High positive predictive value of Gram stain on catheter-drawn blood samples for the diagnosis of catheter-related bloodstream infection in intensive care neonates

2016 ◽  
Vol 35 (4) ◽  
pp. 691-696 ◽  
Author(s):  
M. Deleers ◽  
M. Dodémont ◽  
B. Van Overmeire ◽  
Y. Hennequin ◽  
D. Vermeylen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Positive Predictive Value ◽  
Bloodstream Infection ◽  
Predictive Value ◽  
Gram Stain ◽  
Blood Samples ◽  
High Positive Predictive Value ◽  
Catheter Related Bloodstream Infection

scholarly journals Development of an Algorithm for Surveillance of Ventilator-Associated Pneumonia With Electronic Data and Comparison of Algorithm Results With Clinician Diagnoses

2008 ◽  
Vol 29 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Michael Klompas ◽  
Ken Kleinman ◽  
Richard Platt
Keyword(s):  
Intensive Care ◽  
Positive Predictive Value ◽  
Intensive Care Units ◽  
Predictive Value ◽  
Ventilator Associated Pneumonia ◽  
Surgical Intensive Care ◽  
Electronic Data ◽  
Prospective Comparison ◽  
Control And Prevention ◽  
High Positive Predictive Value

Objective.Surveillance for ventilator-associated pneumonia (VAP) using standard Centers for Disease Control and Prevention (CDC) criteria is labor intensive and involves many subjective assessments. We sought to improve the efficiency and objectivity of VAP surveillance by adapting the CDC criteria to make them amenable to evaluation with electronic data.Design.Prospective comparison of the accuracy of VAP surveillance by use of an algorithm with responses to prospective queries made to intensive care physicians. CDC criteria for VAP were used as a reference standard to evaluate the algorithm and clinicians' reports.Setting.Three surgical intensive care units and 2 medical intensive care units at an academic hospital.Methods.A total of 459 consecutive patients who received mechanical ventilation for a total of 2,540 days underwent surveillance by both methods during consecutive 3-month periods. Electronic surveillance criteria were chosen to mirror the CDC definition. Quantitative thresholds were substituted for qualitative criteria. Purely subjective criteria were eliminated. Increases in ventilator-control settings were taken to indicate worsening oxygenation. Semiquantitative Gram stain of pulmonary secretion samples was used to assess whether there was sputum purulence.Results.The algorithm applied to electronic data detected 20 patients with possible VAP. All cases of VAP were confirmed in accordance with standard CDC criteria (100% positive predictive value). Prospective survey of clinicians detected 33 patients with possible VAP. Seventeen of the 33 possible cases were confirmed (52% positive predictive value). Overall, 21 cases of confirmed VAP were identified by either method. The algorithm identified 20 (95%) of 21 known cases, whereas the survey of clinicians identified 17 (81%) of 21 cases.Conclusions.Surveillance for VAP using electronic data is feasible and has high positive predictive value for cases that meet CDC criteria. Further validation of this method is warranted.

scholarly journals Detection of Aspergillus fumigatus in Blood Samples from Critically Ill Patients in Intensive Care Units by Use of the SeptiFast Assay: TABLE 1

2016 ◽  
Vol 54 (7) ◽  
pp. 1918-1921 ◽  
Author(s):  
Joerg Steinmann ◽  
Jan Buer ◽  
Peter-Michael Rath
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Positive Predictive Value ◽  
Aspergillus Fumigatus ◽  
Critically Ill ◽  
Predictive Value ◽  
Icu Patients ◽  
Blood Samples ◽  
Content Type ◽  
Whole Blood Samples

We retrospectively analyzed the performance and relevance of the SeptiFast assay in detectingAspergillus fumigatusDNA in whole blood samples from 38 critically ill intensive care unit (ICU) patients with probable or proven invasive aspergillosis (IA) and 100 ICU patients without IA. The assay exhibited 66% sensitivity, 98% specificity, a 93% positive predictive value, and an 88% negative predictive value.A. fumigatusDNAemia was associated with poor outcome.

scholarly journals Automated Surveillance for Central Line–Associated Bloodstream Infection in Intensive Care Units

2008 ◽  
Vol 29 (9) ◽  
pp. 842-846 ◽  
Author(s):  
Keith F. Woeltje ◽  
Anne M. Butler ◽  
Ashleigh J. Goris ◽  
Nhial T. Tutlam ◽  
Joshua A. Doherty ◽  
...  
Keyword(s):  
Intensive Care ◽  
Negative Predictive Value ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Predictive Value ◽  
Infection Prevention ◽  
Central Line ◽  
Computer Algorithms ◽  
Predictive Values ◽  
Blood Samples

