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Comparison of diagnostic specimens and methods to evaluate infected venous access ports
1Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Background:
Implanted venous access port infection can be difficult to diagnose and treat. If device removal is necessary, confirming port infection is problematic.
Materials And Methods:
Culture specimens from three sites, catheter tip (Tip), port pocket, and the material within the reservoir (Inside), were sent from ports removed for potential infection. The results of these cultures were compared to preremoval peripheral and central blood cultures.
Results:
Forty-five ports were removed for suspected infection. Confirmed port infection was defined as positive culture(s) from one or more experimental specimen(s). In 29 evaluable cases, the Inside specimens were completely predictive. Tip specimens were less accurate, even with a lower diagnostic threshold. In 7 of 19 confirmed infections, only the Inside culture was diagnostic.
Conclusion:
The most predictive culture specimen in a potentially infected port is the thrombotic material inside the reservoir.
Insights
Diagnosing implanted venous access port infections is challenging. Cultures of material inside the port reservoir are the most accurate method for confirming infection, aiding treatment decisions.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Vascular Surgery
Background:
- Implanted venous access port infections pose diagnostic and therapeutic challenges.
- Confirming infection is difficult, often necessitating device removal.
- Accurate diagnosis is crucial for effective patient management.
Purpose of the Study:
- To evaluate the diagnostic accuracy of different culture sites for implanted venous access port infections.
- To identify the most reliable specimen for confirming port infection.
Main Methods:
- Ports removed for suspected infection were cultured from three sites: catheter tip, port pocket, and reservoir material.
- Cultures were compared to preremoval peripheral and central blood cultures.
- Confirmed port infection was defined by positive cultures from experimental specimens.
Main Results:
- In 29 evaluable cases, cultures from the reservoir material (Inside) were completely predictive of infection.
- Catheter tip cultures were less accurate, even with a lower diagnostic threshold.
- In 7 of 19 confirmed infections, only the Inside culture yielded positive results.
Conclusions:
- Thrombotic material within the port reservoir provides the most predictive culture specimen for diagnosing port infections.
- This finding can improve the accuracy of diagnosing and managing implanted venous access port infections.