May 1987

Diagnosis of Central Venous Catheter-Related SepsisCritical Level of Quantitative Tip Cultures

Author Affiliations

From the Service de Réanimation Médicale (Drs Brun-Buisson, Abrouk, Huet, Larabi, and Rapin), and the Department of Microbiology (Dr Legrand), Hôpital Henri Mondor and Université Paris Val de Marne, Creteil, France.

Arch Intern Med. 1987;147(5):873-877. doi:10.1001/archinte.1987.00370050069012

• The results of a simplified quantitative broth dilution quantitative tip culture (QTC) of 331 central venous catheters were compared with clinical data prospectively recorded in critically ill patients to diagnose bacteremic or nonbacteremic catheter-related sepsis (CRS) (36 catheters), as opposed to contamination (42 catheters) or simple colonization from a distant septic focus (seven catheters). Thirty-five of 36 catheters associated with CRS yielded 103 colony-forming units per milliliter (CFU/mL) or more, and 3.8 × 102 Candida organisms grew from one. In contrast, 5 × 102 CFU/mL or less grew from 37 of 42 contaminated catheters. A QTC of 103 CFU/mL or more was 97.5% sensitive and 88% specific for the diagnosis of CRS. The QTC appeared especially useful for the diagnosis of CRS secondary to blood-borne seeding of catheters, or associated with coagulase-negative staphylococci.

(Arch Intern Med 1987;147:873-877)