Prognostic Value of Quantitative Blood Cultures for the Outcome of Central Venous Catheters in Children

Quantitative blood cultures have been used in order to define catheter-related bloodstream infection (CRBI) in pediatric patients with malignancy and central venous catheters (CVCs). We prospectively followed 32 patients with a total of 38 CVCs for a period of 4 y (14,068 catheter-days). Of a total of 35 cases of bacteremia, 9 were considered to be CRBI (25%). The incidence of bacteremia in our study was 2.48 episodes/1,000 catheter-days and 20/38 CVCs (52%) were affected by bacteremia. The incidence of CRBI was 0.63 episodes/1,000 catheter-days and it was detected in 9/38 CVCs (23%). The catheter salvage rate in cases of bacteremia, irrespective of etiology, was 30/35 (85%). The catheter salvage rate in cases of CRBI was only 4/9 (44%), whereas all the catheters (26/26) in non-catheter-related cases of bacteremia were salvaged. We suggest that the use of quantitative blood cultures is a useful tool for the evaluation of bacteremia in patients with CVCs and is of prognostic value.