Indwelling pleural catheter infection

Background

• Infections complication about about 5% of indwelling pleural catheters (e.g. PleurX catheters)

Microbiology

• Most commonly Staphylococcus aureus, followed by coagulase-negative staphylococci, culture-negative, and a number of other gram-positive and gram-negative organisms

Clinical Manifestations

• Spectrum of infections includes:
  • Cellulitis
  • Exit site infection
  • Tunnel tract infection
  • Pleural space infection
• The catheters can also become colonized, with positive bacterial cultures with no signs of infection

Diagnosis

• Primarily a clinical diagnosis, in conjunction with pleural fluid culture
• However, indwelling catheters may be colonized so a positive culture itself does not on its own confirm infection without clinical signs and symptoms