Short Peripheral Venous Catheters Contamination and the Dangers of Bloodstream Infection in Portugal: An Analytic Study

Abstract

Peripheral venous catheters (PVCs) are the most used vascular access devices in the world. However, failure rates remain considerably high, with complications such as PVC-related infections posing significant threats to patients’ well-being. In Portugal, studies evaluating the contamination of these vascular medical devices and characterizing the associated microorganisms are scarce and lack insight into potential virulence factors. To address this gap, we analyzed 110 PVC tips collected in a large tertiary hospital in Portugal. Experiments followed Maki et al.’s semi-quantitative method for microbiological diagnosis. Staphylococcus spp. were subsequently studied for the antimicrobial susceptibility profile by disc diffusion method and based on the cefoxitin phenotype, were further classified into strains resistant to methicillin. Screening for the mecA gene was also done by a polymerase chain reaction and minimum inhibitory concentration (MIC)-vancomycin as determined by E-test, proteolytic and hemolytic activity on skimmed milk 1% plate and blood agar, respectively. The biofilm formation was evaluated on microplate reading through iodonitrotetrazolium chloride 95% (INT). Overall, 30% of PVCs were contaminated, and the most prevalent genus was Staphylococcus spp., 48.8%. This genus presented resistance to penicillin (91%), erythromycin (82%), ciprofloxacin (64%), and cefoxitin (59%). Thus, 59% of strains were considered resistant to methicillin; however, we detected the mecA gene in 82% of the isolates tested. Regarding the virulence factors, 36.4% presented α-hemolysis and 22.7% β-hemolysis, 63.6% presented a positive result for the production of proteases, and 63.6% presented a biofilm formation capacity. Nearly 36.4% were simultaneously resistant to methicillin and showed expression of proteases and/or hemolysins, biofilm formation, and the MIC to vancomycin were greater than 2 µg/mL. Conclusion: PVCs were mainly contaminated with Staphylococcus spp., with high pathogenicity and resistance to antibiotics. The production of virulence factors strengthens the attachment and the permanence to the catheter’s lumen. Quality improvement initiatives are needed to mitigate such results and enhance the quality and safety of the care provided in this field.

Impact of Bacterial Infections in Peritoneal Dialysis Patients

“…Notably, however, the prevalence of Streptococci and Escherichia coli is similar, highlighting the need for ongoing monitoring and early intervention in the patient population. The predominant clinical manifestations observed, fever and abdominal pain, are consistent with previously reported symptoms of peritoneal infections (Poulsen et al, 2018). In addition, the prevalence of cardiovascular comorbidities among PD patients, specifically coronary artery disease, is consistent with global findings (Kendir et al, 2018).…”

“…Possible sources of these bacterial infections include contamination during fluid exchanges, touch contamination, faulty or improperly placed catheters, and even systemic infections traveling to the peritoneal cavity. Staphylococcus species, such as Staphylococcus aureus and coagulase-negative Staphylococci, are among the most frequently prevailing pathogens in PD-related peritonitis, although a broad spectrum of bacteria can be involved (Osório et al, 2023;Tong et al, 2015). In PD patients, bacterial infections have multiple effects.…”

Evaluating drug use patterns among paediatric outpatients in Burundi

“…Reducing the use of injectables is a positive measure, especially since the high use of injectable drugs necessitates the use of invasive devices, which increases the risk of contracting some communicable diseases such as HIV/AIDS and other blood-borne infectious due to the utilisation of equipment which are not sterile (Osório et al, 2023 ). It is important to prioritise strategies for continuing reducing injectable drug use to mitigate the potential risks.…”

Construção e validação de formulário para avaliação da indicação e manejo do cateter intravenoso periférico curto

“…Um estudo analisou a prática da equipe de enfermagem ao administrar medicamentos via intravenosa e evidenciou que em apenas 42,5% da amostra eram desinfetados o injetor lateral ou dânula antes da administração de medicamentos (OLIVEIRA et al, 2018). Uma investigação conduzida em um hospital de Portugal, com uma amostra de 100 pontas de CIPs mostrou que 30% dos cateteres estavam contaminados principalmente com Staphylococcus spp., com alta patogenicidade e resistência a antibióticos (OSÓRIO et al, 2023). A produção de fatores de virulência fortalece a fixação e a permanência no lúmen do cateter.…”