Bouza Emilio, Alvarado Neisa, Alcalá Luis, Muñoz Patricia, Rabadán Pablo Martín, Rodríguez-Créixems Marta
Clinical Microbiology and Infectious Diseases Service, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Diagn Microbiol Infect Dis. 2006 Nov;56(3):255-60. doi: 10.1016/j.diagmicrobio.2006.05.006. Epub 2006 Jul 18.
This study compared the acridine orange and Gram stains of an external smear of intravascular catheter-tip segments with the culture results obtained 24 to 48 h later. Both staining techniques were randomly assigned to be performed either before (group A) or after (group B) rolling on the agar plate. Of the 425 catheter tips processed, 25.7% were significantly colonized and 6.1% were from patients with catheter-related bloodstream infections (CRBSIs). The yield of group A was superior to that of group B for the prediction of colonization (sensitivity, 94.3%/69.6%; specificity, 92.4%/96.2%; positive predictive value (PPV), 80.6%/86.7%; negative predictive value (NPV), 98.0%/90.0%; and full concordance, 91.9%/89.3%). The values for the prediction of CRBSIs were as follows for group A and group B: sensitivity, 100%/69.2%; specificity, 96.3%/100%; PPV, 86.7%/100.0%; NPV, 100%/93.9%; and full concordance, 97.0%/94.7%. Catheter-tip staining before culture is an easy-to-perform, cheap, and effective procedure to anticipate catheter colonization and rule out CRBSIs.
本研究将血管内导管尖端节段的体外涂片吖啶橙染色和革兰氏染色结果与24至48小时后获得的培养结果进行了比较。两种染色技术被随机分配在琼脂平板上滚动之前（A组）或之后（B组）进行。在处理的425个导管尖端中，25.7%有显著定植，6.1%来自导管相关血流感染（CRBSI）患者。在预测定植方面，A组的检出率优于B组（敏感性，94.3%/69.6%；特异性，92.4%/96.2%；阳性预测值（PPV），80.6%/86.7%；阴性预测值（NPV），98.0%/90.0%；完全一致性，91.9%/89.3%）。A组和B组预测CRBSI的值如下：敏感性，100%/69.2%；特异性，96.3%/100%；PPV，86.7%/100.0%；NPV，100%/93.9%；完全一致性，97.0%/94.7%。培养前的导管尖端染色是一种易于操作、成本低廉且有效的方法，可用于预测导管定植并排除CRBSI。
