What is the evidence for intraluminal colonization of hemodialysis catheters?

Mermel, Leonard A.

doi:10.1038/ki.2013.527

Cited by 31 publications

(42 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, repeated exposure of microorganisms to such a lock solution would be predicted to have a cumulative effect. Exposure times may often be increased from what we have tested here (i.e, hemodialysis patients for 24 to 72 h [ 17 ], oncology patients for 24 h to 3 weeks [ 8 ], and total parenteral nutrition patients for 12 to 24 h [ 66 ]).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tetrasodium EDTA Is Effective at Eradicating Biofilms Formed by Clinically Relevant Microorganisms from Patients’ Central Venous Catheters

Liu¹,

Hansra²,

Crockford³

et al. 2018

mSphere

View full text Add to dashboard Cite

The colonization of catheters by microorganisms often precludes their long-term use, which can be a problem for human patients that have few body sites available for new catheters. The colonizing organisms often form biofilms, and increasingly these organisms are resistant to multiple antibiotics, making them difficult to treat. In this article, we have taken microorganisms that are associated with biofilm formation in catheters from two Canadian hospitals and tested them with tetrasodium EDTA, a new antimicrobial catheter lock solution. Tetrasodium EDTA was effective at eliminating Gram-positive, Gram-negative, and fungal species and represents a promising alternative to antibiotic treatment with less chance of the organisms developing resistance. We expect that our results will be of interest to researchers and clinicians and will lead to improved patient care.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Harsh conditions for microorganisms within a CVAD would include mechanical flushing and the use of antibiotic agents ( 6 ). Each time the CVAD is used, there is potential for resistant microorganisms sloughing off from a biofilm and entering the patient’s bloodstream ( 6 , 11 , 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

Tetrasodium EDTA Is Effective at Eradicating Biofilms Formed by Clinically Relevant Microorganisms from Patients’ Central Venous Catheters

Liu¹,

Hansra²,

Crockford³

et al. 2018

mSphere

View full text Add to dashboard Cite

show abstract

“…Because filling the dialysis catheter with citrate solution can prevent only intraluminal colonization, it is unclear why we observed a significant reduction of catheter-tip colonization in our study. The first hypothesis is that, similarly to long-term dialysis catheters (20,21), the intraluminal route of catheter-tip colonization may predominate for shortterm dialysis catheters in the ICU population due to frequent manipulations of the catheter hub or connectors and possibly the choice of the locking solution (22). Additional studies on the dynamics of catheter colonization are warranted in this setting.…”

Section: Discussionmentioning

confidence: 99%

Quasi-Experimental Study of Sodium Citrate Locks and the Risk of Acute Hemodialysis Catheter Infection among Critically Ill Patients

Parienti

Deryckere

Mégarbane

et al. 2014

Antimicrob Agents Chemother

View full text Add to dashboard Cite

“…Hemodialysis patients with CVCs have significantly higher C-reactive protein and markedly lower serum albumin concentrations, both of which are biomarkers of inflammation with strong associations with mortality in the hemodialysis population ( 3 , 4 ). Several studies have shown that CVCs are rapidly colonized after insertion with Gram-positive organisms that can form intraluminal biofilm which can be a source of inflammation if planktonic bacteria or biofilm fragments enter the systemic circulation ( 5 ). Bosma et al evaluated 32 newly placed CVCs and showed that 30 days after catheter insertion, 100% had biofilm formation when examined by scanning electron microscopy.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, semiquantitative measurement of LTA has been investigated as a bioassay to detect early Gram-positive blood stream infections ( 10 ). However, in hemodialysis patients and other populations requiring longer-term CVC use, inflammation induced by dissociated intraluminal biofilm fragments likely precedes infection ( 5 ). There are currently no published studies that have quantified LTA in the catheter aspirate and systemic circulation of patients with CVCs.…”

Section: Introductionmentioning

confidence: 99%

Quantification of Lipoteichoic Acid in Hemodialysis Patients With Central Venous Catheters

Pai¹,

Garba²,

Neumann³

et al. 2018

Front. Med.

View full text Add to dashboard Cite

Hemodialysis patients with central venous catheters (CVCs) have chronic systemic inflammation, the source of which may be related to intraluminal bacterial biofilm. There is currently no non-invasive method to adequately evaluate intraluminal biofilm. Lipoteichoic acid (LTA) is a Gram-positive bacterial cell wall component that is spontaneously shed. The purpose of this study was to determine whether LTA could be quantified in biological samples and to evaluate potential relationships to markers of inflammation. Heparin-locked catheter aspirate was drawn from both the arterial and venous ports of each CVC prior to dialysis initiation. Venous blood from the dialysis circuit was collected 30 min after dialysis initiation. LTA was quantified in aspirate and plasma. Key markers of inflammation (interleukin-6, and hepcidin) and endothelial dysfunction (soluble vascular endothelial cadherin) were also determined in plasma samples. Catheter aspirate and systemic blood samples were obtained from 40 hemodialysis patients. The median (range) duration of catheter use was 130 (20–1635) days. Unexpectedly, median (range) plasma LTA concentrations (ng/mL) were significantly higher than catheter aspirate LTA concentrations [3.93 (0.25–15) vs. 2.38 (0.1–8.1), respectively, p = 0.01] in the majority (70%) of patients. Area under the receiver operator characteristic (ROC) curve showed good potential prognostic value of catheter aspirate LTA predicting systemic LTA concentrations with an area under the curve of 0.815 (95% CI, 0.68–0.95). A significant correlation was found between LTA and serum ferritin (r = 0.32, p = 0.04), however, there were no significant correlations between LTA and the other inflammation biomarkers assessed. LTA is quantifiable in aspirate and plasma of hemodialysis patients with CVCs and warrants further investigation to determine potential clinical application to intraluminal biofilm evaluation.

show abstract

What is the evidence for intraluminal colonization of hemodialysis catheters?

Cited by 31 publications

References 37 publications

Tetrasodium EDTA Is Effective at Eradicating Biofilms Formed by Clinically Relevant Microorganisms from Patients’ Central Venous Catheters

Tetrasodium EDTA Is Effective at Eradicating Biofilms Formed by Clinically Relevant Microorganisms from Patients’ Central Venous Catheters

Quasi-Experimental Study of Sodium Citrate Locks and the Risk of Acute Hemodialysis Catheter Infection among Critically Ill Patients

Quantification of Lipoteichoic Acid in Hemodialysis Patients With Central Venous Catheters

Contact Info

Product

Resources

About