The use of a rapid in situ test in the detection of central venous catheter-related bloodstream infection: A prospective study

Jin J. Bong, Peter Kite, Basil J. Ammori, Mark H. Wilcox, Michael J. McMahon

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Acridine orange leukocyte cytospin (AOLC) is a highly sensitive and specific test for the detection of catheter-related bloodstream infection (CRBSI). We evaluated the role of the AOLC test in early detection or exclusion of CRBSI and compared the cost of managing patients with suspected CRBSI. Methods: On the day of clinical suspicion of CRBSI, blood samples were obtained from the catheters for the AOLC test, and peripheral blood samples were obtained for quantitative blood cultures. Catheters with positive AOLC results were immediately removed for culture and replaced if necessary. Catheters with negative AOLC tests were left in situ. We compared the catheter lifespan in patients with suspected CRBSI who had positive and negative AOLC tests and calculated the cost of using the AOLC test to prevent indiscriminate catheter removal. Results: Fifty patients with suspected CRBSI were tested and prospectively followed up. Catheters were removed in 10 patients (20%) with a positive AOLC test, and CRBSI was confirmed in each case subsequently. Selective removal of catheters based on AOLC tests significantly extended the lifespan of catheters compared with an indiscriminate removal of catheters based on clinical suspicion of CRBSI (median, 24 versus 11 days; p < .0001). The cost of an AOLC test and selective catheter replacement strategy was significantly lower than the cost of routine removal and replacement of catheters (median, £9.53 versus £64.20; p < .0001). Conclusion: The AOLC test enables a rapid detection of CRBSI, avoids unnecessary removal of catheters, and provides a cost-efficient management approach in patients with suspected CRBSI.

Original languageEnglish
Pages (from-to)146-150
Number of pages5
JournalJournal of Parenteral and Enteral Nutrition
Volume27
Issue number2
Publication statusPublished - Mar 2003
Externally publishedYes

Fingerprint

Catheter-Related Infections
Central Venous Catheters
Acridine Orange
prospective studies
catheters
blood flow
Catheters
Leukocytes
Prospective Studies
acridine orange
infection
leukocytes
testing
Costs and Cost Analysis
Hematologic Tests
blood

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

The use of a rapid in situ test in the detection of central venous catheter-related bloodstream infection : A prospective study. / Bong, Jin J.; Kite, Peter; Ammori, Basil J.; Wilcox, Mark H.; McMahon, Michael J.

In: Journal of Parenteral and Enteral Nutrition, Vol. 27, No. 2, 03.2003, p. 146-150.

Research output: Contribution to journalArticle

Bong, Jin J. ; Kite, Peter ; Ammori, Basil J. ; Wilcox, Mark H. ; McMahon, Michael J. / The use of a rapid in situ test in the detection of central venous catheter-related bloodstream infection : A prospective study. In: Journal of Parenteral and Enteral Nutrition. 2003 ; Vol. 27, No. 2. pp. 146-150.
@article{4cb22fe4757d4af4af7b8d54c34109f7,
title = "The use of a rapid in situ test in the detection of central venous catheter-related bloodstream infection: A prospective study",
abstract = "Background: Acridine orange leukocyte cytospin (AOLC) is a highly sensitive and specific test for the detection of catheter-related bloodstream infection (CRBSI). We evaluated the role of the AOLC test in early detection or exclusion of CRBSI and compared the cost of managing patients with suspected CRBSI. Methods: On the day of clinical suspicion of CRBSI, blood samples were obtained from the catheters for the AOLC test, and peripheral blood samples were obtained for quantitative blood cultures. Catheters with positive AOLC results were immediately removed for culture and replaced if necessary. Catheters with negative AOLC tests were left in situ. We compared the catheter lifespan in patients with suspected CRBSI who had positive and negative AOLC tests and calculated the cost of using the AOLC test to prevent indiscriminate catheter removal. Results: Fifty patients with suspected CRBSI were tested and prospectively followed up. Catheters were removed in 10 patients (20{\%}) with a positive AOLC test, and CRBSI was confirmed in each case subsequently. Selective removal of catheters based on AOLC tests significantly extended the lifespan of catheters compared with an indiscriminate removal of catheters based on clinical suspicion of CRBSI (median, 24 versus 11 days; p < .0001). The cost of an AOLC test and selective catheter replacement strategy was significantly lower than the cost of routine removal and replacement of catheters (median, £9.53 versus £64.20; p < .0001). Conclusion: The AOLC test enables a rapid detection of CRBSI, avoids unnecessary removal of catheters, and provides a cost-efficient management approach in patients with suspected CRBSI.",
author = "Bong, {Jin J.} and Peter Kite and Ammori, {Basil J.} and Wilcox, {Mark H.} and McMahon, {Michael J.}",
year = "2003",
month = "3",
language = "English",
volume = "27",
pages = "146--150",
journal = "Journal of Parenteral and Enteral Nutrition",
issn = "0148-6071",
publisher = "SAGE Publications Inc.",
number = "2",

