Differential time to positivity: Vascular catheter drawn cultures for the determination of catheter-related bloodstream infection
Bibliographic record
Abstract
BACKGROUND: Vascular access catheter-related infections are common. The purpose of this study was to evaluate the accuracy of differential time to positivity (DTP) comparing 2 blood cultures drawn through different lumens of a multi-lumen central venous catheter (CVC DTP) for the diagnosis of catheter-related bloodstream infection (CRBSI). METHODS: This study was performed at a single institution (Health Sciences Centre, Winnipeg, Manitoba, Canada). Microbiology laboratory blood culture records for the period January to November 2009 were retrospectively reviewed. All adult patients with a positive peripheral blood culture and a minimum of 2 positive central line cultures (same organism) drawn from separate lumens of a multi-lumen CVC, all obtained at the same time on the same day, were included in the study. DTP supporting CRBSI diagnosis was defined as a difference in time to positivity of ≥ 2 h between a peripheral blood culture and a CVC blood culture (peripheral DTP), or between 2 CVC blood cultures from different lumens of a multi-lumen catheter (CVC DTP). Peripheral DTP was used as the reference standard for CRBSI diagnosis. RESULTS: Thirty-five episodes of bacteremia from 33 patients were included in this study. CVC DTP had a sensitivity of 76.5% and a specificity of 88.9% for CRBSI diagnosis, using peripheral DTP as the reference standard. CONCLUSIONS: These data suggest that CVC DTP may be of benefit in the diagnosis of CRBSI. Further study is required to better define the patient population/catheter type for which CVC DTP would be of greatest benefit.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".