Recent Techniques for Diagnosing Central Venous Catheter-related Bloodstream Infections in Children (Incat)

Assistance Publique - Hôpitaux de Paris

Status

Completed

Conditions

Catheter-related Bloodstream Infection

Treatments

Other: blood culture

Study type

Interventional

Funder types

Other

Identifiers

NCT01249976

K060210

N° ID RCB :2006-A000515-46 (Other Identifier)

Details and patient eligibility

About

Removal of a central venous catheter (CVC) is often useful to prove its responsibility in a bloodstream infection. To avoid unnecessary removal of CVC, some catheter-spearing diagnostic methods have been recently developed. The aim of the study is to evaluate three catheter-spearing diagnostic methods in critically ill children: 1) the measurement of the differential time to positivity between a blood culture drawn from a peripherical vein and another one drawn through the CVC; 2) the exam of a blood sample drawn for the CVC and stained by acridine orange leucocyte cytospin test; 3) the semi-quantitative skin culture of the area around the insertion site of the CVC.

Full description

Samples for the three techniques described above will be collected from the children admitted in Pediatric Intensive Care Unit with a CVC for more than 48 hours and with clinical or biological signs of systemic infection. Any investigation required to determine the origin of the infection will be performed, according to physician's judgement. If the CVC is removed or changed on a guide wire, a quantitative culture of the distal segment will be performed.

All the patients with a bloodstream infection and sampled according to the protocol will be included for statistical analysis. The physician and an independent medical expert will analyse if the bloodstream infection is CVC-related or not, according to the reference standard, by analysis of the clinical and bacteriological data, blinded towards the three studied techniques. The most optimal threshold will be determined and the sensibility, the specificity, the positive and negative predictable value of the three techniques will be calculated. Then sensibility of these three techniques will be compared.

Enrollment

148 patients

Sex

All

Ages

Under 18 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

age between 0 and 18 years.
Presence of a Central Venous Catheter for more than 48h (excepted umbilical catheter or peripherally inserted central catheters)
Presence of at least one clinical or biological sign of systemic infection
Parents are informed of the protocol and don't refuse the inclusion
Prior inclusion in this study for the same bloodstream infection

Exclusion Criteria: