Apport diagnostique de l'écouvillonnage de la zone d'insertion cutanée dans l'exploration des infections liées aux cathéters veineux centraux dans un service de réanimation médicochirurgicale

Abstract

Objective. – To evaluate the predictive value of pericatheter skin cultures in detecting catheter-related infections in critically-ill patients. Study design. – Prospective study. Patients and methods. – Over a 5 months period (from August 1 st 2001 to December 31 2001), 500 patients were hospitalised, and 108 central venous catheters were prospectively examined. For each catheter, blood cultures, pericatheter skin cultures and semiquantitative culture of the catheter tip were performed. Results. – The median duration of catheterization was 8 days (interquartile: 8 days). Catheter was removed because of suspected infection in 54 cases (50%). Systemic catheter-related infection was found in 12 cases (11%) and the responsible organism was a gram-negative rod in 11 cases (92%). The negative predictive values of pericatheter skin cultures in the diagnosis of catheter-related infections and in case of suspected catheter-related infection were 89 and 86%, respectively. Conclusion. – These results indicate that the pericatheter skin cultures are not an effective procedure for the conservative diagnosis of catheter-related infections and that the skin-insertion wound is not the major source of catheter-contamination in our unit.