Earlier positivity of central-venous- versus peripheral-blood cultures is highly predictive of catheter-related sepsis

J Clin Microbiol. 1998 Jan;36(1):105-9. doi: 10.1128/JCM.36.1.105-109.1998.

Abstract

To diagnose catheter-related sepsis without removing the catheter, we evaluated the differential positivity times of cultures of blood drawn simultaneously from central venous catheter and peripheral sites. In a 450-bed cancer reference center, simultaneous central- and peripheral-blood cultures were prospectively performed for patients with suspicion of catheter-related sepsis over an 18-month period. Data for 64 patients for whom the same microorganisms were found when central- and peripheral-blood samples were cultured were retrospectively reviewed by two independent physicians blinded to the differential positivity time values in order to establish or refute the diagnosis of catheter-related sepsis. The diagnosis was established in 28 cases, refuted in 14, and indeterminate in the remaining 22. The differential positivity time was significantly greater for patients with catheter-related sepsis (P < 10(-4)). A cutoff limit of +120 min had 100% specificity and 96.4% sensitivity for the diagnosis of catheter-related sepsis. These results strongly suggest that measurement of the differential positivity time might be a reliable tool facilitating the diagnosis of catheter-related sepsis in patients with an indwelling catheter.

Publication types

  • Comparative Study

MeSH terms

  • Catheterization, Central Venous / adverse effects*
  • Catheters, Indwelling / adverse effects*
  • Humans
  • Retrospective Studies
  • Sepsis / diagnosis*