Nadine and Lynn are correct on this one.  Our head of ID will not allow
the culture of a tip without a positive blood culture.

Bob

>>> "Lynn Hadaway" <[EMAIL PROTECTED]> 5/31/2006 9:32:58 PM
>>>
The process you are referring to require sacrifice of the catheter 
before a diagnosis is made. There is a better way. Draw blood 
cultures from the catheter and from a peripheral site. There are 2 
ways to assess these cultures
1. positive for catheter related infection if the colony count is 
more than 5 times greater from the catheter than from the peripheral 
site. OR
2. time to positivity - catheter is positive when the catheter sample 
begins to grow bugs 2 hours before the peripheral sample.

Lynn

At 6:16 PM -0700 5/31/06, Jennifer Kettle wrote:
>When culturing for suspected infusion-related infections is it 
>necessary to obtain both the catheter tip AND the catheter skin 
>segment for culture? I am still working to develop a standardized 
>care set for our computer system to help make the diagnosis of 
>suspected CRBSI easier as well as to encourage consistency. I am 
>also a member of the infection control committee here. The infection 
>control committee director (MD) does not feel that it is necessary 
>and compliance with our current policy to obtain the skin segment is 
>next to none anyhow.  I am on the fence as I am having difficulty 
>interpreting the 2006 standards in regard to this. We are also in 
>the process of reviewing our current policy regarding this 
>procedure. Standard #58 under practice criteria E. states, "When 
>culturing a central vascular catheter segment, either the catheter 
>tip or a subcutaneous segment should be submitted for culture." Why 
>would one ever want to culture just the skin segment and not the 
>tip? Don't you need at least the tip for culture? Any input is 
>always appreciated. Thanks in advance.   Jenny


-- 
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com 
office 770-358-7861


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