Skin insertion site culture for the prediction of primary bloodstream infection

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Leonardo Lorente1, María Lecuona2, Alejandra Pérez-Llombet3

  • 1Intensive Care Unit, Hospital Universitario de Canarias, La Laguna 38320, OfraTenerife, s/n, Spain. lorentemartin@msn.com.

Irish Journal of Medical Science
|June 14, 2021
PubMed
Abstract

Insights

Skin insertion site cultures can effectively predict catheter-related bloodstream infections (CRBSI) and primary bloodstream infections (PBSI). This study found a good negative predictive value, aiding in infection diagnosis for intensive care unit patients with central venous catheters.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Clinical Microbiology

Background:

  • Catheter-related bloodstream infection (CRBSI) is a significant concern in intensive care units.
  • Predicting primary bloodstream infection (PBSI), including CRBSI and bloodstream infection of unknown origin (BSIUO), is crucial for patient management.
  • Previous studies focused on CRBSI prediction using skin insertion site cultures, but PBSI prediction remained under-analyzed.

Purpose of the Study:

  • To evaluate the capability of insertion skin site culture in predicting catheter-related bloodstream infection (CRBSI).
  • To determine the efficacy of insertion skin site culture in predicting primary bloodstream infection (PBSI), encompassing CRBSI and bloodstream infection of unknown origin (BSIUO).

Main Methods:

  • An observational, prospective study was conducted in an Intensive Care Unit.
  • Patients with central venous catheters (CVC) and suspected catheter-related infection (CRI) were enrolled.
  • Cultures of skin insertion sites, paired blood samples, catheter tips, and other clinical samples were analyzed.

Main Results:

  • The study analyzed 108 CVCs from 96 suspected CRI episodes.
  • Insertion skin site culture demonstrated a 95% negative predictive value for CRBSI.
  • A negative predictive value of 85% was observed for predicting PBSI.

Conclusions:

  • Insertion skin site culture is a valuable tool for predicting CRBSI.
  • The study highlights the utility of skin insertion site culture in predicting PBSI.
  • This method offers a good negative predictive value for bloodstream infection prediction in CVC patients.
Keywords:
Bloodstream infectionPredictionSkin insertion site culture

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