Vascular catheter-related infection and sepsis

Surg Infect (Larchmt). 2006:7 Suppl 2:S25-7. doi: 10.1089/sur.2006.7.s2-25.

Abstract

Background: Catheter-related sepsis is a clinical syndrome characterized by the presence of a catheter-associated infection along with a systemic inflammatory response. The continual increase in the use of central venous catheters (CVCs) has been associated with a substantial risk of infectious complications that prolong the hospital stay and increase costs.

Methods: The literature on CVCs was reviewed to determine the incidence of catheterrelated sepsis, its diagnosis, and the role of biofilms in pathogenesis.

Results: The European Sepsis Group recently reported that 28% of CVC infections in intensive care unit patients were associated with sepsis, 24% with severe sepsis, and 30% with septic shock. Clinical diagnosis remains difficult. After CVC insertion, the intravascular portion of the device is covered rapidly by a thrombin layer, rich in host-derived proteins, that forms a conditioning film and promotes surface adherence of microbial colonizers. These microorganisms then enter their sessile mode of growth, secreting an exopolysaccharide slime within which organism density is regulated by quorum-sensing molecules. Microorganisms are dispersed in clumps that can become septic emboli. Antiadhesive, antiseptic, and antibiotic coatings of catheters have demonstrated only modest clinical efficacy.

Conclusion: Our group is involved in the design and in vitro assessment of new polymeric matrices for controlled release of antimicrobial molecules, and in comparative clinical studies of conventional versus antibiotic-coated or -impregnated catheters.

Publication types

  • Review

MeSH terms

  • Biofilms / classification
  • Biofilms / growth & development
  • Candida albicans / growth & development
  • Candidiasis / epidemiology*
  • Candidiasis / microbiology
  • Catheterization, Central Venous / adverse effects*
  • Humans
  • Sepsis / epidemiology*
  • Sepsis / microbiology
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / classification
  • Staphylococcus aureus / growth & development