Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-16T23:23:03.205Z Has data issue: false hasContentIssue false
  • English
  • Français

Central Line–Associated Bloodstream Infections in Adult Hematology Patients with Febrile Neutropenia An Evaluation of Surveillance Definitions Using Differential Time to Blood Culture Positivity

Published online by Cambridge University Press:  02 January 2015

Joshua T. Freeman ,
Anna Elinder-Camburn ,
Catherine McClymont ,
Deverick J. Anderson ,
Mary Bilkey ,
Deborah A. Williamson ,
Leanne Berkahn  and
Sally A. Roberts
Joshua T. Freeman*
Affiliation:
Department of Clinical Microbiology, Auckland District Healthboard, Auckland, New Zealand
Anna Elinder-Camburn
Affiliation:
Department of Haematology, Auckland District Healthboard, Auckland, New Zealand
Catherine McClymont
Affiliation:
Department of Infection Prevention and Control, Auckland District Healthboard, Auckland, New Zealand
Deverick J. Anderson
Affiliation:
Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
Mary Bilkey
Affiliation:
Department of Clinical Microbiology, Auckland District Healthboard, Auckland, New Zealand
Deborah A. Williamson
Affiliation:
Department of Clinical Microbiology, Auckland District Healthboard, Auckland, New Zealand
Leanne Berkahn
Affiliation:
Department of Haematology, Auckland District Healthboard, Auckland, New Zealand
Sally A. Roberts
Affiliation:
Department of Clinical Microbiology, Auckland District Healthboard, Auckland, New Zealand
*
Clinical Microbiologist, Auckland District Healthboard, LabPlus, 2 Grafton Road, Auckland, New Zealand (joshuaf@adhb.govt.nz)
Get access Rights & Permissions [Opens in a new window]

Abstract

We used differential time to positivity between central and peripheral blood cultures to evaluate the positive predictive value (PPV) of the National Healthcare Safety Network central line–associated bloodstream infection (CLABSI) surveillance definition among hematology patients with febrile neutropenia. The PPV was 27.7%, which suggests that, when the definition is applied to this population, CLABSI rates will be substantially overestimated.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 1 , January 2013 , pp. 89 - 92
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Centers for Disease Control and Prevention (CDC). CDC/National Healthcare Safety Network Surveillance definition of healthcare-associated infection and criteria for specific types of infections in the acute care setting, http://www.cdc.gov/nhsn/PDFs/pscManual/17pscNosInfDef_current.pdf. Accessed July 27, 2012.Google Scholar
2. Worth, LJ, Black, J, Seymour, JF, Thursky, KA, Slavin, MA. Surveillance of catheter-associated bloodstream infection in hematology units: quantifying the characteristics of a practical case definition. Infect Control Hosp Epidemiol 2008;29:358–360.10.1086/528879Google Scholar
3. Worth, LJ, Slavin, MA, Brown, GV, Black, J. Catheter-related bloodstream infections in hematology: time for standardized surveillance? Cancer 2007;109:1215–1226.10.1002/cncr.22527Google Scholar
4. Australian Council of Healthcare Standards Clinical Indicators Users Manual 2005. Appendix 4. Pp. 212–214.Google Scholar
5. Blot, F, Schmidt, E, Nitenberg, G, et al. Earlier positivity of central venous versus peripheral blood cultures is highly predictive of catheter-related sepsis. J Clin Microbiol 1998;36:105–109.10.1128/JCM.36.1.105-109.1998Google Scholar
6. Raad, I, Hanna, HA, Alakech B, Chatznikolaou, Johnson, MM, Tarrand, J. Differential time to positivity: a useful method for diagnosing catheter-related bloodstream infections. Ann Intern Med 2004;140:18–25.10.7326/0003-4819-140-1-200401060-00007Google Scholar
7. Safdar, N, Fine, JP, Maki, DG. Metra-analysis: methods for diagnosing intravascular device-related bloodstream infection. Ann Intern Med 2005;142:451–466.10.7326/0003-4819-142-6-200503150-00011Google Scholar
8. Wohoush, I, Cairo, J, Rangaraj, G, Granwehr, B, Hachem, R, Raad, I. Comparing quantitative culture of a blood sample obtained through the catheter with differential time to positivity in establishing a diagnosis of catheter-related bloodstream infection. Infect Control Hosp Epidemiol 2010;31:1089–1091.10.1086/656381Google Scholar
9. Blot, F, Nitenberg, G, Chachaty, E, et al. Diagnosis of catheter-related bacteremia: a prospective comparison of the time to positivity of hub-blood versus peripheral-blood cultures. Lancet 1999;354:1071–1077.10.1016/S0140-6736(98)11134-0Google Scholar
10. Seifert, H, Comely, O, Seegewiss, K, et al. Bloodstream infection in neutropenic cancer patients related to short-term non-tunneled catheters determined by quantitative blood cultures, differential time to positivity, and molecular epidemiological typing with pulsed field gel electrophoresis. J Clin Microbiol 2003;41: 118–123.10.1128/JCM.41.1.118-123.2003Google Scholar