The Role of Biofilm in Central Venous Catheter Related Bloodstream Infections: Evidence-based Nursing and Review of the Literature

Author(s): Nicola Ielapi, Emanuela Nicoletti, Carmela Lorè, Giorgio Guasticchi, Tiziana Avenoso, Andrea Barbetta, Stefano de Franciscis, Michele Andreucci, Paolo Sapienza, Raffaele Serra*.

Journal Name: Reviews on Recent Clinical Trials

Volume 15 , Issue 1 , 2020

Become EABM
Become Reviewer

Graphical Abstract:


Abstract:

Background: Biofilm is a fundamental component in the pathogenesis of infections related to the use of the central venous catheter (CVC,) which can represent an important health issue in everyday practice of nursing and medical staff.

Objective: The objective of the following review is to analyze the components of biofilm and their role in catheter-related infection determinism in an evidencebased nursing perspective in such a way as to give health professionals useful suggestions in the prevention and management of these complications.

Methods: The following databases were consulted for the bibliographic search: Medline, Scopus, Science Direct.

Biofilm can be the cause of CVC extraction and can lead to serious haematogenic infectious complications that can increase the morbidity and mortality of affected patients.

Results: Updated pathophysiologic knowledge of biofilm formation and appropriate diagnostic methodology are pivotal in understanding and detecting CVC-related infections. Lock therapy appears to be a useful, preventive, and therapeutic aid in the management of CVCrelated infections. New therapies attempting to stop bacterial adhesion on the materials used could represent new frontiers for the prevention of CVC-related infections.

Conclusion: The correct evidence-based nursing methods, based on the use of guidelines, provides the opportunity to minimize the risks of infection through the implementation of a series of preventive measures both during the CVC positioning phase and in the subsequent phase, for example, during device management which is performed by medical and nursing staff.

Keywords: Biofilm, central venous catheter, infection, nursing, prevention, treatment.

