Universität zu Köln

Kaasch, Achim J., Rieg, Siegbert ORCID: 0000-0001-7493-7080, Hellmich, Martin, Kern, Winfried V. and Seifert, Harald (2014). Differential time to positivity is not predictive for central line-related Staphylococcus aureus bloodstream infection in routine clinical care. J. Infect., 68 (1). S. 58 - 62. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2742

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Abstract

Objectives: Many physicians rely on differential time to positivity (DTP) when diagnosing catheter-related bloodstream infection (CRBSI). We evaluated whether DTP from routine blood cultures can predict catheter-related Staphylococcus aureus bloodstream infection. Methods and patients: From 2006 to 2011 adult patients with monomicrobial S. aureus bloodstream infection and matched pairs of central and peripheral blood cultures were prospectively followed. CRBSI was defined by the absence of other infective foci and recovery of S. aureus from the catheter tip or catheter exit-site, or local signs of infection at the catheter exit site. A DTP of more than two hours (cut-off) was used to define test positivity. Results: CRBSI was present in 30 (34%, prevalence) of 87 patients. In 24 (28%) patients a DTP of more than two hours was measured: eleven patients had CRBSI, ten deep-seated infections, and in three patients an infective focus was not identified. DTP showed a positive predictive value of 0.46 [95% confidence interval (CI) 0.28 to 0.65], and a negative predictive value of 0.70 [95% CI 0.58 to 0.80]. Conclusion: The low test performance suggests that DTP is not useful in diagnosing CRBSI in routinely obtained blood cultures. Therefore, physicians should not solely rely on DTP and rather promote catheter removal and culture. (C) 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kaasch, Achim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieg, Siegbert UNSPECIFIED orcid.org/0000-0001-7493-7080 UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, Winfried V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-452399
DOI:	10.1016/j.jinf.2013.08.006
Journal or Publication Title:	J. Infect.
Volume:	68
Number:	1
Page Range:	S. 58 - 62
Date:	2014
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-2742
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BACTEREMIA; DIAGNOSIS; CULTURES Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/45239