Some of our Doctors do not order a PICC tip culture even though the documentation says they blame the PICC for the fever or bacteremia. I had heard from the infection control nurse, at the last facility I worked, that maybe PICC tips were not deemed as useful as they used to be. I never got a rationale.
If the patient has a trach, a wound, a urinary catheter and a PICC, it seems like you would want to culture all sources to find the matching organism if there is a bacteremia.Â
If you have a positive peripheral BC and a matching positive culture from a PICC blood draw, couldn't the source still be another one besides the PICC? But isn't it still prudent to remove the PICC, do ABX peripherally and PPN for 24 hours, and then replace it?
What if there is a positive culture from the peripheral stick and negative from the PICC blood draw? contaminated peripheral specimen, right?
What if there is a positive culture from the PICC blood draw and a negative one from the peripheral draw? infected PICC, right, or just suspect?
Maybe we captured the organism from the blood in the PICC draw and not the peripheral or visa versa. Wouldn't you still culture the PICC tip to prove that it was the PICC. If the PICC tip is negative, will the hospital be absolved of a CRBI?Â