Efficacy of routine catheter tip culture in a neonatal intensive care unit
| Autor: | Hajime Yasuhara, Hideki Minowa, Taito Kitano, Kazue Masuo, Ayako Ohgitani, Reiko Ebisu, Ikuyo Arai, Kumiko Takagi, Miyako Oka, Daisuke Kitagawa |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Microbiological Techniques medicine.medical_specialty Catheterization Central Venous Neonatal intensive care unit 030106 microbiology Peripherally-inserted central venous catheter Retrospective data 03 medical and health sciences 0302 clinical medicine Japan Intensive Care Units Neonatal medicine Central Venous Catheters Humans 030212 general & internal medicine Retrospective Studies business.industry Infant Newborn Antimicrobial medicine.disease Community hospital Surgery Catheter Bacteremia Catheter-Related Infections Pediatrics Perinatology and Child Health Cost analysis Costs and Cost Analysis Female business |
| Zdroj: | Pediatrics international : official journal of the Japan Pediatric Society. 60(5) |
| ISSN: | 1442-200X |
| Popis: | Background Routine catheter tip cultures are not recommended because some cases of colonization, such as with Staphylococcus aureus, can lead to subsequent bacteremia. To evaluate the safety of colonization without antimicrobial treatment, as well as the effectiveness of routine catheter tip cultures in the neonatal intensive care unit (NICU), we performed a retrospective data analysis in a Japanese community hospital. Methods We reviewed all peripherally inserted central venous catheter tip culture results from the NICU ward between April 2012 and June 2017 and noted outcome (i.e. antimicrobial treatment or subsequent infection). We then performed a cost analysis for routine catheter tip culturing on patients who were symptom free during the study period. Results Of the 93 positive cases in 80 patients from 1,051 catheter tip cultures, seven patients had suspected infection and were treated with antimicrobials. The other 73 symptom-free, positive patients had no subsequent or exacerbated symptoms indicative of an infection, and did not have antimicrobial treatment. The total cost for catheter tip culturing during the study period was ¥548 731. After excluding patients with symptoms of infection at the time of culture, the efficacy of routine catheter tip cultures on symptom-free patients was estimated to be zero. Conclusion Symptom-free colonization did not affect clinician management in this study, and all colonized patients without suspected infection were safely managed without antimicrobials. Furthermore, routine catheter tip culturing was not cost-effective; therefore, this practice may be no longer recommended in the NICU. |
| Databáze: | OpenAIRE |
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