Comparison of diagnostic specimens and methods to evaluate infected venous access ports

: Implanted venous access port infection can be difficult to diagnose and treat. If device removal is necessary, confirming port infection is problematic. : Culture specimens from three sites, catheter tip (Tip), port pocket, and the material within the reservoir (inside), were sent from ports removed for potential infection. The results of these cultures were compared to preremoval peripheral and central blood cultures. : Forty-five ports were removed for suspected infection. Confirmed port infection was defined as positive culture(s) from one or more experimental specimen(s). In 29 evaluable cases, the inside specimens were completely predictive. Tip specimens were less accurate, even with a lower diagnostic threshold. In 7 of 19 confirmed infections, only the inside culture was diagnostic. : The most predictive culture specimen in a potentially infected port is the thrombotic material inside the reservoir.