Diagnosis of CRBSI was based on differential time to positivity or differential colony count. The definitions for CRBSI are those detailed in the recent “Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection”. We compared the yield of cultures of samples obtained from the different lumens and calculated the diagnostic impact of eliminating the results of blood cultures of samples obtained from ⩾1 lumens.ĭefinitions. Consequently, in some triple-lumen central venous catheters (CVCs), we received only 2 lumen samples. An available lumen is defined as one that enables blood to be drawn (ie, it does not contain clots). We selected only those catheters in which blood was sampled from all available clear lumens, which is the standard of care at our institution. During the study period (1 January 2003–), for all patients with proven CRBSI, we compared positive blood cultures of samples obtained from peripheral veins with positive blood cultures of samples obtained from catheter lumens.
We performed a retrospective study at a large teaching institution in Madrid, Spain. We assessed the number of proven CRBSI episodes that would have been missed if blood culture samples had not been obtained from 1 or 2 lumens from multilumen catheters. The recent Infectious Diseases Society of America “Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection” describe as an “unresolved issue” the number of lumens to be sampled to make a correct diagnosis of CRBSI. The colony count (or differential time to positivity) for blood samples obtained from different catheter lumens can be compared with that of blood samples obtained from a peripheral vein.
The diagnosis of catheter-related bloodstream infection (CRBSI) can often be made without having to withdraw the catheter. Samples for blood culture should be obtained through all catheter lumens to establish a diagnosis of CRBSI.
If we had eliminated 2 cultures for triple-lumen catheters, 37.3% of episodes would have been missed.Ĭonclusions. Overall, if 1 lumen-associated culture had been eliminated for both double-lumen and triple-lumen catheters, we would have missed 27.2% and 15.8% of episodes of CRBSI, respectively. We studied 171 episodes of proven CRBSI in 154 patients. We calculated the number of episodes that would have been missed in double- and triple-lumen catheters if the culture of samples obtained from ⩾1 lumens had been eliminated. We performed a retrospective study (1 January 2003–) in patients with microbiologically proven CRBSI in which all available catheter lumens (those that did not contain clots) were used to draw blood culture samples. Our objective was to determine how many CRBSI episodes would be missed if not all catheter lumens were sampled. Recent practice guidelines for the diagnosis of catheter-related bloodstream infection (CRBSI) describe as an “unresolved issue” the number of lumens from which blood culture specimens should be drawn to make a conservative diagnosis of CRBSI. x 1-1/2" (3.81 cm) and 5 mL Luer-Slip Syringe x 1" (2.54 cm) and 3 mL Luer-Lock Syringe x 2-1/2" (6.35 cm) XTW and 5 mL Arrow ® Raulerson Spring-Wire Introduction Syringe x 23-5/8" (60 cm) (Straight Soft Tip on One End - "J" Tip on Other) with Arrow AdvancerĬatheter: 18 Ga.
#Triple lumen central line plus#
x 20 cm Pressure Injectable Radiopaque Polyurethane with Blue FlexTip ®, ARROWg+ard Blue PLUS ® Antimicrobial Surface Treatment 1, Extension Line Clamps
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