Corrigendum to "sonicating multi-lumen sliced catheter tips after the roll-plate technique improves the detection of catheter colonization in adults" [J. Microbiol. Methods 122 (2016) 20-22].

The Maki technique is the standard method for detecting catheter tip (CT) colonization. However, some "multi-lumen" catheters finish in a vaulted fornix and end at different distances from the CT. Therefore, we compared the traditional Maki technique with the sonication method using several cross-cut fragments of the CT. Our objective was to assess the yield of the Maki technique followed by sonication in the detection of adult CT colonization and catheter-related bloodstream infection (C-RBSI). For 3months, we prospectively performed CT cultures of polyurethane catheters from adult patients admitted to our institution. First, we performed CT culture using the Maki technique on blood agar plates and then sonicated small fragments of CTs in 5ml of BHI followed by culture of 100µl of the sonicate. We included a total of 252 CVCs, with overall colonization and C-RBSI rates of 14.3% (36/252) and 5.9% (15/252). Of the 36 colonized CVCs, 21 (58.3%) were detected both by Maki and sonication, 6 (16.7%) were detected only by Maki technique, and 9 (25.0%) only by sonication method. Among 15 episodes with concomitant bacteremia, both techniques were positive and concordant in 11 cases (73.3%) and in 4 cases (26.7%) sonication was the only positive technique. Our study shows that both techniques are complementary. We recommend sonicating fragments of the CT from patients with bacteremia of unknown origin and a negative CT culture by the Maki technique.

Pre-emptive broad-spectrum treatment for ventilator-associated pneumonia in high-risk patients.

PURPOSE: Patients requiring mechanical ventilation (MV) for >48 h after major heart surgery (MHS) are at a high risk of acquiring ventilator-associated pneumonia (VAP) and tracheobronchitis (VAT). Most non-pharmacological interventions to prevent VAP in such patients are usually already implemented. The objective of this study was to evaluate the efficacy in preventing lower respiratory infections of antibiotics active against multidrug-resistant pathogens in this very high-risk population. METHODS: We performed a prospective randomized open-label study of MHS patients requiring MV for >48 h. Patients were randomly allocated to one of two groups: the intervention group, which received a 3-day course of linezolid and meropenem, and the control group, which received the standard of care. The main outcome was the development of VAP or VAT. RESULTS: Overall, of the 78 patients included in the study, 40 were in the intervention group and 38 in the control group. Both groups were comparable. Data for the intervention and control groups respectively were as follows: VAP + VAT/1,000 days was 31.79 vs 64.78 (p = 0.03), median length of MV before the first episode of VAP or VAT 9 vs 4.5 days (p = 0.02). No significant differences were observed in median length of stay in the intensive care unit, median length of hospital stay, antibiotic use, Clostridium difficile infection, and overall mortality rate. We detected linezolid-resistant coagulase-negative and coagulase-positive staphylococci in the MHS intensive care unit after the study period. CONCLUSIONS: A pre-emptive approach with broad-spectrum antibiotics may be effective in reducing the incidence and delaying the onset of VAP + VAT after MHS. The ecological consequences have to be carefully evaluated in future trials.