School of Environment and Science, Griffith University, Brisbane, QLD, Australia.
School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, QLD, Australia.
J Vasc Access. 2021 May;22(3):388-393. doi: 10.1177/1129729820932423. Epub 2020 Jun 22.
Peripherally inserted central catheters are susceptible to microbial colonisation and subsequent biofilm formation, leading to central line-associated bloodstream infection, a serious peripherally inserted central catheter-related complication. Next-generation peripherally inserted central catheter biomaterials, such as hydrophobic materials (e.g. Endexo), may reduce microbial biofilm formation or attachment, consequently reducing the potential for central line-associated bloodstream infection.
Within a randomised controlled trial, culture-dependent and culture-independent methods were used to determine if the biomaterials used in traditional polyurethane peripherally inserted central catheters and hydrophobic peripherally inserted central catheters impacted microbial biofilm composition. This study also explored the impact of other clinical characteristics including central line-associated bloodstream infection, antibiotic therapy and dwell time on the microbial biofilm composition of peripherally inserted central catheters.
From a total of 32 patients, one peripherally inserted central catheter was determined to be colonised with , and on further analysis, the patient was diagnosed with central line-associated bloodstream infection. All peripherally inserted central catheters ( = 17 polyurethane vs = 15 hydrophobic) were populated with complex microbial communities, including peripherally inserted central catheters considered non-colonised. The two main microbial communities observed included spp., dominant on the colonised peripherally inserted central catheter, and , dominant on non-colonised peripherally inserted central catheters. Both the peripherally inserted central catheter biomaterial design and antibiotic therapy had no significant impact on microbial communities. However, the diversity of microbial communities significantly decreased with dwell time.
More diverse pathogens were present on the colonised peripherally inserted central catheter collected from the patient with central line-associated bloodstream infection. Microbial biofilm composition did not appear to be affected by the design of peripherally inserted central catheter biomaterials or antibiotic therapy. However, the diversity of the microbial communities appeared to decrease with dwell time.
外周置入中心静脉导管容易被微生物定植和随后的生物膜形成，导致中心静脉相关血流感染，这是一种严重的外周置入中心静脉导管相关并发症。下一代外周置入中心静脉导管生物材料，如疏水性材料（如 Endexo），可能会减少微生物生物膜的形成或附着，从而降低中心静脉相关血流感染的可能性。
在一项随机对照试验中，使用依赖培养和非依赖培养的方法来确定传统的聚氨酯外周置入中心静脉导管和疏水性外周置入中心静脉导管中使用的生物材料是否会影响微生物生物膜的组成。本研究还探讨了其他临床特征，包括中心静脉相关血流感染、抗生素治疗和留置时间对中心静脉导管微生物生物膜组成的影响。
在总共 32 名患者中，有 1 根外周置入中心导管被确定为定植，进一步分析后，该患者被诊断为中心静脉相关血流感染。所有外周置入中心导管（=17 根聚氨酯导管与=15 根疏水性导管）均定植有复杂的微生物群落，包括被认为未定植的外周置入中心导管。观察到的两个主要微生物群落包括 spp.，定植于感染的外周置入中心导管上，和 ，定植于未感染的外周置入中心导管上。外周置入中心导管生物材料设计和抗生素治疗均未对微生物群落产生显著影响。然而，随着留置时间的延长，微生物群落的多样性显著下降。
在与中心静脉相关血流感染患者的感染外周置入中心导管中，存在更多种类的病原体。微生物生物膜的组成似乎不受外周置入中心导管生物材料设计或抗生素治疗的影响。然而，随着留置时间的延长，微生物群落的多样性似乎会下降。
