Intravenous literature: Guembe, M., Martan-Rabadain, P., Echenagusia, A., Camez, F., Rodreguez-Rosales, G., Sima, G., Echenagusia, M. and Bouza, E. (2011) How Should Long-Term Tunneled Central Venous Catheters Be Managed in Microbiology Laboratories in Order to Provide an Accurate Diagnosis of Colonization? Journal of Clinical Microbiology. 2011 Dec 14. [Epub ahead of print].
Background. Guidelines recommend the roll-plate technique for short-term central venous catheter (CVC) tip culture. However, the issue of whether the roll-plate technique is better than the sonication method in long-term CVCs remains unresolved. In addition, no data are available for predicting the value of direct Gram staining in anticipating catheter colonization or catheter-related bloodstream infection (CRBSI) in these long-term CVCs.Our objectives were to compare the roll-plate technique and the sonication method and to define the validity values of Gram staining for the prediction of colonization and CRBSI in patients with long-term tunneled CVCs.
Methods. During the study period, all tunneled CVCs removed in our institution were prospectively and routinely sent to the microbiology laboratory for Gram staining (first) and tip culture (Maki and sonication in a random order).
Results. We received 149 tunneled CVCs of which 39 (26.2%) were colonized and 11 (7.4%) were associated with CRBSI. Overall, the roll-plate method detected 94.9% of the colonized catheters, whereas sonication detected only 43.6% (p