The value of culturing central-line catheter tips in burn patients

Fifty burn patients who had central venous cannulations performed were randomly assigned to one of two groups. In group 1, the skin around the catheter insertion site was cleaned with 70% isopropyl alcohol prior to catheter removal. In group 2, the skin around the catheter insertion site was not cleaned prior to catheter removal. Twenty (40%) of the patients had negative cultures. The remaining 30 patients had positive cultures, 11 (37%) of which were positive for both skin and catheter tip specimens. All 11 of these cultures matched for the same organism. Six (55%) were from group 1 and five (45%) from group 2. Of the 14 patients with cultures positive for the catheter tips but not the skin, eight (57%) did not have the skin cleaned prior to catheter removal. Five skin cultures were positive, with no organism growth on the corresponding catheter tip; four (80%) of these were from group 2. Data from blood and intravenous (IV) catheter tip cultures performed from November 1982 through December 1985 demonstrated that of the 441 blood cultures obtained, 91 (21%) were positive. Twenty-seven (6%) were positive blood and IV catheter tip cultures; only ten (37%) of these matched for the same organism, accounting for only 2% of the total number of cultures obtained.