Catheter-Related Infection

The “Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Catheter-Related Infection (CRI).

CRI1-CVC (Central Venous Catheter)

local CVC-related infection (no positive blood culture):

• quantitative CVC culture ≥ 103 CFU/ml (1) or semi-quantitative CVC culture > 15 CFU

and

• pus/inflammation at the insertion site or tunnel.

CRI1-PVC (Peripheral Venous Catheter)

local PVC-related infection (no positive blood culture):

• quantitative PVC culture ≥ 103 CFU/ml or semi-quantitative PVC culture > 15 CFU

and

• pus/inflammation at the insertion site or tunnel.

CRI2-CVC (Central Venous Catheter)

General CVC-related infection (no positive blood culture):

• quantitative CVC culture ≥ 103 CFU/ml or semi-quantitative CVC culture > 15 CFU

and

• clinical signs improve within 48 hours after catheter removal.

CRI2-PVC (Peripheral Venous Catheter)

General PVC-related infection (no positive blood culture):

• quantitative PVC culture ≥ 103 CFU/ml or semi-quantitative PVC culture > 15 CFU

and

• clinical signs improve within 48 hours after catheter removal.

CRI3-CVC (Central Venous Catheter)

microbiologically confirmed CVC-related bloodstream infection:

• BSI occurring 48 hours before or after catheter removal

and

• positive culture with the same microorganism of either:
• quantitative CVC culture ≥ 103 CFU/ml or semi-quantitative CVC culture > 15 CFU;
• quantitative blood culture ratio CVC blood sample/peripheral blood sample > 5;
• differential delay of positivity of blood cultures: CVC blood sample culture positive two hours or more
• before peripheral blood culture (blood samples drawn at the same time);
• positive culture with the same microorganism from pus from insertion site.

CRI3-PVC (Peripheral Venous Catheter)

microbiologically confirmed PVC-related bloodstream infection:

• BSI occurring 48 hours before or after catheter removal

and

• positive culture with the same microorganism of either:
• quantitative PVC culture ≥ 103 CFU/ml or semi-quantitative PVC culture > 15 CFU;
• positive culture with the same microorganism from pus from insertion site.

Further instructions for reporting:

• central vascular catheter colonisation must not be reported;

CRI3 (-CVC or -PVC) is also a bloodstream infection with source C-CVC or C-PVC respectively, however when a CRI3 is reported, the BSI must not be reported in the * point prevalence survey, microbiologically confirmed catheter-related BSI must be reported as CRI3.

Link to European IC/HH Core Competencies

• Area 3. Surveillance and investigation of healthcare-associated infection (HAI)

References

• Brun-Buisson C, Abrouk F, Legrand P, Huet Y, Larabi S, Rapin M. Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. Arch Intern Med 1987; 147(5):873-877.
• Quilici N, Audibert G, Conroy MC, Bollaert PE, Guillemin F, Welfringer P et al. Differential quantitative blood cultures in the diagnosis of catheter-related sepsis in intensive care units. ClinInfectDis 1997; 25(5):1066-1070.
• http://www.ecdc.europa.eu/en/publications/Publications/0512-TED-PPS-HAI-antimicrobial-use-protocol.pdf