scholarly journals Comparison of methods for the microbiological diagnosis of totally implantable venous access port-related infections

2020 ◽  
Vol 69 (11) ◽  
pp. 1273-1284
Author(s):  
Esingül Kaya ◽  
Lara Tollapi ◽  
Alberto Pastore ◽  
Giacomo Aringhieri ◽  
Giuseppantonio Maisetta ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
False Negative ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Infection Model ◽  
Bacterial Cells ◽  
Culture Methods ◽  
Access Port ◽  
Catheter Tip ◽  
Micro Organisms

Introduction. Totally implanted venous access ports (TIVAPs) are widely used in patients receiving long-term chemotherapy but may lead to serious complications such as catheter-related bloodstream infections (CRBSIs). Diagnosis of CRBSI requires catheter culture, but there is no consensus on microbiological culture methods to be adopted. Aim. To compare three different procedures to recover bacterial cells from colonized catheters and to determine which section of the TIVAP (i.e. tip, septum, reservoir) is the probable source of infection. To investigate the correlation between blood culture results and TIVAP culture in order to get further evidence about the utility of differential time to positivity (DTP) as a diagnostic tool before TIVAP removal. Hypothesis/Gap statement. Comparisons of different diagnostic procedures for catheter culture have been rarely reported for TIVAPs. We hypothesized that the optimization of methods to recover micro-organisms from different parts of TIVAPs may help to decrease the number of false-negative results in the diagnosis of TIVAP-related bloodstream infections. Methodology. A total of 53 TIVAPs removed because of suspected infection (n=36) or end of use (n=17) were evaluated. The reservoir, the septum and the catheter tip were separated and subjected to different treatments for the recovery of adherent micro-organisms: (a) flushing of the catheter lumen, (b) sonication and flushing, (c) treatment with dithiothreitol and flushing. The three methods were also evaluated in an in vitro catheter infection model with Staphylococcus epidermidis . Culture results were compared to those obtained from paired blood cultures drawn from TIVAP and peripheral vein and to the relative DTP. Results. The results obtained demonstrated that vigorous flushing/vortexing of the catheter lumen/septum, allows the recovery of a number of micro-organisms comparable to that of more complex procedures such as sonication or chemical treatment. Among 24 positive TIVAP-cultures, nine were tip-culture negative, whereas the corresponding reservoirs and septa were culture positive. A good correlation was observed between DTP and TIVAP cultures (P<0.001). Conclusions. The results support the evidence that sending the port reservoir in addition to the catheter tip to the microbiology laboratory may increase the sensitivity and the accuracy of CRBSI diagnosis. Moreover, when a TIVAP-related infection is suspected, DTP is a useful diagnostic tool to decide between device removal or a more conservative approach.

scholarly journals Use of Universal 16S rRNA Gene PCR as a Diagnostic Tool for Venous Access Port-Related Bloodstream Infections

2012 ◽  
Vol 51 (3) ◽  
pp. 799-804 ◽  
Author(s):  
M. Guembe ◽  
M. Marín ◽  
P. Martín-Rabadán ◽  
A. Echenagusia ◽  
F. Camúñez ◽  
...  
Keyword(s):  
16S Rrna ◽  
16S Rrna Gene ◽  
Diagnostic Tool ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Rrna Gene ◽  
Access Port ◽  
Venous Access Port

scholarly journals Migration of catheter of a totally implantable venous access port to right thoracic cavity in a child - a case report

2021 ◽  
Author(s):  
Qiteng Xu ◽  
Yueyi Ren ◽  
Yifei Hu ◽  
Shuhua Duan ◽  
Rui Chen ◽  
...  
Keyword(s):  
Venous Access ◽  
Thoracic Cavity ◽  
Severe Condition ◽  
Access Port ◽  
Intravenous Antibiotics ◽  
Catheter Tip ◽  
Life Threatening ◽  
Venous Access Port ◽  
And Migration ◽  
The Right

