Commonly used clinical definitions of intravascular catheter-related infections

Infection	Definition
Catheter colonization	Significant growth of ≥1 micro-organism in a quantitative or semiquantitative culture of the catheter tip, subcutaneous catheter segment, or catheter hub.
Phlebitis	Induration or erythema, warmth, and pain or tenderness along the tract of a catheterized or recently catheterized vein.
Exit site infection
Microbiologic	Exudate at catheter exit site yields a micro-organism with or without concomitant bloodstream infection.
Clinical	Erythema, induration, and/or tenderness within 2 cm of the catheter exit site; may be associated with other signs and symptoms of infection, such as fever or purulent drainage emerging from the exit site, with or without concomitant bloodstream infection*.
Tunnel infection	Tenderness, erythema, and/or induration >2 cm from the catheter exit site, along the subcutaneous tract of a tunneled catheter (eg, Hickman or Broviac catheter), with or without concomitant bloodstream infection*.
Pocket infection	Infected fluid in the subcutaneous pocket of a totally implanted intravascular device; often associated with tenderness, erythema, and/or induration over the pocket; spontaneous rupture and drainage, or necrosis of the overlying skin, with or without concomitant bloodstream infection*.
Bloodstream infection
Catheter related	Bacteremia or fungemia in a patient who has an intravascular device and >1 positive blood culture result obtained from the peripheral vein, clinical manifestations of infection (eg, fever, chills, and/or hypotension), and no apparent alternative source for bloodstream infection (with the exception of the catheter).
Infusate related	Concordant growth of a micro-organism from infusate and cultures of percutaneously obtained blood cultures with no other identifiable source of infection.

NOTE: Adapted in part from Pearson^[1].

CFU: colony forming units.
* For surveillance purposes, patients with positive results of blood culture would be classified as having central line-associated bloodstream infection.

Reference:

Pearson ML. Guideline for prevention of intravascular device-related infections. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1996; 17:438-73.

Modified with permission from: Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 49:1.

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Commonly used clinical definitions of intravascular catheter-related infections