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  • Title: Improving diagnosis of central venous catheter-related bloodstream infection by using differential time to positivity as a hospital-wide approach at a cancer hospital.
    Author: Chen WT, Liu TM, Wu SH, Tan TD, Tseng HC, Shih CC.
    Journal: J Infect; 2009 Nov; 59(5):317-23. PubMed ID: 19748520.
    Abstract:
    OBJECTIVES: Considering the difficulty of diagnosing catheter-related bloodstream infection (CRBSI), Koo Foundation Sun Yat-Sen Cancer Center uses differential time to positivity (DTP) as a hospital-wide approach to improve the diagnosis of CRBSI in febrile patients with indwelling central venous catheters (CVCs). This study describes the result of a hospital-wide use of DTP in a real practice setting. METHODS: During January 2003-August 2007, 142 positive paired blood cultures from 125 patients without infection focus other than CVC were included. These were evaluated by DTP and semi-quantitative catheter culture (SQCC) to confirm the diagnosis of CRBSI, and were further divided into two groups: confirmed (either by DTP or SQCC) and non-confirmed CRBSI (neither DTP nor SQCC positive). RESULTS: Fifty-nine point two percent (84/142) of episodes were confirmed as CRBSI, of which DTP was positive in 83.3% (n=70). Non-confirmed CRBSI was associated with hematologic malignancy, neutropenia status, previous antibiotics exposure and a lower CVC removal rate. CONCLUSIONS: A hospital-wide approach of DTP was practical and feasible in improving the diagnosis of CRBSI in a real practice setting.
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