Mini-review: Antimicrobial central venous catheters – recent advances and strategies

Abstract

Central venous catheters (CVCs) nowadays constitute critical devices used in medical care, namely in intensive care units. However, CVCs also represent one of the indwelling medical devices with enhanced risk of nosocomial devicerelated infection. Catheter-related infections (CRIs) are a major cause of patient morbidity and mortality, often justifying premature catheter removal and an increase in costs and use of resources. Adhesion and subsequent biofilm formation on the surfaces of indwelling catheters is elemental to the onset of pathogenesis. Seeking the prevention of CVC colonisation and CRI, a variety of approaches have been studied, tested and, in some cases, already applied in clinical practice. This review looks at the current preventive strategies often used to decrease the risk of CRIs due to colonization and biofilm formation on catheter surfaces, as well as at the more recent approaches under investigation.

Vancomycin-Eluting Niosomes: A New Approach to the Inhibition of Staphylococcal Biofilm on Abiotic Surfaces

“…In this context, newer antimicrobial strategies were developed for combating abiotic surface infections (7). These are essentially based on a passive or active approach or a combination thereof.…”

“…Lipidand polymer-based drug carriers are the most exploited in this respect. Liposomes, phospholipid bilayer vesicles, confer antiadhesive properties to abiotic surfaces (7,14,15) and concentrate the antimicrobial pay load at the device surface and biofilm interfaces (15,20). In addition, liposomes can be designed to fuse with microbial cell membrane, enhancing antimicrobial efficacy (21) and to bind with the device-related infection site (22).…”

Incidence of Central Venous Catheter-Related Infection and Risk Factors in Critically Ill Post-Operative Cancer Patients: A Randomized Prospective Cohort Study

“…The risk of catheter-related infection correlates with the patient's age, weight, underlying diseases, immune system status and type of fluid injection (15,16). Several preventive techniques have been shown, which can reduce the incidence of infections including: adequate knowledge, insertion and keeping of catheter only in necessary situations, hygiene, use of appropriate solutions (alcoholicchlorhexidine) for skin disinfection, care protocol implementation, CVC insertion under ultrasound guidance, preference of subclavian line instead of other sites, change of dressings (no more than seven days), and avoiding antibiotic prophylaxis (1,(17)(18)(19)(20).…”

Antimicrobial activity and cytocompatibility of silver nanoparticles coated catheters via a biomimetic surface functionalization strategy

“…Current preventive strategies to decrease the risk of these serious infections include the use of antimicrobial agent impregnated catheters and antimicrobial lock therapy. 3 For example, silver-impregnated CVCs and antiseptic CVCs coated with chlorhexidine and silver sulfadiazine have already been used in clinic medicine. 4 Silver is widely exploited because of its good antimicrobial action to a wide range of microorganisms.…”

“…The catheters can be coated internally and externally with silver containing compounds or impregnated with silver. 3 Various methods have been used for the synthesis of silver-impregnated CVCs, such as silver iontophoretic technology, solvent casting, electrospinning and electrospraying, plasma based deposition processes, in situ light initiated synthesis, [7][8][9][10] etc. Recently, mussel-inspired green synthesis of AgNPs on the surface of various materials has drawn a great attention.…”