Journal Article

Difference in Time to Detection: A Simple Method to Differentiate Catheter-Related from Non—Catheter-Related Bloodstream Infection in Immunocompromised Pediatric Patients

Aditya H. Gaur, Patricia M. Flynn, Mary Anne Giannini, Jerry L. Shenep and Randall T. Hayden

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 4, pages 469-475
Published in print August 2003 | ISSN: 1058-4838
Published online August 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/376904
Difference in Time to Detection: A Simple Method to Differentiate Catheter-Related from Non—Catheter-Related Bloodstream Infection in Immunocompromised Pediatric Patients

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Current methods for diagnosis of catheter-related infection (CRI) are cumbersome and may require removal of the central venous catheter (CVC). A prospective study was conducted to validate the difference in time to detection (DTD) of cultures of blood samples obtained simultaneously from a peripheral vein (PV) and from the CVC for differentiation of CRI and non-CRI. During a 15-month period, 9 episodes were categorized as CRI and 24 as non-CRI. The median DTD for patients with CRI was significantly higher than that for patients with non-CRI (457 vs. -4 min; P < .001). The optimum cutoff point for diagnosis of CRI was a DTD of ⩾120 min (sensitivity, 88.9%; specificity, 100%). With pretest probability of CRI ranging from 28% to 54%, the positive predictive value of a DTD of ⩾120 min for the diagnosis of CRI was 100%; the negative predictive value was 89%–96%. On the basis of findings from this study, which is the largest, to date, to involve pediatric patients with tunneled CVCs and the first to use paired quantitative blood cultures as a “criterion standard,” DTD was found to be a simple, reliable tool for diagnosis of CRI in hospitals that use continuously read blood culture systems.

Journal Article.  3932 words.  Illustrated.

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

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