Time to blood culture positivity as a marker for catheter-related candidemia
Open accessAbstract
Candida spp. are important causes of nosocomial bloodstream infections. Around 80% of patients with candidemia have an indwelling central venous catheter (CVC). Determining whether the CVC is the source of candidemia has implications for patient management. We assessed whether the time to detection of Candida species in peripheral blood (time to positivity [TTP]) can serve as a marker for catheter-related candidemia. Prospective surveillance of Candida bloodstream infection was conducted in two medical centers. TTP was recorded by the BacT/Alert automated system. Sixty-four candidemia episodes were included. Fifty patients (78%) had an indwelling CVC. Thirteen patients (20.3%) had definite catheter-related candidemia. TTP was shorter for definite catheter-related candidemia (17.3 ± 2 h) than that for candidemia from other sources (38.2 ± 3 h; P < 0.001). A TTP cutoff of 30 h was 100% sensitive and 51.4% specific for catheter-related candidemia (area under the receiver-operator characteristic curve of 0.76). We conclude that TTP in peripheral blood is a sensitive but nonspecific marker for catheter-related candidemia and that a TTP of more than 30 h can help exclude an intravascular catheter as the possible source of candidemia.
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Detection of candidemia by blood culture often takes more than 24 hours, and for species such as Candida glabrata the time to positive culture can be even longer.
“Furthermore, detection of candidemia by blood culture often takes more than 24 hours.For certain species, such as C glabrata, the time to positive culture can be even longer.[56][57][58][59][60]”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [57]
Candida glabrata can take longer to grow in blood culture than other Candida species.
“Because growth can take even longer for C glabrata,10 more early infections may have been classified as late infections.”
From Comparison of costs, length of stay, and mortality associated with Candida glabrata and Candida albicans bloodstream infections (2010) · cites this paper as [10]
The average time for a positive blood culture across sites of infection has been reported to be 33.9 ± 3 hours.
“However, the average time for a positive culture across sites of infection has been reported to be 33.9 ± 3 hours, within our 2-day window.10”
From Comparison of costs, length of stay, and mortality associated with Candida glabrata and Candida albicans bloodstream infections (2010) · cites this paper as [10]
Because Candida glabrata can take longer to grow in culture, more early C glabrata infections may have been classified as late infections.
“Because growth can take even longer for C glabrata,10 more early infections may have been classified as late infections.”
From Comparison of costs, length of stay, and mortality associated with Candida glabrata and Candida albicans bloodstream infections (2010) · cites this paper as [10]
Peripheral blood time to positivity greater than 30 h is associated with a significantly lower likelihood of CVC infection; for the slow growing C. glabrata, a breakpoint of 48 h may be used.
“Peripheral blood time to positivity alone may also be of value, as a value greater than 30 h is associated with a significantly lower likelihood of CVC infection [100]. For the slow growing C. glabrata, a breakpoint of 48 h may be used [101].”
From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [100]
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Time to positivity as a diagnostic tool for catheter-related candidemia: A species-specific analysis
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Erratum to: An Italian consensus for invasive candidiasis management (ITALIC)
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Utility of time to positivity for diagnosis of bloodstream infection
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Fungal Infections in Cancer Patients
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- Authors
- Ben-Ami, R., Weinberger, M., Orni-Wasserlauff, R., Schwartz, D., Itzhaki, A., Lazarovitch, T., Bash, E., Aharoni, Y., Moroz, I., & Giladi, M.
- Affiliations
- Infectious Diseases Unit
- Tel Aviv University (IL)
- Tel Aviv Sourasky Medical Center (IL)
- Assaf Harofeh Medical Center (IL)
- Venue
- Journal of Clinical Microbiology
- Publisher
- American Society for Microbiology
- Published
- 2008-07
- Volume
- 46
- Issue
- 7
- Pages
- 2222-2226
- ISSN
- 0095-1137 (ISSN-L)
- 1098-660X
- PMC
- PMC2446879
- OpenAlex
- W2105581912
- Cited by
- 90
- References
- 18
- Citations by year
- 2026: 4 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 3 · 2016: 5 · 2015: 4 · 2014: 10 · 2013: 10 · 2012: 6
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Microbiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Keywords
- catheter-related candidemia, time to positivity, blood culture, candidemia, central venous catheters, nosocomial infections, infection source identification, diagnostic biomarkers, BacT/Alert
- MeSH terms
- Academic Medical Centers, Aged, Aged, 80 and over, Blood, Candida, Candidiasis, Catheters, Indwelling, Cross Infection, Female, Humans, Male, Middle Aged, Mycology, Prospective Studies, Sensitivity and Specificity, Time Factors, Fungemia
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