Density of Microbial Colonization on External and Internal Surfaces of Concurrently Placed Intravascular Devices

Abstract

Background Intravascular devices provide essential vascular access for management of critically ill patients but can be associated with bloodstream infections. Objectives To determine colonization rates in segments of concurrently placed peripheral arterial, nontunnelled short-term central venous catheters and peripherally inserted central catheters and the pattern of heaviest colonization when the catheters are removed. Methods A prospective study was conducted on inpatients with intravascular devices in place for 9 days or more. At removal, each catheter was cut into 3 segments, and each segment was cultured separately. The density of colonization on external and internal surfaces of each segment was compared by estimating odds ratios by repeated-measures ordinal logistic regression. Results A total of 48 peripheral arterial, 135 central venous, and 106 peripherally inserted central catheters were obtained from 289 patients. Colonization was greatest at the proximal external segment of all catheters. On the external surface, colonization was lower on the middle (odds ratio, 0.70; P < .001) and distal (odds ratio, 0.56; P < .001) segments than on the proximal segments. On the internal surface, colonization was lower on the proximal (odds ratio, 0.39; P < .001), middle (odds ratio, 0.30; P < .001), and distal (odds ratio, 0.31; P < .001) segments than on the external proximal segments. This trend was similar for all catheter types. Conclusion Colonization of intravascular devices was heaviest on proximal segments.

A survey of the use of arterial catheters in anesthetized dogs and cats: 267 cases

“…No redness at the catheter site, other than bruising, that would indicate local infection was identified in the postoperative observations or in the medical records. Bacterial colonization has been described on the internal and external surfaces of the arterial catheters inserted in human patients, with colonization greatest at the proximal end nearest to the skin . Arterial catheters have been reported to be at a lower risk for colonization than central venous catheters in some investigations but not in others .…”

Prevention and Control of Infection Related to Peripheral Arterial Catheter Management

“…PAC insertion 17,20,21,24,26,[35][36][37]40,42,48,50,[55][56][57][58][59][60][61][62][63][64] : Insertion site. PAC circuit.…”

Diagnostic accuracy of semi-quantitative and quantitative culture techniques for the diagnosis of catheter-related infections in newborns and molecular typing of isolated microorganisms

“…Contamination of the external catheter surface has been reported as the main route of infection of short-term catheters, whereas intraluminal contamination is an important route of infection in long-term catheterization [ 18 ]. In addition, the density of colonizing bacteria is higher on the external than on the internal surface of the catheter [ 6 , 19 ].…”