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md1
Culturing line tip?

INS standards instruct to clean catheter exit site with alcohol only before removing a catheter for culture tip.  No chlorhexidine? Is this because chlorhexidine remains on the skin and can disinfect an infected catheter when removed?

lynncrni
This recommendation for

This recommendation for alcohol came from Dr. Maki's procedure for doing a semi-quantitative culture method. This was long before there was CHG available. I don't think this procedure has changed but the new edition of the INS standards is in the mail now so you should check that new document as soon as you receive it.

I would also look at why your are doing these tip cultures. Routine culture of all catheters is no longer recommended. Tip culture will only show what is in the extraluminal surface, however if the catheter has been in place for longer than a week, the chances are much greater for this to be caused by intraluminal contamination. So a tip culture will not prove beneficial. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

paul
Lynn, I agree, tip cultures

Lynn,

I agree, tip cultures can be a false positive/negative. If you want to R/O  a  line infection, you have to do it through a series of blood cultures....that is, if the Doc will give you enough time  before they order you to pull the line.

What's your take?

Paul Howell

lynncrni
If you are trying to actually

If you are trying to actually make a diagnosis of CRBSI, then you do need to have paired blood cultures - one taken from a peripheral venipuncture and one taken from the catheter itself. Draw it only from a new needleless connector and not the old, used one as that will produce a false positive. These cultures may be repeated if ordered. But what you are looking for is dependent upon the system used in your lab. You may use colony counts or time to positivity. If the catheter drawn sample produces a colony count that is 5 times or more greater than the peripheral blood, the catheter is considered to be the cause. For time to positivity, the catheter sample will turn positive 2 hours before the peripheral sample. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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