Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Zach, J.
Microbiological screening of central venous catheters for detection of catheter related bloodstream infections in patients receiving haematopoietic stem cell transplantation
[ Diplomarbeit ] Medical University of Graz; 2008. pp.74
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Krause Robert
- Zollner-Schwetz Ines
- Altmetrics:
- Abstract:
- Background: The Gram stain/acridine orange leukocyte cytospin (AOLC) test and the differential time to positivity (DTP) method are used for diagnosis of catheter related bloodstream infections (CRBSI) in patients with clinical signs of CRBSI. Catheter colonization with a cut off level of 1000 organisms/ml catheter blood is considered to be a forerunner of CRBSI. This prospective trial is undertaken to evaluate whether the Gram stain/AOLC test could serve as a screening tool to detect CRBSI in a subclinical stage in patients receiving haematopoietic stem cell transplantation (HSCT). Methods: From February 2007 to January 2008, 32 consecutive HSCT-patients with 36 catheter episodes were prospectively investigated. Screening for CRBSI was performed by Gram stain/AOLC test three times a week using EDTA blood from routinely used lumina of central venous catheters. If CRBSI was clinically suspected, routine investigation was performed by the Gram stain/AOLC test, DTP and Brun Buisson method. Results: 618 blood samples were investigated. Results are depicted in the table. The sensitivity and specificity of screening by Gram stain/ AOLC test were 50% and 86%, the PPV and NPV were 50% and 86%. Table 1 Gram stain/AOLC Screening Routine positive negative 8 CRBSI* 4/8 4/8 28 no CRBSI* 4/28 24/28 * as routinely diagnosed in clinically symptomatic patients within 48 hours after screening. Conclusions: Screening of blood drawn from routinely used lumina of central venous catheters by the Gram stain/AOLC test helps to detect patients at risk for clinically evident CRBSI. Therefore patients with positive screening results should be thoroughly observed with regard to development of clinically evident CRBSI. Patients with negative Gram stain/ AOLC test screening results are unlikely to develop CRBSI.