catheter-related blood stream infections. objectives 1.catheter-related blood stream infections -...
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Catheter-related blood stream infections
Objectives
1. Catheter-related blood stream infections - Present scenario
2. Methods of diagnosing CRBSI
3. Importance of Differential Time to Positivity method by
automated system
4. Interpret DTP result to diagnose CRBSI
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMERApr 21, 2023
Catheter-related blood stream infections(CRBSI)
• Bacteremia/ fungemia in a patient with an intravascular
catheter, associated with clinical manifestations of infections
(i.e., fever, chills, and/or hypotension), and no apparent source
for the BSI except the catheter
• Local signs of inflammation – absent in 70% of cases of CRBSI
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMERApr 21, 2023
Diagnosis
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMER
Apr 21, 2023
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMER
(for bacteria)
≥25 CFU/ml(for fungal)
Apr 21, 2023
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMER
(Maki method)
(Endoluminal flush culture)
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Procedure – Differential time to positivity
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMERApr 21, 2023
Requirements:
• Automated blood culture system- BACTEC 9120
• Bactec blood culture bottles (Paediatric and/or adult – Aerobic)
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMER
Apr 21, 2023
Procedure
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMERApr 21, 2023
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMER
Collection timePositive signal
Entry in BACTECArrival at Lab Identification and AST
report
Transport time Time to positivity(TTP)
Time to reporting
• TTP of catheter sample(TTPC)• TTP of peripheral sample(TTPP)
Apr 21, 2023
XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMER
Peripheral Central
CRBSI
Negative
≥2 hours
Same organism
Positive Positive Negative
Different organisms
Calculate DTP(TTPP-TTPC)
No Yes
?????
Interpretation
Excluded DTP cannot be measured
PossibleContamination
Local colonization
Apr 21, 2023
THANK YOU
Apr 21, 2023 XIII National Workshop on Diagnostic Methods in Clinical Microbiology, JIPMER