PMID- 21341162
OWN - NLM
STAT- MEDLINE
DCOM- 20110816
LR  - 20201209
IS  - 0374-9096 (Print)
IS  - 0374-9096 (Linking)
VI  - 45
IP  - 1
DP  - 2011 Jan
TI  - [Assessment of diagnostic methods for the catheter-related bloodstream infections 
      in intensive care units].
PG  - 75-85
AB  - The majority of catheter-related bloodstream infections (CR-BSI) are associated 
      with central venous catheters (CVCs) and most of them develop in patients staying 
      at intensive care units (ICUs). The aim of this study was to assess the 
      performance of different methods for the diagnosis of CR-BSI in neurology and 
      neurosurgery ICUs of our hospital. This prospective study was carried out between 
      January 2007 and January 2008 and all of the patients were followed daily for 
      CR-BSI after the insertion of CVCs. Blood cultures were taken simultaneously from 
      the catheter lumen and from at least one peripheral vein when there was a 
      suspicion of CR-BSI. Additionally, from patients whose CVCs were removed, 
      catheter tip cultures were taken and from patients with exit site infection, 
      cultures of the skin surrounding the catheter entrance were taken. Catheter tip 
      cultures were done by using quantitative and semiquantitative culture methods. 
      Blood cultures taken from the catheter lumen and peripheral vein were incubated 
      in the BACTEC 9050 (Becton Dickinson, USA) automated blood culture system. Gram 
      and acridine orange (AO) staining were used for the smears prepared from the 
      catheter tips and blood cultures. To evaluate the value of culture and staining 
      methods in the diagnosis of CR-BSI; sensitivity, specificity, positive and 
      negative predictive values (PPV and NPV, respectively) of each method were 
      determined. A total of 148 patients (66 male, 82 female; age range: 1-94 years, 
      mean age: 58.7 +/- 21.8 years) were included in the study, of whom 67 (45.3%) were 
      from neurology and 81 (54.7%) were from neurosurgery ICUs. One hundred 
      ninety-nine CVC application performed in 148 patients were evaluated. Mean 
      duration of catheterization was 8.5 +/- 5.2 days. Thirty-two episodes of CR-BSI 
      among 199 catheterizations (16%) in 29 patients among a total of 148 patients 
      (19.6%) were determined. The most frequently isolated microorganisms were 
      methicillin-resistant coagulase-negative staphylococci (8/32; 25%), 
      penicillin-resistant Enterococcus spp. (8/32; 25%) and Candida albicans (4/32; 
      12.5%). Sensitivity, specificity, PPV and NPVs of the quantitative and 
      semiquantitative culture methods of the catheter tip and the differential time to 
      positivity (positive result obtained at least two hours earlier in blood cultures 
      drawn through the catheter than the peripheral blood cultures which were taken 
      simultaneously) between blood cultures drawn through the catheter and those drawn 
      from the peripheral vein were 100% for the diagnosis of CR-BSI. Sensitivity and 
      NPV of the isolation method of the same microorganism from blood culture drawn 
      through the catheter and drawn from the peripheral vein were 100%, specificity 
      was 85% and PPV was 88% for the diagnosis of CR-BSI. Sensitivity, specificity, 
      PPV and NPVs of Gram and drawn simultaneously from the peripheral vein and 
      quantitative and semiquantitative cultures of the catheter tip in patients with 
      removed catheter, were important factors in terms of diagnosis of CR-BSI. It was 
      also concluded that AO staining could provide additional benefit in the diagnosis 
      of CR-BSI since it has higher sensitivity, specificity, PPV and NPVs for 
      peripheral blood cultures and catheter tip cultures compared to Gram staining.
FAU - Ataman Hatipoglu, Cigdem
AU  - Ataman Hatipoglu C
AD  - Ankara Training and Research Hospital, Department of Infectious Diseases and 
      Clinical Microbiology, Ankara, Turkey. cigdemhatip@yahoo.com
FAU - Ipekkan, Korhan
AU  - Ipekkan K
FAU - Oral, Behic
AU  - Oral B
FAU - Onde, Ufuk
AU  - Onde U
FAU - Bulut, Cemal
AU  - Bulut C
FAU - Demiroz, Ali Pekcan
AU  - Demiroz AP
LA  - tur
PT  - Journal Article
TT  - Yogun Bakim Unitelerinde Gelisen Kateter ile Iliskili Kan Dolasimi 
      Enfeksiyonlarinin Tanisinda Kullanilan Yontemlerin Degerlendirilmesi.
PL  - Turkey
TA  - Mikrobiyol Bul
JT  - Mikrobiyoloji bulteni
JID - 7503830
RN  - 0 (Fluorescent Dyes)
RN  - 0 (Gram's stain)
RN  - 0 (Phenazines)
RN  - F30N4O6XVV (Acridine Orange)
RN  - J4Z741D6O5 (Gentian Violet)
SB  - IM
MH  - Acridine Orange
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Candida albicans/isolation & purification
MH  - Catheter-Related Infections/*diagnosis/microbiology
MH  - Catheterization, Central Venous/*adverse effects
MH  - Catheters, Indwelling/*microbiology
MH  - Child
MH  - Child, Preschool
MH  - Enterococcus/isolation & purification
MH  - Female
MH  - Fluorescent Dyes
MH  - Gentian Violet
MH  - Humans
MH  - Infant
MH  - Intensive Care Units
MH  - Male
MH  - Middle Aged
MH  - Phenazines
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Sepsis/*diagnosis/microbiology
MH  - Staphylococcus/isolation & purification
MH  - Young Adult
EDAT- 2011/02/23 06:00
MHDA- 2011/08/17 06:00
CRDT- 2011/02/23 06:00
PHST- 2011/02/23 06:00 [entrez]
PHST- 2011/02/23 06:00 [pubmed]
PHST- 2011/08/17 06:00 [medline]
PST - ppublish
SO  - Mikrobiyol Bul. 2011 Jan;45(1):75-85.