title: Bacterial colonization of Hemasite access devices.
abstract: Vascular access ports (Hemasites) were recovered from patients in whom they had become foci of infection and were examined according to microbiologic and morphologic techniques. All were covered on their extraluminal surfaces by well-developed biofilms consisting of host material and bacteria and their extracellular products. One Hemasite from which Staphylococcus aureus and Streptococcus faecalis were cultured was covered by a biofilm that consisted of coccoid bacterial cells and occasional fungal cells. Another Hemasite from which Proteus mirabilis was cultured was covered by a polymicrobial biofilm consisting of at least six morphologically distinct bacterial types and their extracellular products. This direct observation of the biofilm mode of bacterial growth on these devices suggests that the colonizing organisms will not be completely recovered by routine microbiologic techniques and that bacteria in the biofilm will tend to resist both host clearance mechanisms and antibiotic therapy. Removal of the device, with its accretion of bacterial biofilm, should allow the resolution of the associated infection.
authors.forename: W P
authors.initials: WP
authors.lastname: Reed
authors.forename: M R
authors.initials: MR
authors.lastname: Moody
authors.forename: K A
authors.initials: KA
authors.lastname: Newman
authors.forename: P D
authors.initials: PD
authors.lastname: Light
authors.forename: J W
authors.initials: JW
authors.lastname: Costerton
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D001424:Bacterial Infections / Q000209:etiology*; D001916:Brachial Artery; D013293:Enterococcus faecalis / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D006801:Humans; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008855:Microscopy, Electron, Scanning; D011138:Polytetrafluoroethylene; D011513:Proteus mirabilis / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000209:etiology; D014025:Titanium
chemical_list: D011138:Polytetrafluoroethylene; D014025:Titanium