{"id":2177,"date":"2022-08-04T17:22:01","date_gmt":"2022-08-04T05:22:01","guid":{"rendered":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/?page_id=2177"},"modified":"2022-08-04T17:22:02","modified_gmt":"2022-08-04T05:22:02","slug":"line-infection-catheter-related-bloodstream-infection","status":"publish","type":"page","link":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/","title":{"rendered":"Line infection \/ catheter-related bloodstream infection"},"content":{"rendered":"\n

Infection:<\/strong>            Catheter-related bloodstream infection (CRBSI), line infection<\/p>\n\n\n\n

Brief description:<\/summary>
\n
  • Bloodstream infection that occurs in association with peripheral or central venous catheters that have been present >48 hours.<\/li>
  • May be clinically obvious e.g. erythema, purulence at site, or non-specific e.g. fevers\/general unwellness without apparent source.<\/li>
  • Fevers or unwellness that coincide with use or flushing of the line are suspicious for CRBSI.<\/li><\/ul>\n<\/div><\/details><\/div>\n\n\n\n
    Did you know?<\/summary>
    \n
    • One of the difficulties with diagnosing line infection, is that it is often caused by common skin commensal organisms (e.g. coagulase negative staphylococci), which are also common contaminants of blood cultures.
      • Differentiating between these two scenarios if a CoNS is grown is difficult.<\/li><\/ul>
        • If >1 blood culture grows the same CoNS, this points more towards line infection.<\/li><\/ul><\/li><\/ul>\n<\/div><\/details><\/div>\n\n\n\n
          Diagnostic approach & test of choice<\/summary>
          \n

          In patients with fevers and peripheral or central venous catheters in place for >48 hours:<\/p>\n\n\n\n

          • Collect 2-3 sets of blood cultures<\/strong>
            • Ideally, at least one of these sets should be from a peripheral vein<\/strong>.<\/li>
            • Avoid sampling from existing peripheral cannulae (high contamination rate).<\/li>
            • In patients with multilumen catheters, all lumens don\u2019t necessarily need to be sampled<\/strong>, as long as 2-3 sets are taken in total.
              • The evidence is uncertain on this, but the sensitivity for diagnosing CRBSI is probably more to do with total number of sets taken<\/strong>, rather than number of lumens sampled.<\/li><\/ul><\/li><\/ul><\/li><\/ul>\n\n\n\n
                • If there is purulence<\/strong> at the exit site of the catheter, take a swab for culture<\/strong>.<\/li><\/ul>\n<\/div><\/details><\/div>\n\n\n\n
                  Interpreting blood culture results<\/summary>
                  \n
                  • Line infection is the commonest cause of Staphylococcus aureus<\/em> bacteraemia in patients who have been in hospital or had lines in for >48 hours.
                    • S. aureus<\/em> bacteraemia in this situation should prompt careful consideration of the line being the source.<\/li><\/ul><\/li>
                    • For other organisms, in the absence of an alternative source, the more sets of blood cultures that are positive with the same organism, the more likely CRBSI is.
                      • This is especially the case for common skin organisms e.g. CoNS, corynebacteria.<\/li><\/ul><\/li>
                      • If blood cultures drawn from the line are positive, but peripheral cultures are negative, it may be more suggestive of line or hub colonisation, rather than CRBSI.<\/li><\/ul>\n<\/div><\/details><\/div>\n\n\n\n
                        Tests to avoid\/specialist tests:<\/summary>
                        \n

                        Culture of line tips<\/strong><\/p>\n\n\n\n

                        • This is no longer a recommended practise, as it rarely adds useful additional information, and positive catheter cultures are not considered diagnostic of CRBSI.<\/li><\/ul>\n\n\n\n