[1]
Woods E, Percival SL. Biofilms’Role in Intravascular Catheter Infections. In: Percival SL, Williams D, Cooper T, Randle J, EdsBiofilm’s in Infection preventio and Control. Amsterdam, Elsevier Inc. . 2014; pp. 185-98.
[2]
Marvaso A. le infezioni da catetere venoso centrale[central venous catheter-related infection]. Le Infezioni Medicina 2000; 4: 202-10.
[3]
Pérez-Zárate P, Aragón-Piña A, Soria-Guerra RE, et al. Risk factors and biofilm detection on central venous catheters of patients attended at tertiary hospital. Micron 2015; 78: 33-9.
[http://dx.doi.org/10.1016/j.micron.2015.07.001] [PMID: 26218801]
[4]
Rosa L, Cutone A, Coletti M, et al. Biotimer assay: A reliable and rapid method for the evaluation of central venous catheter microbial colonization. J Microbiol Methods 2017; 143: 20-5.
[http://dx.doi.org/10.1016/j.mimet.2017.09.016] [PMID: 28966069]
[5]
Mandolfo S. Il rebus del “lock” del catetere venoso centrale per la prevenzione della trombosi e delle batteriemie da catetere. G Ital Nefrol 2012; 29(3): 301-7.
[PMID: 22718454]
[6]
Kumar A, Alam A, Rani M, Ehtesham NZ, Hasnain SE. Biofilms: Survival and defense strategy for pathogens. Int J Med Microbiol 2017; 307(8): 481-9.
[http://dx.doi.org/10.1016/j.ijmm.2017.09.016] [PMID: 28950999]
[7]
Gominet M, Compain F, Beloin C, Lebeaux D. Central venous catheters and biofilms: Where do we stand in 2017? APMIS 2017; 125(4): 365-75.
[http://dx.doi.org/10.1111/apm.12665] [PMID: 28407421]
[8]
Donelli G, De Paoli P, Fadda G, et al. A multicenter study on central venous catheter-associated infections in Italy. J Chemother 2001; 13(1): 251-62.
[9]
Costerton JW, Lewandowski Z, Caldwell DE, Korber DR, Lappin-Scott HM. Microbial biofilms. Annu Rev Microbiol 1995; 49: 711-45.
[http://dx.doi.org/10.1146/annurev.mi.49.100195.003431] [PMID: 8561477]
[10]
Stoodley P, Sauer K, Davies DG, Costerton JW. Biofilms as complex differentiated communities. Annu Rev Microbiol 2002; 56: 187-209.
[http://dx.doi.org/10.1146/annurev.micro.56.012302.160705] [PMID: 12142477]
[11]
Stoodley P, Cargo R, Rupp CJ, Wilson S, Klapper I. Biofilm material properties as related to shear-induced deformation and detachment phenomena. J Ind Microbiol Biotechnol 2002; 29(6): 361-7.
[http://dx.doi.org/10.1038/sj.jim.7000282] [PMID: 12483479]
[12]
Satish JV, Pavan M. Characteristics of biofilms formed on non-tunneled hemodialysis catheters. Dial Traspl 2014; 35(2): 47-51.
[http://dx.doi.org/10.1016/j.dialis.2014.02.005]
[13]
Donlan RM. Biofilms and device-associated infections. Emerg Infect Dis 2001; 7: 1-6.
[http://dx.doi.org/10.3201/eid0702.010226]
[14]
Serra R, Ielapi N, Barbetta A, de Franciscis S. Skin tears and risk factors assessment: A systematic review on evidence-based medicine. Int Wound J 2018; 15(1): 38-42.
[http://dx.doi.org/10.1111/iwj.12815] [PMID: 29045078]
[15]
Jamal M, Ahmad W, Andleeb S, et al. Bacterial biofilm and associated infections. J Chin Med Assoc 2018; 81(1): 7-11.
[http://dx.doi.org/10.1016/j.jcma.2017.07.012] [PMID: 29042186]
[16]
Gristina AG. Biomaterial-centered infection: Microbial adhesion versus tissue integration. Science 1987; 237(4822): 1588-95.
[http://dx.doi.org/10.1126/science.3629258] [PMID: 3629258]
[17]
Serra R, Ielapi N, Barbetta A, et al. Adverse complications of venipuncture: A systematic review. Acta Phlebol 2018; 19(1): 11-5.
[18]
Schoerner C, Guggenbichler JP, Lugauer S, Regenfus A. Silver catheter study: Methods and results of microbiological investigations. Infection 1999; 27(Suppl. 1): S54-5.
[19]
Handrup MM, Møller JK, Schrøder H. Central venous catheters and catheter locks in children with cancer: A prospective randomized trial of taurolidine versus heparin. Pediatr Blood Cancer 2013; 60(8): 1292-8.
[http://dx.doi.org/10.1002/pbc.24482] [PMID: 23417891]
[20]
Safdar N, Fine JP, Maki DG. Meta-analysis: Methods for diagnosing intravascular device-related bloodstream infection. Ann Intern Med 2005; 142(6): 451-66.
[http://dx.doi.org/10.7326/0003-4819-142-6-200503150-00011] [PMID: 15767623]
[21]
Edgeworth J. Intravascular catheter infections. J Hosp Infect 2009; 73(4): 323-30.
[http://dx.doi.org/10.1016/j.jhin.2009.05.008] [PMID: 19699555]
[22]
MacKenzie FM, Bruce J, Struelens MJ, Goossens H, Mollison J, Gould IM. Antimicrobial drug use and infection control practices associated with the prevalence of methicillin-resistant Staphylococcus aureus in European hospitals. Clin Microbiol Infect 2007; 13(3): 269-76.
[http://dx.doi.org/10.1111/j.1469-0691.2006.01592.x] [PMID: 17391381]
[23]
Hansen S, Schwab F, Behnke M, et al. National influences on catheter-associated bloodstream infection rates: Practices among national surveillance networks participating in the European HELICS project. J Hosp Infect 2009; 71(1): 66-73.
