K-3407. Development of Subsequent Bacteremia or Fungemia after Removal of Colonized Central Venous Catheters (CVC) in Patients with Negative Concomitant Blood Cultures
Session: Poster Session: Catheter-Related Bloodstream Infections
Monday, October 27, 2008: 12:00 AM
Room: Hall C
Background: There are limited data on the clinical significance of positive CVC tip cultures with negative concomitant blood cultures around the time of CVC removal. Method: A retrospective cohort study of all patients who had CVC tip cultures was conducted in a tertiary hospital with 2,200 beds during a 10-year period. All patients with isolated positive CVC tip cultures were observed for the development of subsequent bacteremia or fungemia within 28 days after CVC removal. Isolated positive CVC tip culture was defined as a case which: (i) had a CVC tip culture that grew ≥ 15 colonies by the Maki semi-quantitative culture method and (ii) had ≥ two sets of blood samples and revealed no organism around the time of CVC removal (between 24hr before and 24 hr after CVC removal). Results: Of total 13,195 CVC tip cultures, 5,851 had ≥ two sets of blood samples around the time CVC removal. Of these, 1,826 CVC tip cultures were positive. Finally, 333 CVC tip cultures from 329 patients met criteria for isolated positive CVC tip cultures. Seven (2.1%, 95% CI: 0.9% to 4.4%) of the 333 developed subsequent bacteremia or fungemia. Detailed data are shown in Table 1. None of seven patients who developed subsequent bacteremia or fungemia had received susceptible systemic antibiotics within 48 hr of CVC removal.
Conclusion: Bacteremia or fungemia is a rare complication after removal of colonized CVCs in patients with negative concomitant blood cultures. However, our data support the current recommendation that systemic antibiotics would be needed in patients whose catheter tip culture reveal significant growth of certain organisms such as Candida spp..
Table 1. Bacteremia and fungemia after CVC removal in patients with isolated positive tip cultures

Isolated positive CVC tip cultures,

No. (%)

Subsequent bacteremia or fungemia

within 28 days after CVC removal,

No. (%, 95% CI)

Coagulase-negative staphylococci

96 (28.9)

0 (0.0, 0.0- 4.6)

Yang Kim, MD1, Eun Lee2, Jin Jeong, PhD1, Jun Woo, MD1, Ki Park, MD3, Sang- Choi2, Sang- Lee2, Seung Lim, MD1, Sung- Kim2 and  K. H. Park, None., (1)Asan Medical Center, Seoul, Korea, Republic of, (2)ASAN Medical Center, (3)Seoul National University College of Medicine, Seoul, Korea, Republic of