David R. Snydman, MD; Robin Ruthazer, MPH
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Snydman D., Ruthazer R.; Blood Cultures Drawn from Indwelling Central Venous Catheters. Ann Intern Med. 2000;132:922. doi: 10.7326/0003-4819-132-11-200006060-00017
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Published: Ann Intern Med. 2000;132(11):922.
We appreciate Dr. Johnson's interest in our study. We agree that all positive blood cultures require clinical interpretation and concur that blood cultures drawn peripherally and those drawn from a catheter need such interpretation. We have provided a conservative interpretation based on the lower boundary of the 95% CI for the two methods.
Dr. Johnson makes an interesting point about the omission of the predictive value for discordant results. In response to his request we provide these results, but we believe that these results do not indicate a need to obtain a peripheral sample after obtaining a catheter sample. The positive predictive values (probability of an infection) given the following catheter/peripheral results are as follows: catheter-positive/peripheral-positive, 100%; catheter-positive/peripheral-negative, 29%; catheter-negative/peripheral-positive, 28%; and catheter-negative/peripheral-negative, 0%. The negative predictive values (probability of no infection) are as follows: catheter-positive/peripheral-positive, 0%; catheter-positive/peripheral-negative, 71%; catheter-negative/peripheral-positive, 72%; and catheter-negative/peripheral-negative, 100%.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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