Journal Article

Diagnosis of Venous Access Port—Related Infections

Marie Cécile Douard, Guillaume Arlet, Pascale Longuet, Christian Troje, Martine Rouveau, Diane Ponscarme and Benoit Eurin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 5, pages 1197-1202
Published in print November 1999 | ISSN: 1058-4838
Published online November 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313444
Diagnosis of Venous Access Port—Related Infections

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The accumulation of infected clots under the silicone septum of the reservoir of venous access ports (VAPs) has been reported. We analyzed the relationship between these deposits and the occurrence of VAP-related bloodstream infections (VAP-BSIs) by (1) evaluating the accuracy of paired quantitative blood cultures for diagnosing VAP-BSI before the removal of the device and (2) assessing the accuracy of cultures of the tip and septum (i.e., the internal lumen of the VAP) for diagnosing VAP-BSI after removal of the device. Over a 16-month period, all VAPs removed were prospectively investigated. Before VAP removal, paired quantitative blood cultures were 77% sensitive and 100% specific and had a positive predictive value of 100% and a negative predictive value of 98% for diagnosing VAP-BSI. After VAP removal, tip culture was only 46% sensitive, whereas septum culture was 93.3% sensitive for confirming the diagnosis of VAP-BSI. Thus infected deposits that accumulate under the VAP septum are the source of VAP-BSI.

Journal Article.  4339 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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