[http://dx.doi.org/10.1016/j.jhin.2008.07.014] [PMID: 18799236]
[24]
Hansen S, Schwab F, Asensio A, et al. Methicillin-resistant Staphylococcus aureus (MRSA) in Europe: Which infection control measures are taken? Infection 2010; 38(3): 159-64.
[http://dx.doi.org/10.1007/s15010-010-0001-8] [PMID: 20232107]
[25]
Liu WL, Lai CC, Li MC, et al. Clinical manifestations of candidemia caused by uncommon Candida species and antifungal susceptibility of the isolates in a regional hospital in Taiwan, 2007-2014. J Microbiol Immunol Infect 2019; 52(4): 612-9.
[http://dx.doi.org/10.1016/j.jmii.2017.08.007] [PMID: 28886952]
[26]
Sadoyma G, Diogo FA, Gontijo FPP. Central venous catheter-related bloodstream infection caused by Staphylococcus aureus: Microbiology and risk factors. Braz J Infect Dis 2006; 10(2): 100-6.
[http://dx.doi.org/10.1590/S1413-86702006000200006] [PMID: 16878260]
[27]
Kojic EM, Darouiche RO. Candida infections of medical devices. Clin Microbiol Rev 2004; 17(2): 255-67.
[http://dx.doi.org/10.1128/CMR.17.2.255-267.2004] [PMID: 15084500]
[28]
Bosma JW, Siegert CE, Peerbooms PG, Weijmer MC. Reduction of biofilm formation with trisodium citrate in haemodialysis catheters: A randomized controlled trial. Nephrol Dial Transplant 2010; 25(4): 1213-7.
[http://dx.doi.org/10.1093/ndt/gfp651] [PMID: 19948873]
[29]
Jones SM, Ravani P, Hemmelgarn BR, Muruve D, Macrae JM. Morphometric and biological characterization of biofilm in tunneled hemodialysis catheters. Am J Kidney Dis 2011; 57(3): 449-55.
[http://dx.doi.org/10.1053/j.ajkd.2010.10.053] [PMID: 21257245]
[30]
Macrae JM, Dojcinovic I, Djurdjev O, et al. Citrate 4% versus heparin and the reduction of thrombosis study (CHARTS). Clin J Am Soc Nephrol 2008; 3(2): 369-74.
[http://dx.doi.org/10.2215/CJN.01760407] [PMID: 18308996]
[31]
Weijmer MC, Debets-Ossenkopp YJ, Van De Vondervoort FJ, ter Wee PM. Superior antimicrobial activity of trisodium citrate over heparin for catheter locking. Nephrol Dial Transplant 2002; 17(12): 2189-95.
[http://dx.doi.org/10.1093/ndt/17.12.2189] [PMID: 12454232]
[32]
Willicombe MK, Vernon K, Davenport A. Embolic complications from central venous hemodialysis catheters used with hypertonic citrate locking solution. Am J Kidney Dis 2010; 55(2): 348-51.
[http://dx.doi.org/10.1053/j.ajkd.2009.06.037] [PMID: 19800723]
[33]
Capdevila JA, Segarra A, Planes AM, et al. Successful treatment of haemodialysis catheter-related sepsis without catheter removal. Nephrol Dial Transplant 1993; 8(3): 231-4.
[PMID: 8385290]
[34]
Bastani B, Minton J, Islam S. Insufficient penetration of systemic vancomycin into the PermCath lumen. Nephrol Dial Transplant 2000; 15(7): 1035-7.
[http://dx.doi.org/10.1093/ndt/15.7.1035] [PMID: 10862643]
[35]
Lai NM, Chaiyakunapruk N, Lai NA, O’Riordan E, Pau WS, Saint S. Catheter impregnation, coating or bonding for reducing central venous catheter-related infections in adults. Cochrane Database Syst Rev 2016; 3CD007878
[http://dx.doi.org/10.1002/14651858.CD007878.pub3] [PMID: 26982376]
[36]
Tebbs SE, Elliott TSJ. A novel antimicrobial central venous catheter impregnated with benzalkonium chloride. J Antimicrob Chemother 1993; 31(2): 261-71.
[http://dx.doi.org/10.1093/jac/31.2.261] [PMID: 846317137]
[37]
Tebbs SE, Elliott TSJ. Modification of central venous catheter polymers to prevent in vitro microbial colonisation. Eur J Clin Microbiol Infect Dis 1994; 13(2): 111-7.
[http://dx.doi.org/10.1007/BF01982182] [PMID: 8013481]
[38]
Moro ML, Viganò EF, Cozzi Lepri A. Risk factors for central venous catheter-related infections in surgical and intensive care units. Infect Control Hosp Epidemiol 1994; 15(4 Pt 1): 253-64.
[http://dx.doi.org/10.2307/30145577] [PMID: 8207192]
[39]
Desrousseaux C, Sautou V, Descamps S, Traoré O. Modification of the surfaces of medical devices to prevent microbial adhesion and biofilm formation. J Hosp Infect 2013; 85(2): 87-93.
[http://dx.doi.org/10.1016/j.jhin.2013.06.015] [PMID: 24007718]
[40]
Zhang Y, Fu Y, Yu J, et al. Synergy of ambroxol with vancomycin in elimination of catheter-related Staphylococcus epidermidis biofilm in vitro and in vivo. J Infect Chemother 2015; 21(11): 808-15.
[http://dx.doi.org/10.1016/j.jiac.2015.08.017] [PMID: 26423688]
[41]
Ribeiro SM, Felício MR, Boas EV, et al. New frontiers for anti-biofilm drug development. Pharmacol Ther 2016; 160: 133-44.
[http://dx.doi.org/10.1016/j.pharmthera.2016.02.006] [PMID: 26896562]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 15
ISSUE: 1
Year: 2020
Page: [22 - 27]
Pages: 6
DOI: 10.2174/1574887114666191018144739
Price: $65

Article Metrics

PDF: 15
HTML: 2
PRC: 1