TY - JOUR
T1 - Differential quantitative blood cultures for the diagnosis of catheter-related bloodstream infections associated with short- and long-term catheters
T2 - A prospective study
AU - Chatzinikolaou, Ioannis
AU - Hanna, Hend
AU - Hachem, Ray
AU - Alakech, Badie
AU - Tarrand, Jeffrey
AU - Raad, Issam
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2004/11
Y1 - 2004/11
N2 - We prospectively evaluated the value of two levels of differential quantitative blood culture (DQBC) ratio (≥2:1 or ≥5:1) in diagnosing catheter-related bloodstream infections (CRBSIs) in patients with malignancy that have short-term and long-term central venous catheters (CVCs) (<30 and ≥30 days of placement). Diagnosis of CRBSIs was based on results of semiquantitative cultures of removed catheters. For short-term CVCs a 5:1 or greater DQBC ratio had an 18% sensitivity, 67% specificity, 18% positive predictive value (PPV) and 67% negative predictive value (NPV), whereas a 2:1 or greater cut-off point for the DQBC was associated with a 45% sensitivity, 48% specificity, 26% PPV, and 68% NPV for the diagnosis of CRBSIs. For long-term CVCs, a cut-off point of 5:1 or greater of the DQBC had an 81% sensitivity, 40% specificity, 36% PPV, and 83% NPV for the diagnosis of CRBSIa, whereas a 2:1 or greater cut-off point had a 90% sensitivity, 30% specificity, 35% PPV, and 88% NPV for the diagnosis of CRBSIs. In conclusion, DQBCs are not diagnostic of CRBSIs for short-term CVCs. In long-term CVCs, DQBCs at 2:1 or greater or 5:1 or greater are sensitive but associated with low specificity and positive predictive value.
AB - We prospectively evaluated the value of two levels of differential quantitative blood culture (DQBC) ratio (≥2:1 or ≥5:1) in diagnosing catheter-related bloodstream infections (CRBSIs) in patients with malignancy that have short-term and long-term central venous catheters (CVCs) (<30 and ≥30 days of placement). Diagnosis of CRBSIs was based on results of semiquantitative cultures of removed catheters. For short-term CVCs a 5:1 or greater DQBC ratio had an 18% sensitivity, 67% specificity, 18% positive predictive value (PPV) and 67% negative predictive value (NPV), whereas a 2:1 or greater cut-off point for the DQBC was associated with a 45% sensitivity, 48% specificity, 26% PPV, and 68% NPV for the diagnosis of CRBSIs. For long-term CVCs, a cut-off point of 5:1 or greater of the DQBC had an 81% sensitivity, 40% specificity, 36% PPV, and 83% NPV for the diagnosis of CRBSIa, whereas a 2:1 or greater cut-off point had a 90% sensitivity, 30% specificity, 35% PPV, and 88% NPV for the diagnosis of CRBSIs. In conclusion, DQBCs are not diagnostic of CRBSIs for short-term CVCs. In long-term CVCs, DQBCs at 2:1 or greater or 5:1 or greater are sensitive but associated with low specificity and positive predictive value.
KW - Catheter related bloodstream infection
KW - Central venous catheter
KW - Differential quantitative blood culture
KW - Quantitative blood culture
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U2 - 10.1016/j.diagmicrobio.2004.07.007
DO - 10.1016/j.diagmicrobio.2004.07.007
M3 - Article
C2 - 15541601
AN - SCOPUS:8444227398
SN - 0732-8893
VL - 50
SP - 167
EP - 172
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 3
ER -