scholarly journals Molecular epidemiology of catheter-related bloodstream infections caused by coagulase-negative staphylococci in haematological patients with neutropenia

2004 ◽  
Vol 132 (5) ◽  
pp. 921-925 ◽  
Author(s):  
M. MÜLLER-PREMRU ◽  
P. ČERNELČ
Keyword(s):  
Blood Culture ◽  
Staphylococcus Epidermidis ◽  
Clinical Signs ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Blood Cultures ◽  
Peripheral Vein ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Haematological Patients

Catheter-related bloodstream infection (CRBSI) caused by coagulase-negative staphylococci (CNS) is common in haematological patients with febrile neutropenia. As the clinical signs of CRBSI are usually scarce and it is difficult to differentiate from blood culture contamination, we tried to confirm CRBSI by molecular typing of CNS isolated from paired blood cultures (one from a peripheral vein and another from the central venous catheter hub). Blood cultures were positive in 59 (36%) out of 163 patients. CNS were isolated in 24 (40%) patients; in 14 from paired blood cultures (28 isolates) and in 10 from a single blood culture. CNS from paired blood cultures were identified as Staphylococcus epidermidis. Antimicrobial susceptibility was determined and bacteria were typed by pulsed-field gel electrophoresis (PFGE) of bacterial genomic DNA. In 13 patients, the antibiotic susceptibility of isolates was identical. The PFGE patterns from paired blood cultures were identical or closely related in 10 patients, thus confirming the presence of CRBSI. In the remaining four patients they were unrelated, and suggested a mixed infection or contamination. Since CNS isolates from three patients had identical PFGE patterns, they were probably nosocomially spread amongst them.

scholarly journals Quantitative aspects of septicemia.

1990 ◽  
Vol 3 (3) ◽  
pp. 269-279 ◽  
Author(s):  
P Yagupsky ◽  
F S Nolte
Keyword(s):  
Blood Culture ◽  
Venous Catheter ◽  
Bacterial Endocarditis ◽  
Blood Cultures ◽  
Peripheral Vein ◽  
Central Venous ◽  
Culture Methods ◽  
Severity Of Disease ◽  
Patient’S Outcome

For years, quantitative blood cultures found only limited use as aids in the diagnosis and management of septic patients because the available methods were cumbersome, labor intensive, and practical only for relatively small volumes of blood. The development and subsequent commercial availability of lysis-centrifugation direct plating methods for blood cultures have addressed many of the shortcomings of the older methods. The lysis-centrifugation method has demonstrated good performance relative to broth-based blood culture methods. As a result, quantitative blood cultures have found widespread use in clinical microbiology laboratories. Most episodes of clinical significant bacteremia in adults are characterized by low numbers of bacteria per milliliter of blood. In children, the magnitude of bacteremia is generally much higher, with the highest numbers of bacteria found in the blood of septic neonates. The magnitude of bacteremia correlates with the severity of disease in children and with mortality rates in adults, but other factors play more important roles in determining the patient's outcome. Serial quantitative blood cultures have been used to monitor the in vivo efficacy of antibiotic therapy in patients with slowly resolving sepsis, such as disseminated Mycobacterium avium-M. intracellulare complex infections. Quantitative blood culture methods were used in early studies of bacterial endocarditis, and the results significantly contributed to our understanding of the pathophysiology of this disease. Comparison of paired quantitative blood cultures obtained from a peripheral vein and the central venous catheter has been used to help identify patients with catheter-related sepsis and is the only method that does not require removal of the catheter to establish the diagnosis. Quantitation of bacteria in the blood can also help distinguish contaminated from truly positive blood cultures; however, no quantitative criteria can invariably differentiate contamination from bacteremia.

scholarly journals Clinical Evaluation of the iCubate iC-GPC Assay for Detection of Gram-Positive Bacteria and Resistance Markers from Positive Blood Cultures

2018 ◽  
Vol 56 (9) ◽  
Author(s):  
Paul A. Granato ◽  
Melissa M. Unz ◽  
Raymond H. Widen ◽  
Suzane Silbert ◽  
Stephen Young ◽  
...  
Keyword(s):  
Blood Culture ◽  
Staphylococcus Epidermidis ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Gram Positive ◽  
Content Type ◽  
Gram Positive Bacteria ◽  
Sequencing Method ◽  
Resistance Markers ◽  
Gram Positive Cocci

