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Crbsi definition

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"catheter-related bloodstream infection"

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CDC catheter-related bloodstream infection definition CRBSI

CRBSI means catheter-related bloodstream infection.
It is a bloodstream infection in which a vascular catheter is proven to be the source, based on specific microbiological testing, such as:
  • Positive culture of the catheter tip with the same organism as blood cultures
  • Quantitative blood cultures showing a higher colony count from the catheter sample
  • Differential time to positivity, where a blood culture drawn through the catheter becomes positive at least 2 hours before a simultaneously drawn peripheral culture
Other sources of bloodstream infection must be excluded. CRBSI is a clinical diagnostic term, unlike CLABSI, which is primarily a surveillance definition. The CDC terminology guidance makes this distinction.
Current Surgical Therapy 14e, section “CRBSI and CLABSI,” lines 473-475.

List the diagnostic criteria for CRBSI

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"catheter-related bloodstream infection" diagnosis

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IDSA 2009 CRBSI diagnostic criteria quantitative blood cultures differential time positivity catheter tip culture

Diagnostic criteria for definite CRBSI

A patient should have a compatible bloodstream infection, with no other identifiable source, plus one of the following microbiological criteria:
  1. Catheter-tip culture criterion
    • The same organism is isolated from at least one peripheral blood culture and from the removed catheter tip culture.
    • A semiquantitative catheter-tip culture of >15 CFU supports catheter colonization/infection.
  2. Paired quantitative blood-culture criterion
    • Simultaneously collected cultures from the catheter and a peripheral vein grow the same organism, with the catheter-drawn sample having a ≥3:1 colony-count ratio compared with the peripheral sample.
  3. Differential time to positivity (DTP)
    • Simultaneously drawn catheter and peripheral blood cultures grow the same organism, but the catheter sample becomes positive at least 2 hours earlier than the peripheral sample.
  4. When peripheral culture or catheter-tip culture cannot be obtained
    • Quantitative blood cultures from two different catheter lumens may support suspected CRBSI if there is a ≥3-fold difference in colony count between lumens.
CRBSI is a clinical diagnosis requiring microbiological evidence that the catheter is the source. It is distinct from CLABSI, which is a surveillance definition. See the CDC distinction between CRBSI and CLABSI.
Current Surgical Therapy 14e, “Diagnosis,” lines 511-520.
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