The relevance of cultures of catheter-drawn blood and heparin-lock fluid to diagnose infection in hematologic patients |
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Authors: | H F L Guiot A V Helmig-Schurter J M van't Noordende |
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Institution: | (1) Department of Infectious Diseases, University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands;(2) J. A. Cohen Institute for Radiopathology and Radiation Protection, University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands;(3) Department of Electronmicroscopy, University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands;(4) Department of Haematology/BMT, University Medical Center, Bldg. 1, C 6-106, P.O. Box 9600, 2300 RC Leiden, The Netherlands |
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Abstract: | Summary The results of bacteriologic cultures of blood and heparin-lock fluid, both drawn from the central venous catheters of 54 consecutive oncohematologic patients, have been used to determine their value for the diagnosis of systemic and catheter-associated infection. In 30 patients with clinical signs of infection (bacteremia or septicemia), 74 of 1000 (7.4%) heparin-lock fluid cultures, 114 of 542 (21%) catheter-drawn blood cultures, and 36 of 134 (26%) venipuncture blood cultures became positive, whereas in 24 patients without clinical signs of infection the respective values were 5 of 700 (0.7%), one of 220 (0.4%), and none of ten cultures. Comparison of the results of cultures sampled on the same day reveals that the positive and negative predictive values for catheter-drawn blood cultures, with the venipuncture blood cultures taken as the standard for bacteremia, are 82% and 95% respectively. The results of heparin-lock fluid are indicative for clinically relevant colonization of the catheter. Three or more positive heparin-lock fluid cultures, sampled on subsequent days, were correlated with the occurrence of bacteremia or septicemia with a positive predictive value of 100%. The conclusions are supported by the results of scanning electron microscopy. |
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Keywords: | Intravenous catheters Blood cultures Diagnosis Bacteremia |
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