Abstract BackgroundThe totally implantable venous access port (TIVAP) is a secure and practical choice for children undergoing long-term chemotherapy. Nevertheless, various complications still need to be treated cautiously. Among the complications, the migration of catheters to the thoracic cavity is a very rare (but potentially severe) condition that may necessitate device reimplantation. Furthermore, this migration may even be life-threatening if it is not detected in time.Case presentationA 1-year-old girl undergoing palliative chemotherapy underwent TIVAP placement via the right internal jugular vein. During the operating procedure, the catheter tip was located in the right atrium, which was confirmed by the use of C-arm. Prophylactic intravenous antibiotics were then adopted with routine aspiration and with flushing being conducted each time before administration. Massive right pleural effusion and migration of the catheter tip to the right thoracic cavity were detected on the 2nd day after implantation, which resulted in the removal and reimplantation of the TIVAP device.ConclusionsThe migration of the catheter into the thoracic cavity should be considered a possible complication of TIVAP implantation in children. Early detection and reimplantation may provide opportunities for the prevention of further severe complications.

scholarly journals Calcification and abscess formation around the catheter tip of a central venous access port: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Tomoya Takami ◽  
Keisuke Fukuda ◽  
Koji Yasuda ◽  
Nozomi Kasyu ◽  
Hiroyuki Yoshitake ◽  
...  
Keyword(s):  
Case Report ◽  
Central Venous Access ◽  
Venous Access ◽  
Abscess Formation ◽  
Central Venous ◽  
Access Port ◽  
Catheter Tip ◽  
Venous Access Port

scholarly journals Mycobacterium neoaurum Bloodstream Infection Associated with a Totally Implanted Subclavian Port in an Adult with Diabetes and History of Colon Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Jack E. Moseley Jr. ◽  
Sharanjeet K. Thind
Keyword(s):  
Bloodstream Infection ◽  
Antimicrobial Therapy ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Human Infection ◽  
Isolation And Identification ◽  
Access Port ◽  
Susceptibility Data ◽  
Mycobacterium Neoaurum ◽  
History Of

Background. Mycobacterium neoaurum is a rapidly growing nontuberculosis mycobacterium (NTM) that was first isolated from soil in 1972 and is ubiquitous in soil, water, and dust. The first reported case of human infection by M. neoaurum was published in 1988, presenting as a Hickman catheter-related bacteremia in a patient with ovarian cancer. M. neoaurum has since been recognized as a source of predominantly opportunistic bloodstream infections in immunocompromised hosts. We report the case of an adult diabetic male with M. neoaurum bloodstream infection secondary to an infected venous-access port that had been implanted nearly six years prior for temporary chemotherapy. Case Presentation. A 66-year-old male with schizophrenia, type 2 diabetes mellitus, and a history of excision and chemotherapy to treat adenocarcinoma of the colon 6 years prior, presented with fever and behavioral changes. He was found to have a M. neoaurum bloodstream infection secondary to his implanted subclavian port. Multiple preoperative blood cultures, as well as the removed catheter tip culture, were positive for M. neoaurum. The patient’s condition improved to near premorbid levels after port removal and 6 weeks of targeted antimicrobial therapy. Discussion and Conclusions. Bloodstream infections due to rapidly growing NTM, such as M. neoaurum, have been infrequently reported; however, improved isolation and identification techniques based on genomic testing are resulting in a more in-depth recognition of these widely scattered environmental microbes in human infections. Nonetheless, lengthy identification and susceptibility processes remain a diagnostic and treatment barrier. Patients such as ours who have a history of malignancy and an indwelling foreign body have most often been reported as acquiring M. neoaurum bacteremia. Fortunately, device removal and appropriate antimicrobial therapy guided by susceptibility data is often enough to manage these atypical mycobacterial infections.

scholarly journals PICC Insertion could be an optimal choice of central venous access in prone position mechanically ventilated COVID-19 ARDS patient

2021 ◽  
pp. 226
Author(s):  
Keyword(s):  
Prone Position ◽  
Case Reports ◽  
Central Venous Access ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Optimal Choice ◽  
Mechanically Ventilated ◽  
Catheter Tip ◽  
Chest X Ray ◽  
Insertion Techniques

