Intravenous Line Colonization in Patients Receiving Cytotoxic Drugs

Abstract

Background
 Hospital acquired infections are infections that develop during the hospital stay; they mainly include urinary tract, respiratory tract or blood stream infections. 
 Objectives
 To investigate microbial colonization of intravenous cannula of cancers patients receiving cytotoxic drugs. 
 Materials and Methods
 Colonization of intravenous cannulas was investigated by cultivation of the device surface and lumen on different culture media under aerobic incubation. The isolates were identified based on cultural, morphological and biochemical activities. The susceptibility of the isolates to antimicrobial drugs was investigated using Bauer-Kirby disk diffusion method and the bacterial isolates were further investigated for their ability to form biofilm. 
 Results
 From 200 cultivated intravenous cannulas, microbial colonization was detected among 26% and 11% of intravenous cannulas from cancer and non-cancer patients respectively; Out of 37 isolates, 34 (91.9 %) were Gram-positive bacteria, 2 (5.4 %) Gram-negative bacteria and one (2.7 %) was a Candida species. The main bacterial isolates were bacteria belonging to different coagulase negative staphylococci species such as Staphylococcus epidermidis, S. hominis and others. Few faecal organisms were isolated including a single isolate of each Klebsiella pneumoniae and Escherichia coli. All bacterial isolates were able to form biofilm and most showed to have biofilm-related icaA and icaD genes.
 Conclusion
 We detected microbial colonization of intravenous cannulas in 18.5% of all cultivated devices. We observed more colonization in cancer patients (26%) in comparison to the control group (11%). Most of the isolates were species of CoNS that were able to form biofilm.