Those organisms from the first sample were cells which probably
broke free from the biofilm during the sampling procedure. Biofilm is
always going to be present especially in a catheter of this age with
TPN. When in the biofilm, the organisms are known as sessile but once
they break free, they are planktonic or free floating. The mechanism
by which biofilm produces a CRBSI is not totally clear but it is
thought to be related to sessile organisms becoming planktonic and
floating into the bloodstream. A culture may be negative even with a
large bioburden but no planktonic cells were captured. This sample did
capture the planktonic cells but the load of planktonic organisms is
not great enough yet to produce a CRBSI. Those IV antibiotics will not
penetrate the biofilm and thus will have no impact on this catheter. I
would say it needs to come out. What bacteria was found? Lynn
At 12:41 PM -0600 8/10/06, Rakay Dance wrote:
Hi, I am looking for some expert opinions. We had a PICC line in place 8 weeks. Pt is receiving TPN for extreme hyperemesis gravadarium. On weekly labs Monday the lab noted visiable bacteria in the CBC. On Tuesday PICC was pulled and repeat CBC and Blood cultures PIV were drawn. No bacteria noted on this sample. Blood Cultures remain negative after 48 hours. Is this likely a line infection or something else. The tip was not cultured. Pt is now hospitalized and continues to spike fevers and is on IVAB. Infection remains unknown. Pt's WBC was 2.7 when admitted to hospital. Pt has very large swollen glands in neck, headache and stiff neck. No spinal has been done. I would love your opinion's-line infected or no?? RaKay
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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
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