ABSTRACT The iC-GPC Assay (iCubate, Huntsville, AL) is a qualitative multiplex test for the detection of five of the most common Gram-positive bacteria (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis, and Enterococcus faecium) responsible for bacterial bloodstream infections, performed directly from positive blood cultures. The assay also detects the presence of the mecA, vanA, and vanB resistance determinants. This study comparatively evaluated the performance of the iC-GPC Assay against the Verigene Gram-positive blood culture (BC-GP) assay (Luminex Corp., Austin, TX) for 1,134 patient blood culture specimens positive for Gram-positive cocci. The iC-GPC Assay had an overall percent agreement with the BC-GP assay of 95.5%. Discordant specimens were further analyzed by PCR and a bidirectional sequencing method. The results indicate that the iC-GPC Assay together with the iCubate system is an accurate and reliable tool for the detection of the five most common Gram-positive bacteria and their resistance markers responsible for bloodstream infections.

Drawing blood cultures through intravascular catheters: Controversy and update

2019 ◽  
Vol 40 (4) ◽  
pp. 457-459 ◽  
Author(s):  
Leonard A. Mermel
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Culture Collection ◽  
Blood Cultures ◽  
Central Venous ◽  
Intravascular Catheters

AbstractStudies published between 1999 and 2011 demonstrated increased blood culture contamination with catheter-drawn cultures compared with percutaneously-drawn cultures. Studies published between 2012 and 2015 reported that use of antiseptic barrier caps on central venous catheter hubs significantly reduces the incidence of catheter-drawn blood culture contamination. Local guidelines regarding sites for blood culture collection should reflect institution-level blood culture contamination rates for percutaneously-drawn and catheter-drawn cultures using currently available technologies that reduce contamination at both sites.

scholarly journals 81. Reducing Unnecessary Blood Cultures Through Diagnostic Stewardship

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S157-S157
Author(s):  
Sujeet Govindan ◽  
Luke Strnad
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Cost Savings ◽  
Bloodstream Infections ◽  
Central Line ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Candida Sp ◽  
Daily Frequency ◽  
Oregon Health

Abstract Background At our institution, we learned the frequency of blood cultures was sometimes being changed from “Once” to “Daily” without a defined number of days. We hypothesized this led to unnecessary blood cultures being performed. Methods Over a 3 month period from 12/6/2019-3/6/2020, we retrospectively evaluated the charts of patients who had a blood culture frequency changed to “Daily”. We evaluated if there was an initial positive blood culture within 48 hours of the “Daily” order being placed and the number of positive, negative, or “contaminant” sets of cultures drawn with the order. Contaminant blood cultures were defined as a contaminant species, present only once in the repeat cultures, and not present in initial positive cultures. Results 95 unique orders were placed with 406 sets of cultures drawn from 89 adults. ~20% of the time (17 orders) the order was placed without an initial positive blood culture. This led to 62 sets of cultures being drawn, only 1 of which came back positive. 78/95 orders had an initial positive blood culture. The most common initial organisms were Staphylococcus aureus (SA) (38), Candida sp (10), Enterobacterales sp (10), and coagulase negative staphylococci (7). 43/78 (55%) orders with an initial positive set had positive repeat cultures. SA (26) and Candida sp (8) were most common to have positive repeats. Central line associated bloodstream infections (CLABSI) were found in 5 of the orders and contaminant species were found in 4 of the orders. 54% of the patients who had a “Daily” order placed did not have positive repeat cultures. The majority of the cultures were drawn from Surgical (40 orders) and Medical (35 orders) services. Assuming that SA and Candida sp require 48 hours of negative blood cultures to document clearance and other species require 24 hours, it was estimated that 51% of the cultures drawn using the "Daily" frequency were unnecessary. Cost savings over a year of removing the "Daily" frequency would be ~&14,000. Data from "Daily" blood culture orders drawn at Oregon Health & Science University from 12/6/2019-3/6/2020 Conclusion Unnecessary blood cultures are drawn when the frequency of blood cultures is changed to "Daily". Repeat blood cultures had the greatest utility in bloodstream infections due to SA or Candida sp, and with CLABSI where the line is still in place. These results led to a stewardship intervention to change blood culture ordering at our institution. Disclosures All Authors: No reported disclosures

scholarly journals Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Izabela Linha Secco ◽  
Mitzy Tannia Reichembach ◽  
Higor Pacheco Pereira ◽  
Regina Paula Guimarães Vieira Cavalcante da Silva
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Antibiotic Therapy ◽  
Bloodstream Infection ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Cross Sectional Study ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional

