Features:
(1) identifying a patient at low risk for serious infection
(2) using a convenient culture method to establish the diagnosis of a catheter-related infection
Patient at low risk for serious infection:
(1) The patient does not have neutropenia or blood disorder.
(2) The catheter is inserted for short time use (not long-term).
(3) The patient is in the intensive care unit (ICU).
(4) The patient is not rapidly deteriorating.
Preferred method of establishing the catheter as the source of the infection:
(1) Superficial cultures of the skin around the insertion site
(2) Cultures taken inside of the catheter hub (with an alginate swab).
(3) Cultures taken from peripheral blood.
(4) The test is considered positive when the same organism is isolated from the skin and catheter hub (with >= 15 colony forming units per plate) as is seen in the peripheral blood cultures.
(5) If the diagnosis is in doubt, then use differential quantitative blood cultures (blood cultures drawn from the catheter have >= 5 times the number of colony forming units as seen from a simultaneously drawn culture from peripheral blood) to confirm the diagnosis.
If appropriate cultures are negative and the patient is stable, then the intravascular catheter does not need to be removed.
