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Improved diagnosis of central venous catheter-related bloodstream infections using the HB&L UROQUATTRO™ system

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Abstract

The diagnosis of catheter-related bloodstream infections (CRBSIs) in febrile patients with indwelling central venous catheters (CVCs) needs improvement. To diagnose CRBSIs more efficiently, we have developed a novel culture approach using the catheter tips removed from febrile patients. CVCs and blood cultures from 1,070 patients with only CVC-related infections were obtained over a period of 3 years (January 2009 to December 2011). The CVCs were evaluated by a semi-quantitative catheter culture method according to Maki’s method and by our novel method, which is based on the use of the HB&L UROQUATTRO™ system (Alifax, Padova, Italy). Using our new method, 571 (571/1,070) of the infections were confirmed as CRBSIs. The remaining 487 patients had infections that were associated with hematologic malignancies, neutropenia, prior exposure to antibiotics, and a decreased CVC removal rate. Twelve samples were identified as false-positives. The percentage of patients with CRBSIs confirmed using the HB&L UROQUATTRO™ system was 53.36 % versus 34.95 % (p-value 0.004) using Maki’s method (374/1,070 CVC Maki-positive samples). Our results indicate that our new culture method allows for an improved CRBSI diagnosis rate. A significant number of tip cultures (18.41 %) tested positive for CRBSIs using our system but were negative when tested using Maki’s method. Moreover, the use of the HB&L UROQUATTRO™ system allowed us to significantly reduce diagnosis time; a negative CRBSI diagnosis could be made within 6 h and a positive diagnosis could be made within 22–28 h.

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Acknowledgment

We gratefully acknowledge Sire Analytical Systems S.r.l. (Udine, Italy) for providing the instrumentation and/or some of the reagents used in the evaluation.

Conflict of interest

All co-authors have no specific conflict of interest to report except as reported in the specific section.

Additional conflict of interest

Dr. C.Fontana has received expert opinion fees from Sire Analytical System S.r.l. (Udine, Italy).

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Authors and Affiliations

  1. Department of Experimental Medicine and Surgery, “Tor Vergata” University of Rome, Via Montpellier 1, 00133, Rome, Italy

    C. Fontana, M. Favaro & C. Favalli

  2. Clinical Microbiology Laboratories, Foundation Polyclinic Tor Vergata, V.le Oxford 81, 00133, Rome, Italy

    C. Fontana, M. C. Bossa, S. Minelli, A. Altieri, M. Pelliccioni, F. Falcione, L. Di Traglia, O. Cicchetti & C. Favalli

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  1. C. Fontana
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  2. M. Favaro
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  3. M. C. Bossa
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  4. S. Minelli
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  5. A. Altieri
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  6. M. Pelliccioni
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  8. L. Di Traglia
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  9. O. Cicchetti
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  10. C. Favalli
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Correspondence to C. Fontana.

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Fontana, C., Favaro, M., Bossa, M.C. et al. Improved diagnosis of central venous catheter-related bloodstream infections using the HB&L UROQUATTRO™ system. Eur J Clin Microbiol Infect Dis 31, 3139–3144 (2012). https://doi.org/10.1007/s10096-012-1676-9

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  • DOI: https://doi.org/10.1007/s10096-012-1676-9

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