ABSTRACT Objectives: to establish the prevalence of salvage of central venous catheters in newborns with bloodstream infection caused by coagulase-negative staphylococci. Methods: retrospective cross-sectional study with 136 newborns admitted to the Neonatal Intensive Care Unit between 2011 and 2017. The total of 143 infection events undergoing antibiotic therapy were evaluated. Results: among the 143 infection events, 39 catheters in which antibiotic therapy was used were saved and in 69 cases, the device was removed. Positive central blood culture and single lumen catheter were factors associated with salvage failure. The probability of salvage decreased with infections diagnosed from 15 days of using the catheter. Negative blood culture raised the chance of salvage by fourfold. Conclusions: the use of antibiotic therapy in the treatment of infections resulted in a low prevalence of salvage of the central venous catheter. The probability of salvage was associated with variables of the device.

scholarly journals Five-year evaluation of the antimicrobial susceptibility patterns of bacteria causing bloodstream infections in Iran

2011 ◽  
Vol 6 (02) ◽  
pp. 120-125 ◽  
Author(s):  
Babak Pourakbari ◽  
Alireza Sadr ◽  
Mohammad Taghi Haghi Ashtiani ◽  
Setareh Mamishi ◽  
Mahdi Dehghani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Infection Control ◽  
Medical Center ◽  
Pediatric Population ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Antimicrobial Drug Resistance ◽  
Oxacillin Resistance

Introduction: Bloodstream infections (BSI) are a serious cause of morbidity and mortality worldwide. Emerging antimicrobial drug resistance among bacterial pathogens causing BSI can limit therapeutic options and complicate patient management. Methodology: To encourage the prudent use of appropriate antibiotics in our pediatric population at Children's Medical Center Hospital, Tehran, Iran, we studied the frequency and antibiogram patterns of blood culture isolates from January 2001 to December 2005. Results: Of 25,223 blood cultures examined, 2,581 (10.23 %) were positive for bacterial growth. The frequency of Gram-positive bacteria isolated was 47.6% (1228 of 2581) and that for Gram-negatives was 52.4% (1353 of 2581). The rates of methicillin (oxacillin) resistance in Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were 79% and 89%, respectively. About 45% of Streptococcus pneumoniae were resistant to trimethoprim-sulfamethoxazole and approximately 66% to penicillin. Among the Gram-negative isolates, Pseudomonas aeruginosa was most frequently isolated, representing 943 (36.7%) over five years. This possibly represents an unrecognized hospital outbreak or contamination of blood culture bottles or other products such as skin disinfectants. Additionally, this pathogen showed extremely high rates of antimicrobial resistance. There were notable differences in frequency of the five most common microorganisms isolated from blood cultures, which can help set priorities for focused infection control efforts. Conclusions: Our findings underscore the need to monitor blood culture isolates and their antimicrobial resistance patterns to observe resistance trends that would influence appropriate empiric treatment and infection control strategies for bacteremic children.  

Role of the Central Venous Catheter in Bloodstream Infections Caused by Coagulase-negative Staphylococci in Very Preterm Neonates

2013 ◽  
Vol 32 (6) ◽  
pp. 622-628 ◽  
Author(s):  
Margaux Lepainteur ◽  
Marine Desroches ◽  
Anne Sophie Bourrel ◽  
Said Aberrane ◽  
Vincent Fihman ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Preterm Neonates ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Very Preterm

Central Line–Associated Bloodstream Infections in Children With Hematologic and Oncologic Diseases: First Prevalence Results From a University Hospital

2019 ◽  
Vol 36 (5) ◽  
pp. 327-336
Author(s):  
Gülçin Özalp Gerçeker ◽  
Figen Yardımcı ◽  
Yeşim Aydınok
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
University Hospital ◽  
High Rate ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional ◽  
Pediatric Hematology

Central line–associated bloodstream infections (CLABSIs) are still a major cause of morbidity and mortality in pediatric hematology-oncology patients in many countries. This cross-sectional study was a retrospective review of CLABSI in inpatient pediatric hematology-oncology cases with long-term central venous catheter at the Pediatric Hematology Department from January 2013 to June 2014. Characteristics of CLABSI events in pediatric patients with hematologic malignancies and related nonmalignant hematologic conditions are documented. CLABSI developed in 61.8% ( n = 21) of the 34 hospitalized patients included in the study. The CLABSI rate was 7.8 per 1,000 inpatient central venous catheter days. Coagulase-negative staphylococci was the predominant pathogen in 47.6% of the patients with CLABSI. The high rate of CLABSI requires prevention strategies to reduce CLABSI immediately. This study provides guidance in prioritizing strategies for reducing rates of infection.

