The Role of Biofilm in Central Venous Catheter Related Bloodstream Infections: Evidence-based Nursing and Review of the Literature

Abstract

Background: Biofilm is a fundamental component in the pathogenesis of infections related to the use of the central venous catheter (CVC,) which can represent an important health issue in everyday practice of nursing and medical staff. Objective: The objective of the following review is to analyze the components of biofilm and their role in catheter-related infection determinism in an evidencebased nursing perspective in such a way as to give health professionals useful suggestions in the prevention and management of these complications. Methods: The following databases were consulted for the bibliographic search: Medline, Scopus, Science Direct. Biofilm can be the cause of CVC extraction and can lead to serious haematogenic infectious complications that can increase the morbidity and mortality of affected patients. Results: Updated pathophysiologic knowledge of biofilm formation and appropriate diagnostic methodology are pivotal in understanding and detecting CVC-related infections. Lock therapy appears to be a useful, preventive, and therapeutic aid in the management of CVCrelated infections. New therapies attempting to stop bacterial adhesion on the materials used could represent new frontiers for the prevention of CVC-related infections. Conclusion: The correct evidence-based nursing methods, based on the use of guidelines, provides the opportunity to minimize the risks of infection through the implementation of a series of preventive measures both during the CVC positioning phase and in the subsequent phase, for example, during device management which is performed by medical and nursing staff.

Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients

“…Biofilm is a well-known and pivotal problem when dealing with infections due to contaminated CVCs as demonstrated in a recent review by Ielapi et al [15]. In fact, preventive measures during insertion and thereafter are crucial to prevent biofilm formation and bacterial colonization of the catheter.…”

“…In fact, preventive measures during insertion and thereafter are crucial to prevent biofilm formation and bacterial colonization of the catheter. These may include lock therapies or coated materials besides best nursing practices [15]. In order to address this topic in our definition, significant bacterial growth on the central line tip simultaneous to a positive blood culture and/or the difference in time to positivity between a central and peripheral blood culture of more than 2 hours was used in our study to support the thesis of the CVC being the actual origin of the infection [16].…”

Clinical characteristics of peripheral venous catheter-associated gram-negative bloodstream infection among patients with malignancy

“…Since biofilm typically forms within 10 days on the external surface of catheters [29], its formation likely promotes PVC-associated bloodstream infections. In fact, the most popular gram-negative organism in our study was Pseudomonas aeruginosa, an organism known for robust biofilm production [30,31]. Biofilms should therefore be considered in the pathogenesis of PVC-associated bloodstream infections, as has been well established for CVC-associated bloodstream infections, so that effective bundles can be designed and implemented for prevention.…”

Stuck fragment of totally implantable central venous access ports during removal: risk factor analysis in children

“…The diagnosis of CLABSI is based on clinical and laboratory criteria. Adequate treatment and even more importantly, effective prevention represent to reduce the incidence of CLABSI during the use of TICVAP [ 6 ].…”