Pérez Granda, María JesúsGuembe, MaríaCruces, RaquelBouza Santiago, Emilio2025-05-222025-05-222016-05-28Pérez-Granda MJ, Guembe M, Cruces R, Bouza E. Vascular catheter colonization: Surveillance based on culture of needleless connectors. Critical Care. 2016;20(1).1364-853510.1186/s13054-016-1334-1https://hdl.handle.net/20.500.14352/120428Background Superficial culture has a high negative predictive value in the assessment of catheter tip colonization (CC) and catheter-related bloodstream infection (C-RBSI). However, the process of hub culture requires the hubs to be swabbed, and this carries a risk of dislodging the biofilm. At present, most catheter hubs are closed by needleless connectors (NCs) that are periodically replaced. Our objective was to compare the yield of SC (skin + hub culture) with that of skin + NC culture in the assessment of CC and C-RBSI. Methods During 5 months, we included the patients on the Major Heart Surgery ICU when a central venous catheter (CVC) remained in place ≥7 days after insertion. SCs were taken simultaneously when the NC was withdrawn and processed by the semi-quantitative method, even when the catheter was not removed. All catheter tips were cultured. All NCs belonging to a single catheter lumen were individually flushed with 100 μl of brain-heart infusion (BHI) broth. We considered the lumen to be colonized when ≥1 NC culture from the lumen flush was positive. We collected a total of 60 catheters. Results The overall CC rate was 15.0 %, and we confirmed two episodes of C-RBSI. The validity values after the comparison of SCs with skin + NC culture for prediction of CC were the following: sensitivity 66.7 % vs. 77.8 %, and negative predictive value 93.6 % vs. 93.1 %. The sensitivity and negative predictive value for prediction of C-RBSI was 100 % for both SC and skin + NC culture. Conclusion The combination of skin and flushed NC culture can be an alternative to conventional SC for ruling out CC and C-RBSI.engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/journal articlehttps://doi.org/10.1186/S13054-016-1334-1https://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1334-1open access61Needleless connectorsFlushingSuperficial cultureHub cultureCatheter colonizationCatheter-related bloodstream infectionCiencias Biomédicas3299 Otras Especialidades Médicas