predominantly on external catheter surfaces. Any catheter with at least one organism per 20 oil-immersion fields was designated as positive by Gram stain, but the majority of the 41 positive catheters had much larger numbers of organisms. The Gram stain of the catheter tip was 100 per cent sensitive and 96.9 per cent specific for the detection of catheter-tip colonization, with positive and negative predictive values of 83.9 and 100 per cent, respectively. We conclude that a Gram stain of the distal catheter tip is a simple, inexpensive, and accurate test for the rapid diagnosis of intravascular catheter-associated infection.

Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates

“…14 Colonization was selected as a primary outcome because of its association with CRBSI and bloodstream infection (BSI) without a source. 14,16,17 BSI without a source was defined by all of the following: a positive peripheral blood culture during the time of catheterization or within 24 h of catheter removal, clinical signs and symptoms of a BSI, antibiotic therapy for X7 days and no other documented primary site of infection. 18 The catheter tip was not colonized or was colonized with organisms other than that grown from the blood.…”

Antifungal Properties of Cationic Phenylene Ethynylenes and Their Impact on β-Glucan Exposure

“…Patients with indwelling medical devices, such as central venous catheters (CVCs), are most at risk for these infections (2). Frequently, various microorganisms from the skin of the patient, or the respective health care professional, can gain access through the catheter wound as a result of nonsterile conditions (3)(4)(5)(6). Of these resulting bloodstream infections, Candida species account for 9% of all instances and are associated with an ϳ40% mortality rate (2,7).…”

Septicemia asociada a catéter venoso central

“…Se ha descrito cuatro fuentes principales (16) : a. Colonización: la colonización por microorganismos (de la flora cutánea del paciente y de las manos de los trabajadores en salud) de las porciones intracutánea e intravascular del catéter, es la fuente más frecuente de CR-BSI (25) . b. Contaminación intraluminal o del capuchón: es una fuente importante de CR-BSI en pacientes portadores de CVC colocados por más de dos semanas o de dispositivos de implantación quirúrgi-ca (15,26,27) .…”