Endoluminal brushing for detection of central venous catheter colonization--a comparison of daily vs. single brushing on removal
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H A McLure1, R N Juste, M L Thomas
1Department of Microbiology, Chelsea and Westminster Hospital, London, UK.
Abstract:
The fibrin assay system (FAS) has been designed to address the problem of in-situ diagnosis of central venous catheter (CVC) colonization. The FAS was evaluated in 12 critically ill patients with daily brushings, comparing results with culture of the catheter tip and blood. Data analysis of the FAS showed a sensitivity of 0 with a specificity of 1.0. The study was repeated in a further 12 high-risk patients with a single terminal brushing on catheter removal. This gave a sensitivity of 0.14 and a specificity of 0.8. Differences in sensitivity may be due to daily disruption of the endoluminal fibrin clot. Our results do not support the routine use of the FAS to detect CVC colonization in the intensive care unit.