Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Mar 9, 2024; 13(1): 89085
Published online Mar 9, 2024. doi: 10.5492/wjccm.v13.i1.89085
Adding vortexing to the Maki technique provides no benefit for the diagnosis of catheter colonization or catheter-related bacteremia
Leonardo Lorente, Maria Lecuona Fernandez, Adriana González-Mesa, Judith Oliveras-Roura, Cristina Rosado, Pablo Cabrera, Emma Casal, Alejandro Jiménez, María Luisa Mora, Ana Madueño
Leonardo Lorente, Adriana González-Mesa, Judith Oliveras-Roura, Cristina Rosado, Pablo Cabrera, María Luisa Mora, Intensive Care Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain
Maria Lecuona Fernandez, Emma Casal, Ana Madueño, Microbiology and Infection Control Service, Hospital Universitario de Canarias, La Laguna 38320, Spain
Alejandro Jiménez, Research Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain
Author contributions: Lorente L conceived, designed and coordinated the study, participated in acquisition and interpretation of data, and drafted the manuscript; Lecuona M, González-Mesa, Oliveras-Roura J, Rosado C, Cabrera P, Casal E, Mora ML and Madueño A participated in acquisition of data; Jiménez A participated in the interpretation of data; all authors revised the manuscript critically for important intellectual content, made the final approval of the version to be published and were agreed to be accountable for all aspects of the work.
Institutional review board statement: The Institutional Board of Hospital Universitario de Canarias (San Cristóbal de La Laguna) approved the study protocol.
Clinical trial registration statement: This study is registered at https://www.clinicaltrials.gov/. The registration identification number is NCT06216184.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Data sharing statement: The datasets generated during the current study are available from the corresponding author on reasonable request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Leonardo Lorente, MD, PhD, Medical Assistant, Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n, La Laguna 38320, Spain. lorentemartin@msn.com
Received: October 20, 2023
Peer-review started: October 20, 2023
First decision: December 28, 2023
Revised: January 12, 2024
Accepted: February 21, 2024
Article in press: February 21, 2024
Published online: March 9, 2024
ARTICLE HIGHLIGHTS
Research background

A previous study compared the vortexing and the Maki techniques for the diagnosis of catheter-related bloodstream infection (CRBSI), and concluded that vortexing was not superior to the Maki method.

Research motivation

The above study did not compare the combined use of vortexing and Maki with respect to the Maki technique alone for the diagnosis of catheter tip colonization (CTC) and CRBSI.

Research objectives

To determine whether the combined use of vortexing and Maki techniques provide profitability to the Maki technique alone for the diagnosis of CTC and CRBSI.

Research methods

Observational and prospective study. We included patients admited in one Intensive Care Unit that had suspicion of catheter-related infection (CRI) and with one central venous catheter for at least 7 d. The area under the curve (AUC) of the Maki technique, the vortexing technique and the combination of both techniques for the diagnosis of CTC and CRBSI were compared.

Research results

We included 136 episodes of suspected CRI. We found 21 episodes of CTC and 10 episodes of CRBSI. Of the 21 episodes of CTC, 18 (85.7%) were diagnosed by the techniques of Maki and vortexing, 3 (14.3%) were diagnosed only by the technique of Maki, and none was diagnosed only by the technique of vortexing. Of the 10 episodes of CRBSI, 9 (90.0%) were diagnosed by the techniques of Maki and vortexing, 1 (10.0%) was diagnosed by the technique of Maki alone, and none only by the technique of vortexing. No differences had found in the comparison of AUC between the technique of Maki alone and the combination of techniques for the diagnosis of CTC (P = 0.99) and CRBSI (P = 0.99).

Research conclusions

The novel finding of our study was that the use combined of vortexing and Maki techniques did not provide profitability to the technique of Maki alone to CRBSI.

Research perspectives

To study other quantitative techniques (as flushing) to compare the profitability of all of them for the diagnosis of CTC and CRBSI.