Catheter-related infections: does the spectrum of microbial causes change over time? A nationwide surveillance study

Abstract

ObjectivesTo estimate the incidence and epidemiology of catheter-related bloodstream infections (CRBSIs) on a national scale by using prospective epidemiological data from the Swiss Antibiotic Resistance Surveillance System (ANRESIS).DesignObservational study.SettingNational surveillance from 2008 to 2015 of acute hospitals in Switzerland.ParticipantsWe included acute Swiss hospitals that sent blood cultures and catheter tip culture results on a regular basis during the entire study period to the ANRESIS database.Outcome measureA catheter-related bloodstream infection (termed ‘modified CRBSI’, mCRBSI) was defined as isolating the same microorganism with identical antibiogram from ≥1 blood cultures (performed ±7 days around the catheter removal) as the one recovered from the catheter tip. Incidence rates of mCRBSI were calculated per 1000 admissions.ResultsFrom 2008 to 2015, the mCRBSI incidence rate decreased from 0.83 to 0.58 episodes/1000 admissions (−6% per year, p<0.001). Coagulase-negative staphylococci, Staphylococcus aureus and fungi all exhibited decreasing trends, while rates of enterococci and Gram-negative bacteria remained stable.ConclusionsThe overall incidence of mCRBSI in Switzerland is decreasing; however, the incidence of mCRBSI due to Enterococci and Gram-negative micro-organisms did not change over time. These pathogens may grow in importance in catheter-related infections, which would have clinical implications for the choice of empirical treatment.

Local signs at insertion site and catheter-related bloodstream infections: an observational post hoc analysis using individual data of four RCTs

“…In contrast, in the Safdar’s study, 87% of microorganisms identified were CoNS. In this context, and consistently with our findings, a change in the epidemiology of intravascular catheter infection toward lower prevalence of CoNS and increasing proportion of Gram-negative microorganisms has been documented in several recent studies [ 12 , 13 , 35 ]. In light of these considerations, the description of this cohort may probably better represent this issue.…”

“…Indeed, the use of intravascular catheter bundles has recently changed the landscape of the risk factors [ 11 ] and, probably, of the clinical predictors for intravascular catheter infections. Moreover, recent studies suggested that the epidemiology of intravascular catheter-related infections is changing [ 12 , 13 ]. To the best of our knowledge, there are no recent data on the role of exit-site signs with regards to intravascular catheter infections.…”

AFM-Based Correlative Microscopy Illuminates Human Pathogens

“…The inverse relationship between viability and adhesion for the two species in the context of the multi-species biofilm, and the shift from a single to multilayer biofilm for the mixed-species underscores the complexity of clinical biofilms, which must be considered when developing treatment options. Pathogen adhesion to abiotic surfaces such as catheters and other medical instruments is a major source of secondary infections in hospitals (Buetti et al, 2018). The adhesive forces of Caulobacter cresentus (Sprecher et al, 2017), E. coli, Streptococcus pyogenes (Potthoff et al, 2015), and variety of plant pathogens (Mittelviefhaus et al, 2019) to abiotic surfaces have been successfully probed using single-cell force spectroscopy (SCFS) and fluidic force microscopy (FluidFM) (Potthoff et al, 2015).…”

A New Antibiotic-Loaded Sol-Gel can Prevent Bacterial Intravenous Catheter-Related Infections

“…Classically, Gram-positive cocci-e.g., coagulase-negative staphylococci (CoNS) (mainly Staphylococcus epidermidis) (34.1%), enterococci (16%), and Staphylococcus aureus, 9.9%-are the most common, followed by Candida species (11.8%), and Gram-negative bacilli-Klebsiella, 5.8%; Enterobacter, 3.9%; Pseudomonas, 3.1%; Escherichia coli, 2.7%; Acinetobacter, 2.2%-and other bacteria (10.5%) [5]. However, the incidence of CoNS, S. aureus and yeasts decreased significantly over time, while Gram-negative bacilli and enterococci remained stable over time in terms of CRSBSI per 1000 admissions [6]. For all these organisms, biofilm development on the surface of indwelling catheters is central to the pathogenesis of this infection [7].…”