Catheter Design Influences Recurrence of Catheter-Related Bloodstream Infection in Children With Cancer

2003 ◽  
Vol 21 (18) ◽  
pp. 3520-3525 ◽  
Author(s):  
Patricia M. Flynn ◽  
Brian Willis ◽  
Aditya H. Gaur ◽  
Jerry L. Shenep
Keyword(s):  
Central Venous Catheter ◽  
Management Strategies ◽  
Multivariable Analysis ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous ◽  
Short Term ◽  
Coagulase Negative Staphylococci ◽  
Catheter Design

Purpose: Multiple studies have demonstrated that catheter-related bloodstream infections (CRBI) can be successfully treated without catheter removal (in situ therapy), but there is insufficient information available to determine if catheter design can influence the eradication of bacteremia or recurrence. Patients and Methods: Bacteremic episodes in patients at St Jude Children’s Research Hospital between January 1996 and May 2001 were identified and patient records were reviewed. Results: A total of 172 unique episodes of CRBI were identified. In situ therapy resulted in successful eradication of bacteremia in 87% of the episodes. Bacteremia recurred in 10% of the episodes. Although catheter design (Hickman and Broviac versus totally implantable central venous catheter) did not influence short-term eradication of bacteremia, totally implantable central venous catheters were significantly associated with recurrence of bacteremia (odds ratio, 10; 95% confidence interval, 3.1 to 33.3). In a multivariable analysis, this association between catheter design and recurrence remained statistically significant after adjustment for other factors that influenced recurrence in this study (isolation of coagulase-negative staphylococci and inadequate duration of initial antibiotic therapy). Conclusion: This study demonstrates that patients with CRBI with a totally implantable central venous catheter in place are more likely to develop recurrent bacteremia. Management strategies to prevent recurrence in this setting should be explored.

Surveillance of Hemodialysis-Associated Primary Bloodstream Infections: The Experience of Ten Hospital-Based Centers

2002 ◽  
Vol 23 (12) ◽  
pp. 721-724 ◽  
Author(s):  
Margaret Dopirak ◽  
Connie Hill ◽  
Marylee Oleksiw ◽  
Diane Dumigan ◽  
Jean Arvai ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Central Venous Catheter ◽  
Descriptive Analysis ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Hemodialysis Access ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Large Pool

Objective:To determine baseline rates of primary bloodstream infection (BSI) among a large pool of patients receiving hemodialysis using standardized surveillance tools and methodology.Design:Prospective, descriptive analysis of primary BSI rates.Setting:Ten hospital-based hemodialysis centers in Connecticut.Patients:All patients receiving long-term hemodialysis in the participating facilities.Results:A total of 158 BSIs occurred during 142,525 dialysis sessions within a 12-month study period. Of the BSIs, 15.2% occurred in patients with fistula or graft access and 84.8% in patients with central venous catheter access (P < .001). Rates per 100 patient-years in centers ranged from 0 to 30.8, with a mean of 16.6. Rates per 1,000 dialysis sessions ranged from 0 to 2.1, with a mean of 1.1. Coagulase-negative staphylococci and Staphylococcus aureus (including methicillin-resistant S. aureus) accounted for 61% and Klebsiella or Enterobacter species for 14.6% of infections. Of the patients, 63.3% received vancomycin, 24.7% received cefazolin, and 41.7% received aminoglycosides. Rates declined in the second 6 months of the study from 1.4 to 0.8 infections per 1,000 dialysis sessions (P < .001).Conclusions:Primary BSI rates varied widely among participating centers and declined during the study period. BSIs were strongly associated with central venous catheter access. Further studies are needed to determine the reasons for variance in rates between centers and among various types of hemodialysis access.

Sign in / Sign up

Export Citation Format

Share Document