Frequently, the distal tip of intravascular catheters are used to diagnose central line–associated blood stream infection. Where is the colonization heaviest on these catheters? Koh and colleagues studied 289 patients with arterial, central venous catheters, or peripherally inserted central lines (PICCs) in place for 9 days or longer. They cultured segments of these devices and found the following:

  • Microbial colonization was greatest at the proximal external segment (nearest the skin) on all catheters.

  • The distal tip of the catheters may not have been colonized even when the proximal end was positive for growth.

  • Arterial catheters had higher rates of microbial colonization than PICCs.

  • Microbial colonization increases directly as the number of lumens Increases in all central lines.

—Maureen Seckel,rn,apn,msn,aprn-bc,ccrn,ccns

See Article, pp 162–171

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