Rabensteiner, J., Theiler, G., Duettmann, W., Zollner-Schwetz, I., Hoenigl, M., Valentin, T., Leitner, E., Luxner, J., Grisold, A., Valentin, A., Neumeister, P. and Krause, R. (2015) Detection of central venous catheter-related bloodstream infections in hematooncological patients. European Journal of Clinical Investigation. June 8th. .
BACKGROUND: Catheter-related bloodstream infections (CRBSIs) are currently detected in patients with clinically suspicion. The aim of our study was to evaluate whether CRBSIs could be anticipated and detected in a subclinical stage by peptide nucleic acid fluorescence in situ hybridization (PNA FISH) using universal hybridization probes or acridine orange leukocyte cytospin (AOLC) tests in hematooncological patients with central venous catheters (CVCs) in situ.
METHODS: PNA FISH and AOLC tests using blood samples from one CVC lumen/port chamber in hematooncological patients were continuously performed. These results were compared to those obtained from routinely performed CRBSI diagnostic tests.
RESULTS: 182 patients with 342 catheter periods were investigated. Seventeen CRBSI cases were detected in 6466 CVC days by routine measures resulting in a CRBSI rate of 2.6/1000 catheter days. Two of 17 showed positive PNA FISH tests and 5 positive AOLC tests results before the diagnosis was established with routine measures. The screening revealed further 7 patients with positive universal PNA FISH tests and 10 positive AOLC tests without symptoms indicative for infection and were therefore considered not to have CRBSI.
CONCLUSIONS: Sampling of only one CVC lumen/ port chamber screening for CRBSI in hematooncological patients seems not to be a useful tool for anticipative diagnosis of CRBSI. Reasons for false negative results might include origin of CRBSIs from the other CVC lumina not sampled for screening and false positive results might origin from catheter colonization without subsequent spread of microorganisms into the peripheral bloodstream.