Positive Catheter Tip Culture Without Bloodstream Infection — To Treat or Not to Treat?

Central venous catheter tips are often colonized with pathogenic organisms that may cause bloodstream infection (BSI). After a catheter is removed for suspected infection, a positive tip culture often tempts the clinician to start antimicrobial treatment — even if simultaneously drawn blood cultures do not yield the same pathogen. Is this practice beneficial? Researchers in France retrospectively analyzed a cohort of 427 critically ill patients without BSI but with potentially pathogenic microorganisms isolated from removed intravascular catheters. In all, 150 patients who received active antimicrobial treatment against the isolated pathogen within 48 hours were matched to 150 patients without this early treatment (37% of the latter group e…