SUPPLEMENTARY METHODS AND RESULTS Criteria for central venous catheter‐related bloodstream infections (CRBSI) The CDC‐criteria for laboratory‐confirmed bloodstream infection (BSI) are used. For recording a BSI related to a catheter the HAI‐Net (formerly HELICS/IPSE) criteria for CRI3 are used, with the extension of the possibility to diagnose a CRBSI based on the resolving of clinical symptoms. A BSI is defined as bacteraemia or fungaemia without other documented source and requires: 1. one positive blood culture with a recognized pathogen or 2. two positive blood cultures with a common skin contaminant (coagulase negative staphylococci, Micrococcus sp., Proprionibacterium acnes, Bacillus sp., Corynebacterium sp.) and clinical symptoms: fever (>38°C, chills, hypotension (<100 mm Hg). To record a CRBSI the following criteria should also be met: 1. There is a positive culture with the same micro‐organism of either a quantitative culture of the catheter (≥1000 cfu/ml) or a semi‐quantitative culture of the catheter (>15cu) positive for the same micro‐organism as found in the blood culture and the BSI is occurring within 48 hours before or after catheter removal or 2. A quantitative blood culture of a CVC blood sample yields 5 fold higher in numbers of cfu than a peripheral blood sample or 3. CVC blood sample culture positive 2 hours or more before peripheral blood culture (blood samples drawn at the same time) = differential time‐to‐positivity is ≥ 2 hours or 4. Clinical signs of infection resolve within 24 hours after CVC removal or subside within 48 hours after antibiotic therapy refractory before removal and the BSI is occurring within 48 hours before or after catheter removal or start of antibiotic therapy or 5. Culture of purulent discharge of the catheter insertion site is positive for the same micro‐ organism as found in the blood culture. There are several issues to consider when determining sameness of organisms. 1. If the common skin contaminant is identified to the species level from 1 culture, and a companion culture is identified with only a descriptive name (i.e., to the genus level), then it is assumed that the organisms are the same. The speciated organism should be reported as the infecting pathogen (Table M1). 2. If common skin contaminant organisms from the cultures are speciated but no antibiogrammes are done or they are done for only 1 of the isolates, it is assumed that the organisms are the same. 3. If the common skin contaminants from the cultures have antibiogrammes that are different for 2 or more antimicrobial agents, it is assumed that the organisms are not the same (Table M2).
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