During the management of critically ill covid-19 patients obtaining an appropriate centrally inserted central catheter (CICC) can be a prime necessity. Traditionally, a CICC is inserted in a supine position. However, a CICC may not be possible in some COVID-19 patients with severe hypoxia or sudden clinical deterioration who need urgent intubation and immediate proning. Therefore, CICC in pronated COVID-19 ARDS patients is challenging. Recent studies limited to case reports have shown that peripherally inserted central catheters (PICC) are safer in pronated ARDS patients. PICC lines minimize mechanical complications and lower catheter-related bloodstream infections when compared to standard CICC. However, there is a scarcity of evidence showing the efficacy of PICC in pronated COVID-19 ARDS patients, possibly due to the complex precautionary safety measures, insertion techniques, and expertise team deficit. Herein, we present a 57-year-old male as a case of COVID-19 ARDS, mechanically ventilated in a prone position with existing subcutaneous emphysema. Our case illustrates PICC insertion challenges in the prone position, ultrasound guidance in PICC insertion to comprehend the vein’s diameter for accurate vein needling in proportion to the external catheter diameter, and intracavitary electrocardiographic (ECG) navigation method to confirm catheter tip location. So that chest X-ray and radiology risk of contamination is avoided. Long-term research urged to validate the efficacy of PICC in this group of patients.

scholarly journals Migration of catheter of a totally implantable venous access port to right thoracic cavity in a child - a case report

2021 ◽  
Author(s):  
Qiteng Xu ◽  
Yueyi Ren ◽  
Yifei Hu ◽  
Shuhua Duan ◽  
Rui Chen ◽  
...  
Keyword(s):  
Venous Access ◽  
Thoracic Cavity ◽  
Severe Condition ◽  
Access Port ◽  
Intravenous Antibiotics ◽  
Catheter Tip ◽  
Life Threatening ◽  
Venous Access Port ◽  
And Migration ◽  
The Right

Abstract Background: The totally implantable venous access port (TIVAP) is a secure and practical choice for children undergoing long-term chemotherapy. Nevertheless, various complications still need to be treated cautiously. Among the complications, the migration of catheters to the thoracic cavity is a very rare (but potentially severe) condition that may necessitate device reimplantation. Furthermore, this migration may even be life-threatening if it is not detected in time.Case presentation: A 1-year-old girl undergoing palliative chemotherapy underwent TIVAP placement via the right internal jugular vein. During the operating procedure, the catheter tip was located in the right atrium, which was confirmed by the use of C-arm. Prophylactic intravenous antibiotics were then adopted with routine aspiration and with flushing being conducted each time before administration. Massive right pleural effusion and migration of the catheter tip to the right thoracic cavity were detected on the 2nd day after implantation, which resulted in the removal and reimplantation of the TIVAP device.Conclusions: The migration of the catheter into the thoracic cavity should be considered a possible complication of TIVAP implantation in children. Early detection and reimplantation may provide opportunities for the prevention of further severe complications.

Validated PCR Assay for the Routine Detection of Salmonella in Food

2006 ◽  
Vol 69 (2) ◽  
pp. 282-287 ◽  
Author(s):  
N. S. BANSAL ◽  
V. GRAY ◽  
F. McDONELL
Keyword(s):  
False Negative ◽  
Food Samples ◽  
Bacterial Cells ◽  
Pcr Assay ◽  
Culture Methods ◽  
Perfect Agreement ◽  
Selective Enrichment ◽  
Negative Results ◽  
Standard Culture ◽  
Pure Cultures

We developed a rapid and reliable PCR assay with genus-specific primers for the detection of Salmonella in food samples. With these primers, no primer-specific amplicons were detected when challenged with cultures of microorganisms other than salmonellae, and positive results, i.e., Salmonella-specific bands, were obtained with pure cultures of all 125 Salmonella isolates tested, which represented 100 serovars. The PCR assay was optimized using both pure cultures and artificially inoculated food samples. The assay results were compared with those of the Australian standard culture methods, using more than 500 “naturally” contaminated food samples, over a period of 9 years. Food samples were subjected to nonselective preenrichment in buffered peptone water followed by selective enrichment in Rappaport Vassiliadis (RV) broth and mannitol selenite cystine (MSC) broth. A simple sample preparation method was developed based on concentrating bacterial cells from 1 ml of RV or MSC broths. The PCR results were in perfect agreement with the results of the standard culture methods; no false-positive or false-negative results were obtained. However, the PCR assay was extremely rapid, and results could be obtained within 4 h of testing of enrichment broths.

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