                          Blood culture differential time to positivity (DTP)<\/strong><\/p>\n\n\n\n

                          • This is where the time to positivity between peripheral and line blood cultures, collected at the same time, are compared.<\/li>
                          • If the line culture flags positive significantly sooner it is taken as evidence of CRBSI.<\/li>
                          • The predictive value of this approach is uncertain, and may vary by organism, so is no longer recommended.<\/li><\/ul>\n<\/div><\/details><\/div>\n","protected":false},"excerpt":{"rendered":"Infection:            Catheter-related bloodstream infection (CRBSI), line infection","protected":false},"author":18,"featured_media":0,"parent":2060,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-left-sidebar.php","meta":{"footnotes":""},"yoast_head":"\nLine infection \/ catheter-related bloodstream infection — Awanui Labs \u2013 Otago, Southland<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Line infection \/ catheter-related bloodstream infection — Awanui Labs \u2013 Otago, Southland\" \/>\n<meta property=\"og:description\" content=\"Infection:            Catheter-related bloodstream infection (CRBSI), line infection\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/\" \/>\n<meta property=\"og:site_name\" content=\"Awanui Labs \u2013 Otago, Southland\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/SouthernCommunityLaboratories\" \/>\n<meta property=\"article:modified_time\" content=\"2022-08-04T05:22:02+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/5\/2023\/07\/Awanui-Labs-Lab-Technician-min.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2000\" \/>\n\t<meta property=\"og:image:height\" content=\"917\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/\",\"url\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/\",\"name\":\"Line infection \/ catheter-related bloodstream infection — Awanui Labs \u2013 Otago, Southland\",\"isPartOf\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#website\"},\"datePublished\":\"2022-08-04T05:22:01+00:00\",\"dateModified\":\"2022-08-04T05:22:02+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/#breadcrumb\"},\"inLanguage\":\"en-NZ\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"For Referrers\",\"item\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Microbiology Resources\",\"item\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"How do I diagnose?\",\"item\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Line infection \/ catheter-related bloodstream infection\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#website\",\"url\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/\",\"name\":\"Awanui Labs \u2013\u00a0Otago, Southland\",\"description\":\"Laboratory and pathology services\",\"publisher\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-NZ\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#organization\",\"name\":\"Awanui Labs \u2013\u00a0Otago, Southland\",\"url\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-NZ\",\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/5\/2023\/07\/RGB_Awanui-Labs-horizonal-colour-positive.svg\",\"contentUrl\":\"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/5\/2023\/07\/RGB_Awanui-Labs-horizonal-colour-positive.svg\",\"width\":861,\"height\":133,\"caption\":\"Awanui Labs \u2013\u00a0Otago, Southland\"},\"image\":{\"@id\":\"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/SouthernCommunityLaboratories\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Line infection \/ catheter-related bloodstream infection — Awanui Labs \u2013 Otago, Southland","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/","og_locale":"en_US","og_type":"article","og_title":"Line infection \/ catheter-related bloodstream infection — Awanui Labs \u2013 Otago, Southland","og_description":"Infection:            Catheter-related bloodstream infection (CRBSI), line infection","og_url":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/","og_site_name":"Awanui Labs \u2013 Otago, Southland","article_publisher":"https:\/\/www.facebook.com\/SouthernCommunityLaboratories","article_modified_time":"2022-08-04T05:22:02+00:00","og_image":[{"width":2000,"height":917,"url":"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/5\/2023\/07\/Awanui-Labs-Lab-Technician-min.jpeg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/","url":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/","name":"Line infection \/ catheter-related bloodstream infection — Awanui Labs \u2013 Otago, Southland","isPartOf":{"@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#website"},"datePublished":"2022-08-04T05:22:01+00:00","dateModified":"2022-08-04T05:22:02+00:00","breadcrumb":{"@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/#breadcrumb"},"inLanguage":"en-NZ","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/line-infection-catheter-related-bloodstream-infection\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/"},{"@type":"ListItem","position":2,"name":"For Referrers","item":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/"},{"@type":"ListItem","position":3,"name":"Microbiology Resources","item":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/"},{"@type":"ListItem","position":4,"name":"How do I diagnose?","item":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/referrers\/microbiology-resources\/how-do-i-diagnose\/"},{"@type":"ListItem","position":5,"name":"Line infection \/ catheter-related bloodstream infection"}]},{"@type":"WebSite","@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#website","url":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/","name":"Awanui Labs \u2013\u00a0Otago, Southland","description":"Laboratory and pathology services","publisher":{"@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-NZ"},{"@type":"Organization","@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#organization","name":"Awanui Labs \u2013\u00a0Otago, Southland","url":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/","logo":{"@type":"ImageObject","inLanguage":"en-NZ","@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#\/schema\/logo\/image\/","url":"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/5\/2023\/07\/RGB_Awanui-Labs-horizonal-colour-positive.svg","contentUrl":"https:\/\/fl-healthscope-media.s3.amazonaws.com\/lab-sites\/uploads\/sites\/5\/2023\/07\/RGB_Awanui-Labs-horizonal-colour-positive.svg","width":861,"height":133,"caption":"Awanui Labs \u2013\u00a0Otago, Southland"},"image":{"@id":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/SouthernCommunityLaboratories"]}]}},"featured_image_src":null,"featured_image_src_square":null,"_links":{"self":[{"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/pages\/2177"}],"collection":[{"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/users\/18"}],"replies":[{"embeddable":true,"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/comments?post=2177"}],"version-history":[{"count":1,"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/pages\/2177\/revisions"}],"predecessor-version":[{"id":2178,"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/pages\/2177\/revisions\/2178"}],"up":[{"embeddable":true,"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/pages\/2060"}],"wp:attachment":[{"href":"https:\/\/www.awanuilabs.co.nz\/south\/otagosouthland\/wp-json\/wp\/v2\/media?parent=2177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}