Line Colonization

Blood culture from line positive, but peripheral cultures negative

If the blood culture from the line is positive for coagulase negative Staph, viridans Streptococci, or Coryneform bacilli WITHOUT symptoms consider contamination or colonization and repeat cultures

If patient has symptoms/signs consistent with line infection, or fever/rigors with use of the line, treat as for a line infection especially if positive for a gram negative bacillus, Candida, or S. aureus

Patients with colonized lines are at risk of developing true CRBSI and should be closely monitored with low threshold for repeat cultures, especially if the organism is S. aureus, in which case line removal and one week of antimicrobials is often used

In general the safest treatment is line removal, but Antimicrobial Lock Therapy can be tried if catheter retention desired and the organism is coagulase negative Staph or a GNB

Discuss uncertainties with Infectious Diseases