Molecular Comparison of Bacterial Communities on Peripheral Intravenous Catheters and Matched Skin Swabs

Abstract

Skin bacteria at peripheral intravenous catheter (PIVC) insertion sites pose a serious risk of microbial migration and subsequent colonisation of PIVCs, and the development of catheter related bloodstream infections (CRBSIs). Common skin bacteria are often associated with CRBSIs, therefore the bacterial communities at PIVC skin sites are likely to have major implications for PIVC colonisation. This study aimed to determine the bacterial community structures on skin at PIVC insertion sites and to compare the diversity with associated PIVCs. A total of 10 PIVC skin site swabs and matching PIVC tips were collected by a research nurse from 10 hospitalised medical/surgical patients at catheter removal. All swabs and PIVCs underwent traditional culture and high-throughput sequencing. The bacterial communities on PIVC skin swabs and matching PIVCs were diverse and significantly associated (correlation coefficient = 0.7, p<0.001). Methylobacterium spp. was the dominant genus in all PIVC tip samples, but not so for skin swabs. Sixty-one percent of all reads from the PIVC tips and 36% of all reads from the skin swabs belonged to this genus. Staphylococcus spp., (26%), Pseudomonas spp., (10%) and Acinetobacter spp. (10%) were detected from skin swabs but not from PIVC tips. Most skin associated bacteria commonly associated with CRBSIs were observed on skin sites, but not on PIVCs. Diverse bacterial communities were observed at skin sites despite skin decolonization at PIVC insertion. The positive association of skin and PIVC tip communities provides further evidence that skin is a major source of PIVC colonisation via bacterial migration but microbes present may be different to those traditionally identified via culture methods. The results provide new insights into the colonisation of catheters and potential pathogenesis of bacteria associated with CRBSI, and may assist in developing new strategies designed to reduce the risk of CRBSI.

Short Peripheral Venous Catheters Contamination and the Dangers of Bloodstream Infection in Portugal: An Analytic Study

“…These medical devices provide a surface area to which microorganisms can attach [ 23 ]. The most common microorganisms involved are Staphylococcus species, namely coagulase-negative staphylococci (CoNS), predominantly S. epidermidis and S. aureus [ 21 , 22 , 23 , 26 , 27 , 28 , 29 ]. Although these are commensal human skin bacteria and are considered non-pathogenic, they have been recognized as relevant opportunistic pathogens [ 22 , 27 , 29 ].…”

“…The most common microorganisms involved are Staphylococcus species, namely coagulase-negative staphylococci (CoNS), predominantly S. epidermidis and S. aureus [ 21 , 22 , 23 , 26 , 27 , 28 , 29 ]. Although these are commensal human skin bacteria and are considered non-pathogenic, they have been recognized as relevant opportunistic pathogens [ 22 , 27 , 29 ]. Other microorganisms have been identified as the Gram-negative bacilli, Enterococcus spp., and fungi, such as Candida species [ 21 , 22 , 26 , 27 ].…”

“…Although these are commensal human skin bacteria and are considered non-pathogenic, they have been recognized as relevant opportunistic pathogens [ 22 , 27 , 29 ]. Other microorganisms have been identified as the Gram-negative bacilli, Enterococcus spp., and fungi, such as Candida species [ 21 , 22 , 26 , 27 ]. Some of these microorganisms are associated with hospital-acquired infections through cross-contamination between health professionals/medical devices and the patients, mainly due to the incorrect disinfection technique of the catheter insertion site, poor hand hygiene practices, and inefficient device maintenance [ 19 , 24 , 27 , 30 ].…”

Catheter tips are a possible resource for biological study on catheter failure

“…With this new evaluation method, it would become possible to evaluate changes that are difficult to detect on the skin, and it may be possible to elucidate the causes of CF in detail and to evaluate the differences between varying devices and placement depths. Many studies have evaluated the status of catheter infection (16)(17)(18)(19). For example, reports on the estimation of the infection route have been made by analyzing bacterial flora using next generation sequencing for the collected catheter (16).…”

“…Many studies have evaluated the status of catheter infection (16)(17)(18)(19). For example, reports on the estimation of the infection route have been made by analyzing bacterial flora using next generation sequencing for the collected catheter (16). However, few studies have focused on the tissues and cells in the vicinity where the catheter is inserted.…”