Catheter impregnation, coating or bonding for reducing central venous catheter-related infections in adults

Lai, Nai Ming; Chaiyakunapruk, Nathorn; Lai, Nai An; O'Riordan, Elizabeth; Pau, Wilson Shu Cheng; Saint, Sanjay

doi:10.1002/14651858.cd007878.pub2

Cited by 70 publications

(85 citation statements)

References 135 publications

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“…For example, catheters coated with chlorhexidine-silversulfadiazine or minocycline-rifampin have reduced bacterial colonization and bloodstream infections (92). Catheters impregnated with amphotericin B are also effective against C. albicans biofilm infections in animal models and avoid the systemic toxicity of this compound (93).…”

Section: Biofilm-associated Infections Indwelling Catheter-associatedmentioning

confidence: 99%

Microbial Biofilms in Pulmonary and Critical Care Diseases

et al. 2016

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Microbial biofilms can colonize medical devices and human tissues, and their role in microbial pathogenesis is now well established. Not only are biofilms ubiquitous in natural and human-made environments, but they are also estimated to be associated with approximately twothirds of nosocomial infections. This multicellular aggregated form of microbial growth confers a remarkable resistance to killing by antimicrobials and host defenses, leading biofilms to cause a wide range of subacute or chronic infections that are difficult to eradicate. We have gained tremendous knowledge on the molecular, genetic, microbiological, and biophysical processes involved in biofilm formation. These insights now shape our understanding, diagnosis, and management of many infectious diseases and direct the development of novel antimicrobial therapies that target biofilms. Bacterial and fungal biofilms play an important role in a range of diseases in pulmonary and critical care medicine, most importantly catheter-associated infections, ventilator-associated pneumonia, chronic Pseudomonas aeruginosa infections in cystic fibrosis lung disease, and Aspergillus fumigatus pulmonary infections.

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Section: Biofilm-associated Infections Indwelling Catheter-associatedmentioning

confidence: 99%

Microbial Biofilms in Pulmonary and Critical Care Diseases

et al. 2016

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“…Two systematic reviews evaluating randomized controlled trials (RCTs) found an overall significant difference between antimicrobial‐impregnated and standard CVCs in the rates of catheter colonization and catheter‐related bloodstream infection (CRBI) (Lai et al . ; Wang et al . ).…”

Section: Discussionmentioning

confidence: 99%

In vitro activity of antimicrobial‐impregnated catheters against biofilms formed by KPC‐producing Klebsiella pneumoniae

et al. 2019

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Aim To evaluate the activity and effectiveness of impregnated central venous catheters (CVC) against Klebsiella pneumoniae biofilms. Methods and Results The antimicrobial activity and durability of impregnated‐CVCs were evaluated over time and the size of zones of inhibition (ZI) was measured. Biofilm formation was observed by quantitative culture and also by scanning electron microscopy. The catheters impregnated with chlorhexidine/silver sulfadiazine (CHX/SS) reduced bacteria counts by 0·3 log and were most effective (P < 0·01) against Klebsiella pneumoniae biofilms N‐acetylcysteine/levofloxacin (NAC/LEV) catheters. It was observed that the catheter impregnated with NAC/LEV had initially the largest average ZI size being statistically significant (P < 0·01). The NAC/LEV combination remained active until day 30, whereas the combination of CHX/SS was completely inactivated from day 15 on. Conclusions The NAC/LEV combination showed greater durability on the catheters, but it was the CHX/SS combination that had the greater initial efficacy in bacterial inhibition. It was also observed that NAC/LEV‐impregnated catheters do not prevent the emergence of resistant subpopulations inside the inhibition halos during antimicrobial susceptibility tests. Significance and Impact of the Study Our results highlighted that the in vitro efficacy of antimicrobial‐impregnated CVCs is limited by time and that their colonization occurred earlier than expected. Our data also demonstrated that NAC/LEV remained active until day 30 of evaluation and CHX/SS combination was completely inactivated from day 15 on. Our findings suggested that implantable devices should be carefully used by medical community.

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“…It is essential that studies of catheter‐related infection express results in events per 1000 catheter days. Because CRBSI significantly increases risk of mortality, especially in transplant and immunocompromised patients, it is also important that sepsis and mortality be included as key outcome measures whenever possible …”

Section: Failure Points and Essential Components Of Carementioning

confidence: 99%

Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children

Baskin

Mermel

Saad

et al. 2019

J Parenter Enteral Nutr

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Children with chronic illness often require prolonged or repeated venous access. They remain at high risk for venous catheter–related complications (high‐risk patients), which largely derive from elective decisions during catheter insertion and continuing care. These complications result in progressive loss of the venous capital (patent and compliant venous pathways) necessary for delivery of life‐preserving therapies. A nonstandardized, episodic, isolated approach to venous care in these high‐need, high‐cost patients is too often the norm, imposing a disproportionate burden on affected persons and escalating costs. This state‐of‐the‐art review identifies known failure points in the current systems of venous care, details the elements of an individualized plan of care, and emphasizes a patient‐centered, multidisciplinary, collaborative, and evidence‐based approach to care in these vulnerable populations. These guidelines are intended to enable every practitioner in every practice to deliver better care and better outcomes to these patients through awareness of critical issues, anticipatory attention to meaningful components of care, and appropriate consultation or referral when necessary.*

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Catheter impregnation, coating or bonding for reducing central venous catheter-related infections in adults

Cited by 70 publications

References 135 publications

Microbial Biofilms in Pulmonary and Critical Care Diseases

Microbial Biofilms in Pulmonary and Critical Care Diseases

In vitro activity of antimicrobial‐impregnated catheters against biofilms formed by KPC‐producing Klebsiella pneumoniae

Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children

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