Electron-microscopic description of accretions occurring on tips of infected and non-infected central venous catheters.
OBJECTIVE
The purpose of the study was do describe the architecture of accretions occurring on the tips of central venous catheters (CVC).


METHODS
A conservative procedure was used followed by two different techniques of electron microscopy.


METHODS
the study included 19 catheters which have been used on intensive cared adults, and which were chosen among those of parallel 300 CVC study.


RESULTS
CVC were considered sterile, contaminated, colonized or infected according to microbiological and clinical criteria. CVC were found to remain much cleaner than in past descriptions. When present, accretions were located on the olive-shaped end, and displayed stratified structures with three types of material: amorphous material, thrombus components and inflammatory cells. Bacteria were not seen, even on culture positive CVC. Candida albicans was found on one CVC in the cytoplasm of granulocytes, and made no direct contact with the plastic surface.


CONCLUSIONS
This technique should contribute to the understanding of the pathobiology of CVC infection and provide information proving or precluding the involvement of microbial adherence to polymers in vivo.
Poisson
D M
DM
Microbiology Unit, Centre Hospitalier Régional d'Orléans, France.
Touquet
S
S
Bercault
N
N
Arbeille
B
B
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001422:Bacterial Adhesion; D002176:Candida albicans / Q000254:growth & development / Q000648:ultrastructure; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000145:classification / Q000592:standards*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D004867:Equipment Design / Q000592:standards; D005069:Evaluation Studies as Topic; D005337:Fibrin / Q000648:ultrastructure; D005602:France / Q000453:epidemiology; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008855:Microscopy, Electron, Scanning; D017348:Microscopy, Electron, Scanning Transmission; D013997:Time Factors
D000900:Anti-Bacterial Agents; D005337:Fibrin