Objective.To develop and evaluate computer algorithms with high negative predictive values that augment traditional surveillance for central line–associated bloodstream infection (CLABSI).Setting.Barnes-Jewish Hospital, a 1,250-bed tertiary care academic hospital in Saint Louis, Missouri.Methods.We evaluated all adult patients in intensive care units who had blood samples collected during the period from July 1, 2005, to June 30,2006, that were positive for a recognized pathogen on culture. Each isolate recovered from culture was evaluated using the definitions for nosocomial CLABSI provided by the National Healthcare Safety Network of the Centers for Disease Control and Prevention. Using manual surveillance by infection prevention specialists as the gold standard, we assessed the ability of various combinations of dichotomous rules to determine whether an isolate was associated with a CLABSI. Sensitivity, specificity, and predictive values were calculated.Results.Infection prevention specialists identified 67 cases of CLABSI associated with 771 isolates recovered from blood samples. The algorithms excluded approximately 40%-62% of the isolates from consideration as possible causes of CLABSI. The simplest algorithm, with 2 dichotomous rules (ie, the collection of blood samples more than 48 hours after admission and the presence of a central venous catheter within 48 hours before collection of blood samples), had the highest negative predictive value (99.4%) and the lowest specificity (44.2%) for CLABSI. Augmentation of this algorithm with rules for common skin contaminants confirmed by another positive blood culture result yielded in a negative predictive value of 99.2% and a specificity of 68.0%.Conclusions.An automated approach to surveillance for CLABSI that is characterized by a high negative predictive value can accurately identify and exclude positive culture results not representing CLABSI from further manual surveillance.

Gram stain/aolc screening for detection of catheter related bloodstream infection

2010 ◽  
Vol 60 (3) ◽  
pp. 254-255 ◽  
Author(s):  
Julia Zach ◽  
Ines Zollner-Schwetz ◽  
Robert Krause ◽  
Armin Zebisch ◽  
Angelika Rohn ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Gram Stain ◽  
Catheter Related Bloodstream Infection

scholarly journals Prognostic value of serum proadrenomedullin in catheter-related bloodstream infection in the intensive care unit

Medicine ◽  
2018 ◽  
Vol 97 (42) ◽  
pp. e12821
Author(s):  
Juping Ni ◽  
Yingjie Sun ◽  
Hongping Qu ◽  
Aqian Wang ◽  
Yunshan Cao ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Prognostic Value ◽  
Catheter Related Bloodstream Infection

Automated screening tool for Subcutaneous Implantable Defibrillator in Brugada syndrome has a high eligibility rate which is predicted by simple electrocardiographic parameters

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Marelli ◽  
D Kukavica ◽  
A Mazzanti ◽  
T Chargeishvili ◽  
A Trancuccio ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Brugada Syndrome ◽  
Predictive Value ◽  
Screening Tool ◽  
Screening Tools ◽  
Molecular Medicine ◽  
Funding Source ◽  
S Wave ◽  
High Positive Predictive Value ◽  
Automated Screening

Abstract Background Manual electrocardiographic (ECG) screening tools for the use of subcutaneous cardiac defibrillator (S-ICD) have been associated with high ineligibility rates in Brugada syndrome patients (BrS). Although recent works identified ECG parameters for S-ICD eligibility in general population, automated screening tool (AST) for S-ICD eligibility have not even been assessed in large series of patients with BrS. Purpose This study evaluates the AST-derived eligibility rates for an S-ICD in patients with BrS, and ECG parameters associated with S-ICD eligibility. Methods Screening for S-ICD eligibility was performed using AST in 194 consecutive patients with BrS. Eligibility was defined when at least one of the three vectors was acceptable both in supine and standing position. Twelve-lead ECGs were registered during the screening. ECG parameters associated with AST eligibility were identified using multivariable logistical regression. Results Our study population consisted of 194 patients, with male preponderance (n=165/194; 85%); and were 43±12 years old at the time of screening. Majority of patients presented a spontaneous type 1 pattern during screening (n=128/194; 66%), with an average pattern height of 3±3 mm. Remarkably, 93% of patients passed the screening with AST. No differences in eligibility rates in terms of gender (93% males vs. 93% females eligible; p=1) and age (48±9 years non-eligible vs. 42±12 eligible; p=0.07) existed. Notably, our eligibility rate was 2.5 times higher than rates reported in literature when using manual screening tools (p=0.023). Independent 12-lead ECG parameters (Table) associated with AST eligibility were duration of S wave <80 ms in aVF and R/T ratio ≥3 in lead II (Figure), which have a high positive predictive value (97% and 99%, respectively) for screening eligibility. Conclusions Most BrS patients (93%) are eligible for S-ICD when AST is used. S wave <80 ms in aVF, and R/T ratio ≥3 in lead II have a high positive predictive value for S-ICD eligibility. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Italian Ministry of Research and University Dipartimenti di Eccellenza 2018–2022 grant to the Molecular Medicine Department (University of Pavia)

Sign in / Sign up

Export Citation Format

Share Document