Not a routine. If suspected for the source of infection or upon the request of infection committee

Not routinely. As the Mehmet Canturk said, only in those who have suspect or active infection. And in all patients with organ transplantation if remove catheters before discharging to the ward.

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Thanks Mehmet and Nikola for your input!

We also do not send them routinely. If we suspect an infection and in transplant or VAD patients.

Thanks for your reply,

I agree that routine cultures of CVC tips is not warranted except if infection is suspected or in the high risk patient, especially those who may have typical sepsis manifestation like immune deficiency or transplant on immune suppression.

As per CDC- Catheter tip cultures have been shown to have higher rates of contamination than blood cultures. Furthermore, not all laboratories are able to perform quantified catheter tip cultures. Catheter tips are a part of other types of non-NHSN surveillance such as catheter-related BSI (CRBSI) which is generally thought of as a clinical definition, used when diagnosing and treating patients.

https://academic.oup.com/cid/article/60/3/492/312676

I agree with you all to send it in immunocompromised patients, as far as I know this is clinical practice -do we have it in any guidelines or any RCT ?

We routinely do send tips for culture,and obviously of great importance in line related sepsis.

Whether or not we find more cases of sub clinical sepsis,and prevent more serious problems,I think we'd find impossible to say,but we do feel it worth doing.

That sounds great @Ian Ewart.

We are considering a similar approach in our Pediatric ICU, as a CLABSI QIP