Prevention of Central-Line Associated Bloodstream Infections

Selby, Laura; Rupp, Mark E.; Cawcutt, Kelly

doi:10.1016/j.idc.2021.07.004

Cited by 26 publications

(26 citation statements)

References 76 publications

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“…This may also represent an increased likelihood of hospital-acquired pneumonia and bloodstream infections in the hospitals surveyed in the present study. This could allow for improvement since implementation of infection control measures through application of specific bundles of care could lead to reduced rates of pneumonia and bloodstream infections [ 23 , 24 ]. Notably, in a previous Greek study, lower respiratory tract infections were the most common HAIs, followed by bloodstream infections, which is in line with the findings of the present study [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

A Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Public Acute Care Hospitals in Crete, Greece

et al. 2022

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Background: Both healthcare-associated infections (HAIs) and antimicrobial resistance are associated with an increased length of stay and hospital costs, while they have also been linked to high morbidity and mortality rates. In 2016 and 2017, the latest point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals highlighted an HAI prevalence of 6.5%, while Greece had a higher HAI prevalence of 10%. The aim of this PPS was to record the prevalence of HAIs and antimicrobial use in all eight public acute care hospitals in Crete, Greece during the COVID-19 pandemic in order to highlight the types of infections and antimicrobial practices that need to be prioritized for infection control initiatives. Methods: The PPS was conducted between 30 March and 15 April 2022, according to the ECDC standardized relevant protocol (version 5.3). Statistics were extracted using the ECDC Helics.Win.Net application (software version 4.1.0). Results: A total of 1188 patients were included. The overall point prevalence of patients with at least one HAI was 10.6%. The most frequent types of infections were pneumonia (34.3%), bloodstream infections (10.5%), systemic infections and urinary tract infections (10.5% and 9.1%, respectively). In 14 (12.4%) cases, the pathogen responsible for HAI was SARS-CoV-2 following onsite spread, accounting for almost 10% of all HAIs. Microorganisms were identified in 60.1% of HAIs. Antimicrobials were administered in 711 (59.8%) patients, with 1.59 antimicrobials used per patient. Conclusion: The prevalence of HAI and antimicrobial use among hospitalized patients in Crete, Greece was similar to the national HAI prevalence in 2016 despite the enormous pressure on public hospitals due to the COVID-19 pandemic. Nevertheless, both HAI prevalence and antimicrobial use remain high, underlining the need to implement adequate infection control and antimicrobial stewardship interventions.

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Section: Discussionmentioning

confidence: 99%

A Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Public Acute Care Hospitals in Crete, Greece

et al. 2022

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“…Regarding the etiology, gram-positive bacteria are the most common causative agents (especially coagulase-negative Staphylococci). However, it may also be variable depending on the type of catheter or the patient’s comorbidities, i.e., hemodialysis catheters are more frequently associated with gram-negative bacilli and peripheral catheters to S. aureus [ 55 ].…”

Section: Biofilm and Device-related Infectionsmentioning

confidence: 99%

“…This colonization can occur within the first 24 h after insertion (extraluminal) and up to 7–14 days (intraluminal). Once the biofilm is established, it can be identified within 48 to 72 h, so at this moment, the effectiveness of the immune system’s phagocytes and complement system decreases, and antibiotic susceptibility decreases around 1000-fold, causing further difficulty in eradication [ 55 ].…”

Section: Biofilm and Device-related Infectionsmentioning

confidence: 99%

The Current Knowledge on the Pathogenesis of Tissue and Medical Device-Related Biofilm Infections

2022

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Biofilm is the trigger for the majority of infections caused by the ability of microorganisms to adhere to tissues and medical devices. Microbial cells embedded in the biofilm matrix are highly tolerant to antimicrobials and escape the host immune system. Thus, the refractory nature of biofilm-related infections (BRIs) still represents a great challenge for physicians and is a serious health threat worldwide. Despite its importance, the microbiological diagnosis of a BRI is still difficult and not routinely assessed in clinical microbiology. Moreover, biofilm bacteria are up to 100–1000 times less susceptible to antibiotics than their planktonic counterpart. Consequently, conventional antibiograms might not be representative of the bacterial drug susceptibility in vivo. The timely recognition of a BRI is a crucial step to directing the most appropriate biofilm-targeted antimicrobial strategy.

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“…Bloodstream infection (BSI) is a serious clinical condition that affected 8.3% of intensive care unit (ICU) patients in 2017 with 37% of the cases being catheter-related [ 1 ]. Although recent official data are missing, several studies suggest that during the COVID-19 pandemic the incidence of catheter-related bloodstream infections (CRBSIs) increased [ 2 , 3 ]. Most CRBSIs are monomicrobial with only one etiological agent identified.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance and Biofilms Underlying Catheter-Related Bloodstream Coinfection by Enterobacter cloacae Complex and Candida parapsilosis

et al. 2022

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Biofilm-associated infections are a public health concern especially in the context of healthcare-associated infections such as catheter-related bloodstream infections (CRBSIs). We evaluated the biofilm formation and antimicrobials resistance (AMR) of Enterobacter cloacae complex and Candida parapsilosis co-isolated from a CRBSI patient. Antimicrobial susceptibility of central venous catheters (CVCs) and hemoculture (HC) isolates was evaluated, including whole genome sequencing (WGS) resistome analysis and evaluation of gene expression to obtain insight into their AMR determinants. Crystal violet assay was used to assess dual biofilm biomass and microscopy was used to elucidate a microorganism’s distribution within biofilms assembled on different materials. Bacteria were multidrug-resistant including resistance to colistin and beta-lactams, likely linked to the mcr-9-like phosphoethanolamine transferase and to an ACT family cephalosporin-hydrolyzing class C beta-lactamase, respectively. The R398I and Y132F mutations in the ERG11 gene and its differential expression might account for C. parapsilosis resistance to fluconazole. The phenotype of dual biofilms assembled on glass, polystyrene and polyurethane depends on the material and how biofilms were initiated by one or both pathogens. Biofilms assembled on polyurethane were denser and richer in the extracellular polymeric matrix, and microorganisms were differently distributed on the inner/outer surface of the CVC.

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Prevention of Central-Line Associated Bloodstream Infections

Cited by 26 publications

References 76 publications

A Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Public Acute Care Hospitals in Crete, Greece

A Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Public Acute Care Hospitals in Crete, Greece

The Current Knowledge on the Pathogenesis of Tissue and Medical Device-Related Biofilm Infections

Antimicrobial Resistance and Biofilms Underlying Catheter-Related Bloodstream Coinfection by Enterobacter cloacae Complex and Candida parapsilosis

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