Biofilm-Based Central Line-Associated Bloodstream Infections

Abstract

Different types of central venous catheters (CVCs) have been used in clinical practice to improve the quality of life of chronically and critically ill patients. Unfortunately, indwelling devices are usually associated with microbial biofilms and eventually lead to catheter-related bloodstream infections (CLABSIs).An estimated 250,000-400,000 CLABSIs occur every year in the United States, at a rate of 1.5 per 1,000 CVC days and a mortality rate of 12-25 %. The annual cost of caring for patients with CLABSIs ranges from 296 million to 2.3 billion dollars.Biofilm formation occurs on biotic and abiotic surfaces in the clinical setting. Extensive studies have been conducted to understand biofilm formation, including different biofilm developmental stages, biofilm matrix compositions, quorum-sensing regulated biofilm formation, biofilm dispersal (and its clinical implications), and multi-species biofilms that are relevant to polymicrobial infections.When microbes form a matured biofilm within human hosts through medical devices such as CVCs, the infection becomes resistant to antibiotic treatment and can develop into a chronic condition. For that reason, many techniques have been used to prevent the formation of biofilm by targeting different stages of biofilm maturation. Other methods have been used to diagnose and treat established cases of CLABSI.Catheter removal is the conventional management of catheter associated bacteremia; however, the procedure itself carries a relatively high risk of mechanical complications. Salvaging the catheter can help to minimize these complications.In this article, we provide an overview of microbial biofilm formation; describe the involvement of various genetic determinants, adhesion proteins, organelles, mechanism(s) of biofilm formation, polymicrobial infections, and biofilm-associated infections on indwelling intravascular catheters; and describe the diagnosis, management, and prevention of catheter-related bloodstream infections.

Healthcare-associated infections, medical devices and biofilms: risk, tolerance and control

“…However, the chlorhexidine/silver sulfadiazine-impregnated catheters were only treated with the antimicrobials on the external surface, whereas the comparator catheters were treated with minocycline/rifampicin on both the luminal and external surfaces. Furthermore, the concentration and availability of the antimicrobials used in the minocycline/rifampicin catheters was considerably higher than those in the chlorhexidine/silver sulfadiazine-treated catheters (Darouiche et al, 1999;Yousif et al, 2015).…”

In Vivo Biocompatibility and In Vitro Efficacy of Antimicrobial Gendine-Coated Central Catheters

“…Further, 37,000 CLABSIs occurred among patients receiving outpatient hemodialysis in 2008 alone (7). At least 400,000 episodes of CLABSI occur every year among cancer patients alone (8), and the overall annual cost estimates range from $296 million to $2.3 billion (9)(10)(11).…”

Diagnostic of Fungal Infections Related to Biofilms

“…Most cases of central line-associated BSI (CLABSI)-that occur, in the United States, at a rate of 1.5 per 1000 CVC days and a mortality rate of 12-25 %-involve microbial biofilms on the catheter surfaces (Yousif et al 2015). Once a mature biofilm is formed within the human host through a medical device, the infection becomes recalcitrant to antimicrobial treatment (Ramage et al 2012) and can develop into a chronic condition (Yousif et al 2015).…”