Hudson-Civetta J A, Civetta J M, Martinez O V, Hoffman T A
Crit Care Med. 1987 Jan;15(1):29-34. doi: 10.1097/00003246-198701000-00006.
Specimen cultures were evaluated in 49 catheterized patients who had a known focus of infection (primarily intra-abdominal peritonitis). Bacteria were recovered from 2% of flush solutions, 14% of transducer domes, 18% of diaphragms, and 24% of cardiac output fluids; however, these bacteria were not found in cultures of the pulmonary artery (PA) catheter segments. The rates of positive PA catheter-aspirate cultures were 30.6% on day 1, 20.4% on day 2, and 32.7% on day 3 (not statistically different). PA catheter-aspirate cultures had a sensitivity of 5.7% and a positive predictive value of 30% for catheter-related infection, and 15% sensitivity and 40% positive predictive value for peripheral bacteremia. While 95% (55 of 58) of the catheter-aspirate cultures were false-positives, only 0.5% (3 of 588) were true-positives. Peripheral blood cultures were positive in 10% of the patients, but the catheter segments were sterile or grew different organisms. Arterial line cultures had zero sensitivity and predictive value to detect catheter-related infection, and 15% sensitivity and 40% predictive value to detect peripheral bacteremia. Thus, PA catheter-aspirate cultures, routine peripheral blood cultures, and arterial cultures cannot be recommended to detect PA catheter-related infection. Catheter-related infection confirmed by catheter-segment cultures was 10.2% when the PA catheters were removed after 73 +/- 6.5 (SD) h. Bacteria from catheter-segment cultures corresponded to those from the primary infection site.
对49例有已知感染灶（主要是腹腔内腹膜炎）的留置导管患者的标本培养物进行了评估。在2%的冲洗液、14%的传感器探头、18%的隔膜和24%的心排液中发现了细菌；然而，在肺动脉（PA）导管段培养物中未发现这些细菌。PA导管抽吸物培养物第1天的阳性率为30.6%，第2天为20.4%，第3天为32.7%（无统计学差异）。PA导管抽吸物培养物对导管相关感染的敏感性为5.7%，阳性预测值为30%，对外周菌血症的敏感性为15%，阳性预测值为40%。虽然95%（58例中的55例）的导管抽吸物培养为假阳性，但只有0.5%（588例中的3例）为真阳性。10%的患者外周血培养呈阳性，但导管段无菌生长或生长出不同的微生物。动脉导管培养物对检测导管相关感染的敏感性和预测值为零，对检测外周菌血症的敏感性为15%，预测值为40%。因此，不推荐用PA导管抽吸物培养、常规外周血培养和动脉培养来检测PA导管相关感染。当PA导管在73±6.5（标准差）小时后拔除时，经导管段培养确诊的导管相关感染率为10.2%。导管段培养出的细菌与原发感染部位的细菌一致。
