Microbiology · Healthcare-Associated Infections and Hospital Microbiology (CLABSI, CAUTI, VAP, Sterilization Monitoring)

Central line-associated bloodstream infection (CLABSI) surveillance criteria require which minimum finding to attribute bacteremia to the central venous catheter?

  • A Positive blood culture from central line only, with no symptoms
  • B Positive catheter tip culture with > 15 CFU by roll-plate method, regardless of blood culture
  • C Positive blood culture from peripheral vein in a patient with a central line in place for > 2 days, with no other identifiable source of infection
  • D Both peripheral and central blood cultures positive with differential time to positivity (DTP) ≥ 2 hours favouring the central line
Correct answer: C. Positive blood culture from peripheral vein in a patient with a central line in place for > 2 days, with no other identifiable source of infection

Explanation

CDC/NHSN CLABSI definition requires: a recognized pathogen isolated from ≥ 1 blood culture, or a common skin commensal (coagulase-negative Staphylococcus, Bacillus spp., Corynebacterium, etc.) from ≥ 2 blood cultures within 48 hours, in a patient with a central line in situ for > 2 calendar days, with no other source (primary BSI). A positive catheter tip culture alone (Maki roll-plate > 15 CFU) does not fulfill CLABSI criteria — it only indicates catheter colonization. Differential time to positivity (DTP ≥ 2 hours earlier in the central vs. peripheral culture) is used in clinical diagnosis but is not part of the formal NHSN CLABSI definition.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

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