Evaluation of infectious complications of the implantable venous access system in a general oncologic population

Chang, Lilu; Tsai, Jir-Shiong; Huang, Shin-Ju; Shih, Chia-Lung

doi:10.1067/mic.2003.29

Cited by 79 publications

(64 citation statements)

References 12 publications

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“…The frequency of CRBSI in past studies was 0.10 cases to 0.25 cases per 1,000 catheter days [2,3,[9][10][11][12][13][14]. Therefore, our results are comparable to those of past studies.…”

Section: Discussionsupporting

confidence: 92%

A retrospective statistical analysis of the late complications associated with central venous port placements

et al. 2014

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“…The frequency of CRBSI in past studies was 0.10 cases to 0.25 cases per 1,000 catheter days [2,3,[9][10][11][12][13][14]. Therefore, our results are comparable to those of past studies.…”

Section: Discussionsupporting

confidence: 92%

A retrospective statistical analysis of the late complications associated with central venous port placements

et al. 2014

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“…Although multiresistance associated with Gram-negative pathogens is of some concern, these bacteria are often overlooked in studies using catheter-related infections (8,21,43). In the case of P. aeruginosa CRBSI, treatment failures are frequent and conservative management is often excluded (31).…”

Section: Discussionmentioning

confidence: 99%

Full and Broad-Spectrum In Vivo Eradication of Catheter-Associated Biofilms Using Gentamicin-EDTA Antibiotic Lock Therapy

Chauhan

Lebeaux

Ghigo

et al. 2012

Antimicrob Agents Chemother

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Biofilms that develop on indwelling devices are a major concern in clinical settings. While removal of colonized devices remains the most frequent strategy for avoiding device-related complications, antibiotic lock therapy constitutes an adjunct therapy for catheter-related infection. However, currently used antibiotic lock solutions are not fully effective against biofilms, thus warranting a search for new antibiotic locks. Metal-binding chelators have emerged as potential adjuvants due to their dual anticoagulant/antibiofilm activities, but studies investigating their efficiency were mainly in vitro or else focused on their effects in prevention of infection. To assess the ability of such chelators to eradicate mature biofilms, we used an in vivo model of a totally implantable venous access port inserted in rats and colonized by either Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, or Pseudomonas aeruginosa. We demonstrate that use of tetrasodium EDTA (30 mg/ml) as a supplement to the gentamicin (5 mg/ml) antibiotic lock solution associated with systemic antibiotics completely eradicated Gram-positive and Gramnegative bacterial biofilms developed in totally implantable venous access ports. Gentamicin-EDTA lock was able to eliminate biofilms with a single instillation, thus reducing length of treatment. Moreover, we show that this combination was effective for immunosuppressed rats. Lastly, we demonstrate that a gentamicin-EDTA lock is able to eradicate the biofilm formed by a gentamicin-resistant strain of methicillin-resistant S. aureus. This in vivo study demonstrates the potential of EDTA as an efficient antibiotic adjuvant to eradicate catheter-associated biofilms of major bacterial pathogens and thus provides a promising new lock solution.C entral venous catheters are routinely used to administer medication or fluids to patients admitted to oncology, nephrology, and intensive care units (2, 47, 52). Although these devices greatly improve patient health, their use is often associated with medical complications due to colonization by pathogenic microorganisms (38). This leads to development of complex bacterial or fungal biofilm communities that display strong tolerance toward antimicrobials (15,37,45). Biofilms are difficult to eradicate; moreover, they constitute a potential source of bloodstream infections, a leading cause of health care-associated infections in critically ill patients (29). Currently, there is no fully efficient method for treating catheter-related biofilms aside from traumatic and costly removal of colonized devices (5,11,42,49). However, recent clinical practice guidelines recommended the use of antibiotic lock therapy (ALT) for treatment of uncomplicated long-term catheter-related infections (31). ALT relies on the instillation of highly concentrated antibiotic solutions (up to 1,000 times the MIC) left to dwell in the catheter for 12 to 24 h in order to prevent or eradicate biofilm formation. Although ALT shows a high success rate for coagulase-negative staphyl...

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“…When the IC is used after transplantation, the Huber needle is changed every 7 days according to aseptic techniques. 4 When placement of the IC has been performed outside of our institution, information regarding the type of catheter care that patients received from the time of catheter placement until arrival at our institution for APSCT is not available.…”

Section: Catheter Carementioning

confidence: 99%

“…[1][2][3] However, one of the most serious complications of these intravascular devices is infection, particularly among patients with cancer. 4,5 The accumulation of infected clots under the silicone septum of the reservoir has been reported as the source for IC-related bloodstream infections. 6 The Foundation for the Fight against Leukemia (FUN-DALEU) is a national referral center for patients receiving autologous peripheral stem cell transplantation (APSCT) who come from all areas of Argentina.…”

mentioning

confidence: 99%

Leaving previously implanted central venous catheters (ports) in place does not increase morbidity in patients undergoing autologous peripheral stem cell transplantation

Miceli

Lei

Coria³

et al. 2005

Bone Marrow Transplant

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Evaluation of infectious complications of the implantable venous access system in a general oncologic population

Cited by 79 publications

References 12 publications

A retrospective statistical analysis of the late complications associated with central venous port placements

A retrospective statistical analysis of the late complications associated with central venous port placements

Full and Broad-Spectrum In Vivo Eradication of Catheter-Associated Biofilms Using Gentamicin-EDTA Antibiotic Lock Therapy

Leaving previously implanted central venous catheters (ports) in place does not increase morbidity in patients undergoing autologous peripheral stem cell transplantation

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