Approximately 80,000 central venous catheter-related bloodstream infections occur in United States intensive care units each year [1,2]. In general, the diagnostic approach to catheter-related blood stream infection (CRBSI) consists of clinical evaluation and microbiologic confirmation with blood and catheter cultures.
The clinical features and diagnosis of CRBSI will be reviewed here. Issues related to treatment of CRBSI are discussed in detail separately (see "Treatment of intravascular catheter-related infections").
For surveillance purposes, the Centers for Disease Control has introduced the term laboratory-confirmed bloodstream infection (LCBI) . LCBI must meet at least one of the following criteria:
- Patient has a recognized pathogen cultured from one or more blood cultures and the pathogen is not related to an infection at another site.
- Patient has fever, chills, and/or hypotension as well as positive laboratory cultures from two or more blood samples drawn on separate occasions which are not related to infection at another site and do not reflect contamination.
- Patient <1 year of age has at least one of the following signs or symptoms: fever, hypothermia, apnea, or bradycardia (in addition to above criteria).
For clinical purposes, the diagnosis of an intravenous catheter-related infection requires host, epidemiologic, clinical and laboratory criteria as discussed in the following sections.