EARLIER POSITIVITY OF CENTRAL-VENOUS-BLOOD VERSUS PERIPHERAL-BLOOD CULTURES IS HIGHLY PREDICTIVE OF CATHETER-RELATED SEPSIS

To diagnose catheter related sepsis without removing the catheter, we evaluated the differential positivity times of cultures of blood drawn simultaneously from central venous catheter and peripheral sites. In a 450-bed cancer reference center, simultaneous central-and peripheral -blood cultures were prospectively performed for patients with suspici on of catheter-related sepsis over an 18-month period. Data for 64 pat ients for whom the same microorganisms were found when central-and per ipheral-blood samples were cultured were retrospectively reviewed by t wo independent physicians blinded to the differential positivity time values in order to establish or refute the diagnosis of catheter-relat ed sepsis, The diagnosis was established in 28 cases, refuted in 14, a nd indeterminate in the remaining 22. The differential positivity time was significantly greater for patients with catheter-related sepsis ( P < 10(-4)), A cutoff limit of +120 min had 100% specificity and 96.4% sensitivity for the diagnosis of catheter-related sepsis, These resul ts strongly suggest that measurement of the differential positivity ti me might be a reliable tool facilitating the diagnosis of catheter-rel ated sepsis in patients with an indwelling catheter.