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Repeat blood cultures before pulling line?

PICC placed over a week ago. Patient spiked a temp on the 7th day after being reintubated for possible aspiration. BC were drawn, one set from PICC and one peripherally.  PICC cultures positive for Streptococcus sp(not S. pyogenes, S. agalactiae, S. pneumo) but peripheral draw has shown no growth after 24 hours.  Would you suspect confirmed line infection or false positive from contaminated connector? Physician wants line pulled, tip cultured, and new PICC placed.  Would this situation benefit from redrawing BC from PICC since peripheral draw has grown nothing?  This was a difficult placement and want to verify pulling the line would be prudent.

Does your lab do time to

Does your lab do time to positivity or colony counts? If time to positivity, the set of cultures from the PICC becomes positive 2 hours before the peripheral sample. If colony counts, the sample from the PICC grows out 3-5 times greater colony count than the peripheral sample. I would say this line needs to be pulled. All blood cultures drawn from a CVAD should have the used needleless connector removed BEFORE the sample is drawn. Was that done? I would place the new line just to make sure I could get it in, then pull the old one. 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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