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Sonication did not provide reliability to Maki technique for catheter related bloodstream infection diagnosis
L Lorente1, M Lecuona, A Pérez-Llombet
1Leonardo Lorente. Intensive Care Unit. Hospital Universitario de Canarias. Ofra, s/n. La Laguna - 38320. Tenerife. Spain. lorentemartin@msn.com.
Objective:
The aim of our study was to analyze sonication and Maki techniques for diagnosis of catheter tip colonization and catheter-related bloodstream infection (CRBSI) on patients admitted to ICU.
Methods:
Observational and prospective study in one Intensive Care Unit. Patients with some central venous catheter (CVC) at least for 7 days and catheter-related infection (CRI) suspicion (new episode of fever or sepsis) were included. We performed Maki technique followed by sonication of catheter tip. We compared area under the curve (AUC) of Maki, sonication, and techniques combination to diagnosis catheter tip colonization and CRBSI.
Results:
We included 94 CVC from 87 CRI suspicion episodes. We found 14 cases of catheter tip colonization and 10 cases of CRBSI. Of the 14 catheter tip colonization cases, 7 (50.0%) were detected by Maki and sonication techniques, 6 (42.9%) were detected only by Maki technique, and 1 (7.1%) was detected only by sonication technique. Of the 10 CRBSI, 6 (60.0%) were detected by Maki and sonication techniques, 4 (40.0%) were detected only by Maki technique, and any only by sonication technique. We found higher AUC in Maki technique than in sonication technique to diagnosis of CRBSI (p=0.02) and to diagnosis of catheter tip colonization (p=0.03). No significant differences were found in AUC between Maki technique and combination techniques for diagnosis of catheter tip colonization (p=0.32) and of CRBSI (p=0.32).
Conclusions:
Sonication did not provide reliability to Maki technique for diagnosis of catheter tip colonization and CRBSI.
Insights
The Maki technique is more reliable than sonication for diagnosing catheter tip colonization and catheter-related bloodstream infections (CRBSI). Combining sonication with the Maki technique did not improve diagnostic accuracy for these infections.
Area of Science:
- Infectious Diseases
- Medical Diagnostics
- Critical Care Medicine
Background:
- Central venous catheters (CVCs) are essential in intensive care units (ICUs) but pose a risk of catheter-related infections (CRIs).
- Accurate diagnosis of catheter tip colonization and catheter-related bloodstream infection (CRBSI) is crucial for timely and appropriate patient management.
Purpose of the Study:
- To compare the diagnostic accuracy of the Maki technique and sonication for catheter tip colonization and CRBSI.
- To evaluate the added value of combining sonication with the Maki technique.
Main Methods:
- An observational, prospective study was conducted in an ICU.
- Patients with CVCs and suspected CRIs underwent Maki technique followed by catheter tip sonication.
- Diagnostic performance was assessed using the area under the curve (AUC) for Maki, sonication, and combined techniques.
Main Results:
- The Maki technique demonstrated a higher AUC than sonication for diagnosing both CRBSI (p=0.02) and catheter tip colonization (p=0.03).
- No significant difference in AUC was observed between the Maki technique and the combination of Maki and sonication for either diagnosis (p=0.32).
- Sonication alone detected only one case of catheter tip colonization and no cases of CRBSI.
Conclusions:
- Sonication does not enhance the diagnostic reliability of the Maki technique for catheter tip colonization or CRBSI.
- The Maki technique remains a valuable diagnostic tool for CVC-related infections in the ICU setting.
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