Re: catheter cultures

[Jennifer Kettle]

This is why when the catheter is d/c'ed we always order a standard peripheral blood cultutre to compare with the tip cultures. If there is no peripheral then the catheter tip, even if positive means nothing. Many MD's will culture just the tip and if colonization is present (>15cfu) they will automatically treat with antibiotics. Nothing peripheral to compare to so can not prove this is true bacteremia. Therefore, many unnecessary antibiotics are given, etc. When the MD wishes to maintain the line and to rule out infection we will be ordering QBC from the line (each lumen) and a peripheral for comparison. The MD's here also want to draw a standard peripheral blood culture as well at that time. This result comes back faster and allows them to treat a systemic infection if needed, whether it is related to the line or not. But, the QBC comparison based on variance allows for a definitive line infection or not. Even if the MD pulls our line after the stanbdard culture is back we will know whether or not it was a line infection. More standardization will allow us to hopefully prevent unnecessary discontinuation of our lines in the long run. >>> Anna Liang <[EMAIL PROTECTED]> 5/31/2006 8:06:20 PM >>> we don't rely on catheter tip culture to define CRBSI. and we don't routinely culture the skin segment either. if I understand correctly, if CRBSI is based on positive catheter culture, there could be false low rates. --- Jennifer Kettle <[EMAIL PROTECTED]> 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 > __________________________________________________ Do You Yahoo!? Tired of spam?  Yahoo! Mail has the best spam protection around http://mail.yahoo.com