Santral venöz katetere bağlı infeksiyonların tanısında endolüminal fırça tekniğinin yeri
Bu çalışmada, kalelere bağlı infeksiyonların tanısında endolüminal fırça tekniği ile semikantitalif kültür tekniği (Maki tekniği) karşılaştırıldı. Santral venöz kalelere bağlı infeksiyon düşünülen on olgu çalışmaya alındı. Bu olgulardan; kaleler ucu, endolüminal fırça ve periferik kan kültürleri alındı. Kateter ucu kültürü semikantitatif tekniğe uygun olarak yapıldı. Kaleler ucunda ve periferik kan kültüründe aynı mikroorganizma üreyen iki olgudan birine kalelere bağlı bakleriyemi, diğerine kalelere bağlı fungemi tanısı konuldu. Lokal inflamasyon bulguları olan ve kaleler ucu küllüm pozitif, kan küllüm negatif bulunan diğer iki olguda ise lokal kaleler infeksiyonu düşünüldü. Endolüminal fırça kültürü tüm olgularda negatif bulundu. Sonuç olarak; bu ön çalışmada, katetere bağlı infeksiyonların tanısında endolüminal fırça tekniğine göre semikantitatif tekniğin daha yararlı olduğu düşünüldü.
Evaluation of endoluminal brush technique for diagnosis of central venous catheter-related infections
In this study, endoluminal brush and semiquantitative culture techniques (Maki's technique) were compared for the diagnosis of catheter-related infections. Ten patients considered to have central venous catheter-related infections have been included in this study. Catheter tip, endoluminal brush and peripheral blood cultures were obtained from patients. Catheter tip cultures were performed according to the semiquantitative technique. One of the two cases in which the same microorganisms yielded from catheter tip and peripheral blood cultures were determined as catheter-related bacteriemia and the other as the catheter-related fungemia. Other two patients with local inflammation signs were supposed to have local catheter infection because of positive catheter tip and negative peripheral blood cultures. Endoluminal brush cultures were negative in all of the cases. We concluded that semiquantitative technique was more useful than endoluminal brush technique for detection of catheter-related infections when compared to endoluminal brush technique.
___
- 1.Capdevila JA. Catheter-related infection: An update on diagnosis, treatment, and prevention, J Infect Dis 1998: 4 : 230-6
- 2.Henderson DK. Bacteremia due to percutaneous intravascular devices. In: Mandel GL. Douglas RG, Bennett JE (eds). Principles And Practice Of Infectious Diseases, New York: Churchill Livingstone 1995: 2587-2599
- 3.Rello J, Coll P, Prats G, Laboratory diagnosis of catheter-related bacteremia. Scand J Infect Dis 1991; 23: 583-8
- 4.Garrison RN, Wilson MA, Intravenous and central catheter infections. Surg Clin North Am 1994; 3 : 557-6
- 5.Corona ML, Peters SG, Narr BJ, et al. Infections related to central venous catheters. Mayo Clin Proc 1990; 65: 979-86
- 6.Wijngaerden EV, Bobbaers H, Intravascular catheter related bloodstream infection: Epidemiology, pathogenesis and prevention. Acta Clin Belg 1997; 52: 9-18
- 7.Raad I. Intravascular-catheter-related infections. Lancet 1998; 351:893-8
- 8.Kite P, Dobbins BM, Wilcox MH, et al. Evaluation of a novel endoluminal brush method for in situ diagnosis of catheter related sepsis. J Clin Pathol 1997; 50: 278-82
- 9.Tighe Ml, Kite P, Fawley WN. An endolüminal brush to detect the infected central venous catheter in situ: A pilot study. BMJ 1996; 313: 1528-9
- 10.Dobbins BM. Kite P. Miller GV, et al. The use of endolüminal brushes to screen for diagnose and assess the treatment of catheter related sepsis in Hickman catheters in patients receiving home parenteral nutrition. Clinical Nutrition 1997; 2 (Suppl); 71
- 11.Heerden PV, Webb SAR, Fong S, et al. Central venous catheters revisited-infection rates and an assessment of the new fibrin analysing system brush. Anesth Intens Care 1996; 24: 330-3