}

TY - JOUR

T1 - The use of a rapid in situ test in the detection of central venous catheter-related bloodstream infection

T2 - A prospective study

AU - Bong, Jin J.

AU - Kite, Peter

AU - Ammori, Basil J.

AU - Wilcox, Mark H.

AU - McMahon, Michael J.

PY - 2003/3

Y1 - 2003/3

N2 - Background: Acridine orange leukocyte cytospin (AOLC) is a highly sensitive and specific test for the detection of catheter-related bloodstream infection (CRBSI). We evaluated the role of the AOLC test in early detection or exclusion of CRBSI and compared the cost of managing patients with suspected CRBSI. Methods: On the day of clinical suspicion of CRBSI, blood samples were obtained from the catheters for the AOLC test, and peripheral blood samples were obtained for quantitative blood cultures. Catheters with positive AOLC results were immediately removed for culture and replaced if necessary. Catheters with negative AOLC tests were left in situ. We compared the catheter lifespan in patients with suspected CRBSI who had positive and negative AOLC tests and calculated the cost of using the AOLC test to prevent indiscriminate catheter removal. Results: Fifty patients with suspected CRBSI were tested and prospectively followed up. Catheters were removed in 10 patients (20%) with a positive AOLC test, and CRBSI was confirmed in each case subsequently. Selective removal of catheters based on AOLC tests significantly extended the lifespan of catheters compared with an indiscriminate removal of catheters based on clinical suspicion of CRBSI (median, 24 versus 11 days; p < .0001). The cost of an AOLC test and selective catheter replacement strategy was significantly lower than the cost of routine removal and replacement of catheters (median, £9.53 versus £64.20; p < .0001). Conclusion: The AOLC test enables a rapid detection of CRBSI, avoids unnecessary removal of catheters, and provides a cost-efficient management approach in patients with suspected CRBSI.

AB - Background: Acridine orange leukocyte cytospin (AOLC) is a highly sensitive and specific test for the detection of catheter-related bloodstream infection (CRBSI). We evaluated the role of the AOLC test in early detection or exclusion of CRBSI and compared the cost of managing patients with suspected CRBSI. Methods: On the day of clinical suspicion of CRBSI, blood samples were obtained from the catheters for the AOLC test, and peripheral blood samples were obtained for quantitative blood cultures. Catheters with positive AOLC results were immediately removed for culture and replaced if necessary. Catheters with negative AOLC tests were left in situ. We compared the catheter lifespan in patients with suspected CRBSI who had positive and negative AOLC tests and calculated the cost of using the AOLC test to prevent indiscriminate catheter removal. Results: Fifty patients with suspected CRBSI were tested and prospectively followed up. Catheters were removed in 10 patients (20%) with a positive AOLC test, and CRBSI was confirmed in each case subsequently. Selective removal of catheters based on AOLC tests significantly extended the lifespan of catheters compared with an indiscriminate removal of catheters based on clinical suspicion of CRBSI (median, 24 versus 11 days; p < .0001). The cost of an AOLC test and selective catheter replacement strategy was significantly lower than the cost of routine removal and replacement of catheters (median, £9.53 versus £64.20; p < .0001). Conclusion: The AOLC test enables a rapid detection of CRBSI, avoids unnecessary removal of catheters, and provides a cost-efficient management approach in patients with suspected CRBSI.

UR - http://www.scopus.com/inward/record.url?scp=0037371847&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037371847&partnerID=8YFLogxK

M3 - Article

C2 - 12665171

AN - SCOPUS:0037371847

VL - 27

SP - 146

EP - 150

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

SN - 0148-6071

IS - 2

ER -