. 2009 May 15:1003–1069. doi: 10.1016/B978-032304841-5.50053-4

Table 51-8.

Proposed Definitions for Intravascular Device-Related (IVDR) Colonization, Local Infection, and Bloodstream Infection (BSI) Based on Microbiologic Confirmation of the IVD as the Source

IVD colonization	(i) A positive semiquantitative^* (or quantitative^†) culture of the implanted portion or portions of the IVD; (ii) absence of signs of local or systemic infection.
Local IVD infection	(i) A positive semiquantitative^* (or quantitative^†) culture of the removed IVD or a positive microscopic examination or culture of pus or thrombus from the cannulated vessel; (ii) clinical evidence of infection of the insertion site (i.e., erythema, induration or purulence); but (iii) absence of systemic signs of infection and negative blood cultures, if done.
IVDR BSI	If the IVD is removed: (i) A positive semiquantitative^* (or quantitative^†) culture of the IVD or a positive culture of the catheter hub or infusate (or positive microscopic examination or culture of pus or thrombus from the cannulated vessel) and one or more positive blood cultures, ideally percutaneously drawn, concordant for the same species, ideally by molecular subtyping methods; (ii) clinical and microbiologic data disclose no other clear-cut source for the BSI. If the IVD is retained: (i) If quantitative blood cultures are available, cultures drawn both from the suspect IVD and a peripheral vein (or another IVD) are both positive and show a marked step-up in quantitative positivity (≥fivefold) in the IVD-drawn culture; (ii) clinical and microbiologic data disclose no other clear-cut source for the BSI. or (i) If automated monitoring of incubating blood cultures is available, blood cultures drawn concomitantly from the suspect IVD and a peripheral vein (or another IVD) show both are positive, but the IVD-drawn blood culture turns positive more than 2 hr before the peripherally drawn culture; (ii) clinical and microbiologic data disclose no other clear-cut source for the BSI.

Roll plate of cannula segment(s) >15 colony-forming units (CFUs).

^†

Sonication culture of cannula segment(s) ≥103CFUs.

Modified from Crnich CJ, Maki DG: The role of intravascular devices in sepsis. Curr Infect Dis Rep 2001;3:497-506.