Value of bedside plating of semiquantitative cultures for diagnosis of central venous catheter-related infections in ICU patients.

We compared semiquantitative central venous catheter tip cultures plated at the bedside with those cultured in the laboratory, to determine if bedside plating provides a significantly better yield. Paired segments of 197 catheter tips from 92 surgical and medical ICU patients were evaluated prospectively. A total of 31 catheter tip cultures were positive for > or = 15 organisms per agar plate, with 10 of these being simultaneously positive at the bedside and in the laboratory. Cultures were exclusively positive in 18 cases plated immediately at the bedside, whereas laboratory plating resulted in only 3 exclusively positive cases. This discrepancy was statistically significant (p < 0.005). Compared with bedside plating, the sensitivity and specificity of sending catheters to the laboratory were 36 percent and 98 percent, respectively. These results indicate that the practice of sending central venous catheter tips to the laboratory for routine culture should be reconsidered in favor of bedside plating.

[1]  S. Norwood,et al.  Catheter-related infections and associated septicemia. , 1991, Chest.

[2]  H. Richet,et al.  Prospective multicenter study of vascular-catheter-related complications and risk factors for positive central-catheter cultures in intensive care unit patients , 1990, Journal of clinical microbiology.

[3]  E. Bouza,et al.  A conservative procedure for the diagnosis of catheter-related infections. , 1990, Archives of internal medicine.

[4]  J. A. Kruse,et al.  Triple- vs single-lumen central venous catheters. A prospective study in a critically ill population. , 1989, Archives of internal medicine.

[5]  T. Endy,et al.  Catheter Infection: A Comparison of Two Catheter Maintenance Techniques , 1988, Annals of surgery.

[6]  T. Elliott Intravascular-device infections. , 1988, Journal of medical microbiology.

[7]  S. Norwood,et al.  Prospective study of catheter-related infection during prolonged arterial catheterization. , 1988, Critical care medicine.

[8]  F. Coutlée,et al.  Value of direct catheter staining in the diagnosis of intravascular-catheter-related infection , 1988, Journal of clinical microbiology.

[9]  J. May,et al.  Infection rate for single lumen v triple lumen subclavian catheters. , 1988, Infection control and hospital epidemiology.

[10]  H. Isenberg,et al.  Central catheter infections: single- versus triple-lumen catheters. Influence of guide wires on infection rates when used for replacement of catheters. , 1988, The American journal of medicine.

[11]  P. Collignon,et al.  Rapid diagnosis of intravascular catheter-related sepsis. , 1988, Archives of internal medicine.

[12]  T. Sorrell,et al.  Is semiquantitative culture of central vein catheter tips useful in the diagnosis of catheter-associated bacteremia? , 1986, Journal of clinical microbiology.

[13]  C. Hopkins,et al.  Rapid diagnosis of intravascular catheter-associated infection by direct Gram staining of catheter segments. , 1985, The New England journal of medicine.

[14]  M. Moyer,et al.  Comparative culture methods on 101 intravenous catheters. Routine, semiquantitative, and blood cultures. , 1983, Archives of internal medicine.

[15]  D. Maki,et al.  A semiquantitative culture method for identifying intravenous-catheter-related infection. , 1977, The New England journal of medicine.