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Efficacy of routine catheter tip culture in a neonatal intensive care unit
Author(s) -
Kitano Taito,
Takagi Kumiko,
Arai Ikuyo,
Yasuhara Hajime,
Ebisu Reiko,
Ohgitani Ayako,
Kitagawa Daisuke,
Oka Miyako,
Masuo Kazue,
Minowa Hideki
Publication year - 2018
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13538
Subject(s) - medicine , catheter , bacteremia , neonatal intensive care unit , antimicrobial , intensive care unit , central venous catheter , retrospective cohort study , colonization , intensive care , surgery , intensive care medicine , antibiotics , pediatrics , microbiology and biotechnology , biology
Background Routine catheter tip cultures are not recommended because some cases of colonization, such as with Staphylococcus aureus , can lead to subsequent bacteremia. To evaluate the safety of colonization without antimicrobial treatment, as well as the effectiveness of routine catheter tip cultures in the neonatal intensive care unit ( NICU ), we performed a retrospective data analysis in a Japanese community hospital. Methods We reviewed all peripherally inserted central venous catheter tip culture results from the NICU ward between April 2012 and June 2017 and noted outcome (i.e. antimicrobial treatment or subsequent infection). We then performed a cost analysis for routine catheter tip culturing on patients who were symptom free during the study period. Results Of the 93 positive cases in 80 patients from 1,051 catheter tip cultures, seven patients had suspected infection and were treated with antimicrobials. The other 73 symptom‐free, positive patients had no subsequent or exacerbated symptoms indicative of an infection, and did not have antimicrobial treatment. The total cost for catheter tip culturing during the study period was ¥548 731. After excluding patients with symptoms of infection at the time of culture, the efficacy of routine catheter tip cultures on symptom‐free patients was estimated to be zero. Conclusion Symptom‐free colonization did not affect clinician management in this study, and all colonized patients without suspected infection were safely managed without antimicrobials. Furthermore, routine catheter tip culturing was not cost‐effective; therefore, this practice may be no longer recommended in the NICU .