Biofilms on indwelling vascular catheters

Passerini, Louise; Lam, Kei Fong; Costerton, J. W.; King, Elizabeth G.

doi:10.1097/00003246-199205000-00020

Cited by 154 publications

(79 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The intraluminal presence of the biofilm is the reason for bacteremia, and the antibiotic levels around the biofilm are negligible with the use of systemic antibiotics alone. Scanning electron microscopic studies demonstrated the formation of biofilms on external and internal surfaces of indwelling catheters within 24 h after placement (1,2). The key to the success of the ABL is their ability to reach 100-to 1000-fold higher than minimal inhibitory concentration intraluminally in the vicinity of the biofilm (4 -6).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Early versus Late Use of Antibiotic Locks in the Treatment of Catheter-Related Bacteremia

Onder¹,

Chandar²,

Billings³

et al. 2008

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…Biofilms that harbor microorganisms are demonstrated on external and internal surfaces of the indwelling catheters within as early as 24 h after their placement (1,2). The fibrinousproteinous ultrastructure of the biofilm gives both protection and antimicrobial resistance to the microorganisms.…”

mentioning

confidence: 99%

Comparison of Early versus Late Use of Antibiotic Locks in the Treatment of Catheter-Related Bacteremia

Onder¹,

Chandar²,

Billings³

et al. 2008

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

“…13 The pathogenesis of CVC colonization involves formation of a bacterial biofilm on the catheter surface. 14,15 Embedded biofilm bacteria are less metabolically active because of a lack of accessibility to essential nutrients and/or an inadequate dis-charge of metabolic waste products. These bacteria are also less permeable to antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Central venous catheter exchange by guidewire for treatment of catheter-related bacteraemia in patients undergoing BMT or intensive chemotherapy

Martínez

Rovira

Martínez

et al. 1998

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Current guidelines for the treatment of catheter-related bacteraemia (CRB) advise against central venous catheter (CVC) exchange because of the potential risk of prolonging infection. However, there are no consistent data proving this recommendation. We evaluated prospectively the usefulness of CVC exchange by guidewire for the treatment of CRB in patients undergoing BMT or intensive chemotherapy. CVC exchange was considered when fever and positive blood cultures persisted after 2 days of adequate antimicrobial therapy and no potential source of bacteraemia other than CVC could be identified. The guidewire exchange was preceded and followed by a slow infusion of adequate antimicrobial therapy. Bacteraemia was confirmed as catheter-related by demonstrating concordance between isolates from the tip and blood cultures by pulsed-field electrophoresis of genomic DNA. This procedure was performed in 19 episodes of bacteraemia during a 1-year period. Fourteen episodes (74%) were catheter-related and 71% of these were due to coagulase-negative staphylococci. Guidewire replacement was accomplished uneventfully 4 days after development of sepsis (range 3-6). In all cases, clinical signs of sepsis disappeared in less than 24 h after replacement. Definitive catheter withdrawal was carried out a median of 16 days (range 3-42) after guidewire exchange; in all cases, the tip culture was negative. We conclude that CVC replacement by guidewire under adequate antimicrobial therapy may be a reasonable option for the treatment of CRB when antimicrobial therapy alone has been unsuccessful. Keywords: catheter-related bacteraemia; infections treatment; catheter exchange Bacteraemia is the most frequent life-threatening complication of central venous catheters (CVC). 1 Catheter removal is usually required for the diagnosis and the treatment of catheter-related bacteraemia (CRB). Nevertheless, the catheter may not be the source of infection in as many as three out of four suspected cases of CRB. 2 CVC exchange by guidewire is currently accepted in the management of suspected CRB, although the catheter should be relocated to a new site if the tip culture confirms the diagnosis of CRB. [3][4][5][6] This recomendation is based on several studies 7-9 reporting anecdotal cases of immediate tip contamination of the guidewire-inserted catheter. However, in BMT patients and other high-risk patients with thrombocytopenia, this policy constitutes a potential risk for haemorrhage. We hypothesized that, as it occurs in replacement surgery of infected prosthetic devices, adherence of microorganisms and subsequent biofilm formation on the CVC exchanged by guidewire would be unlikely if a high concentration of an appropriate antibiotic were present on the surface of the catheter at the time or shortly after the arrival of the pathogen and were maintained for a critical span of time.To evaluate the safety and efficacy of CVC exchange by guidewire after unsuccesful antimicrobial therapy in patients undergoing BMT or intensive chemotherapy with a...

show abstract

“…The most common occurrence is through the migration of skin organisms along the external surface of the catheter from the exit site wound or via the catheter lumen due to breakdown of aseptic technique. The organism can be embedded in a biofilm layer that confers protection from antibiotic therapy (Passerini et al 1992 Table 6. Catheter locking solutions for prophylaxis against catheter-related bacteremia (CRB)…”

Section: Catheter-related Bacteremiamentioning

confidence: 99%