Korean J Lab Med.  2002 Aug;22(4):260-266.

Prevalence of Pathogens Causing Central Venous Catheter (CVC)-Related Sepsis: Results of Semiquantitative CVC Tip Cultures and Differential Quantitative Blood Cultures

• Kim KJ
• Shin JH
• Shin DH
• Choi MJ
• Cho D
• Kee SJ
• Suh SP
• Ryang DW

Abstract

BACKGROUND: Catheter-related sepsis (CRS) has become an important cause of nosocomial infections and the major complication with the intravenous central venous catheter (CVC) use. In this paper, we present the culture results of two years from Chonnam National University Hospital on the etiologic agents of CRS.
METHODS
We reviewed the culture results for the most recent two years (July 1999 to June 2001) including semiquantitative CVC tip cultures (n=622) and differential quantitative blood cultures (n=149), as well as hospital records to determine clinical correlates of CRS. CRS was defined as a positive blood culture and catheter culture with the same organism in conjunction with a CVC tip >or=15 CFU or a central-to-peripheral blood culture colony count ratio of >or=5 :1.
RESULTS
Forty-two (6.8%) of 622 CVC tip cultures and 13 (8.7%) of 149 differential quantitative blood cultures were associated with CRS. A total of 48 (32.0%) of 150 patients with bacteremia or candidemia were confirmed as having CRS, using semiquantitative tip cultures (30.9%, 42 of 136) and/or differential quantitative blood cultures (27.1%, 13 of 48). Twenty-one (48.8%) of 43 candidacies patients were associated with CRS and were more frequent than bacteremia due to Gram-positive cocci (27.3%, 18 of 66), and Gram-negative bacilli (23.1%, 9 of 39)(P<0.05). In 48 cases with proven CRS, Candida parapsilosis (29.2%) and Staphylococcus aureus (25.0%) were the most common etiologic agents, followed by coagulase negative Staphylococcus (10.4%), and Acinetobacter baumannii (8.3%).
CONCLUSIONS
In culture proven cases of CRS, C. parapsilosis and S. aureus were the predominant causative organisms, and candidemia was more frequently associated with CRS than was bacteremia.

Keyword

Catheter-related septicemia; Catheter tip culture; Differential quantitative blood culture; Central venous catheter

MeSH Terms

Acinetobacter baumannii
Bacteremia
Candida
Candidemia
Catheters
Central Venous Catheters*
Coagulase
Cross Infection
Gram-Positive Cocci
Hospital Records
Humans
Jeollanam-do
Prevalence*
Sepsis*
Staphylococcus
Staphylococcus aureus
Coagulase