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Which lumen is the source of catheter-related bloodstream infection in patients with multi-lumen central venous catheters?

  • Clinical and Epidemiological Study
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Abstract

Purpose

Paired blood cultures, drawn from the catheter and a peripheral vein, used for calculation of the differential time to positivity (DTP), have been proposed for the detection of catheter-related bloodstream infections (CRBSIs). The most relevant catheter lumen to be sampled in multi-lumen central venous catheters (CVCs) has not been recommended.

Methods

Forty-four febrile neutropaenic patients, following haematopoietic stem cell transplantation (HSCT) and with multi-lumen CVCs in place, were investigated using the DTP method of blood samples drawn from every lumen of the CVC and a peripheral vein.

Results

Twelve of 44 patients (27 %) had CRBSIs, as determined by the DTP method. In 10 of 12 (83 %) febrile neutropaenic patients, after HSCT, CRBSIs originated from the CVC lumen used for parenteral nutrition and blood products only. 17 % had CRBSI originating from the other CVC lumen (p = 0.039).

Conclusion

In most patients, CRBSIs originated from the CVC lumen used for parenteral nutrition and blood products, indicating that this lumen is the main source of CRBSI. However, since 17 % of patients had CRBSIs originating from another lumen, each lumen of multi-lumen CVCs has to be considered as a potential source of CRBSI and should, ideally, be sampled in order to avoid failure in diagnostic procedures.

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Acknowledgments

We gratefully acknowledge the excellent technical assistance of Christina Strempfl and Bernadette Neuhold.

Conflict of interest

None.

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Authors and Affiliations

  1. Section of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 20, 8036, Graz, Austria

    R. Krause, T. Valentin, H. Salzer, M. Hönigl & I. Zollner-Schwetz

  2. Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria

    A. Valentin

  3. Gene Regulation and Chromatin Group, Medical Research Council, Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK

    H. Auner

Authors
  1. R. Krause
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  2. T. Valentin
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  3. H. Salzer
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  4. M. Hönigl
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  5. A. Valentin
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  6. H. Auner
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  7. I. Zollner-Schwetz
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Corresponding author

Correspondence to R. Krause.

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Krause, R., Valentin, T., Salzer, H. et al. Which lumen is the source of catheter-related bloodstream infection in patients with multi-lumen central venous catheters?. Infection 41, 49–52 (2013). https://doi.org/10.1007/s15010-012-0391-x

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  • DOI: https://doi.org/10.1007/s15010-012-0391-x

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