How to use central venous catheter tip cultures

Arch Dis Child Educ Pract Ed. 2015 Apr;100(2):69-74. doi: 10.1136/archdischild-2013-305096. Epub 2014 Apr 7.

Abstract

Central venous catheter (CVC) tip cultures are useful in the assessment of a patient with a potential catheter-related bloodstream infection (CRBSI). However, these results can be misleading particularly in the absence of concomitant peripheral and central line blood cultures. Catheter tip cultures should not be submitted to the laboratory unless CRBSI is suspected as the predictive value of culture results depends on the pretest probability of CRBSI. A positive CVC tip culture does not usually warrant further investigation or therapy (except in the case of Staphylococcus aureus and possibly Candida sp) while a negative catheter tip culture in isolation does not definitively exclude CRBSI. Clinicians can use alternative criteria for the diagnosis of CRBSI that do not require catheter tip cultures if necessary. Further research into the significance of CVC tip cultures in the absence of concomitant bacteraemia is required.

Keywords: General Paediatrics; Infectious Diseases; Microbiology; Paediatric Practice.

Publication types

  • Review

MeSH terms

  • Bacteriological Techniques
  • Candida / isolation & purification
  • Candidiasis / diagnosis*
  • Candidiasis / drug therapy
  • Catheter-Related Infections / diagnosis*
  • Catheter-Related Infections / drug therapy
  • Central Venous Catheters / microbiology*
  • Child
  • Humans
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / drug therapy
  • Staphylococcus aureus / isolation & purification