Contribution of vascular catheter material to the pathogenesis of infection: the enhanced risk of silicone in vivo.
There is currently very little information to suggest that polymer materials used to make vascular catheters differ in their risk of infection. A rabbit model of subcutaneous Staphylococcus aureus infection was used to determine the relative risk of infection associated with silicone, polyurethane, polyvinylchloride, and Teflon catheters. Seven days after catheter implantation and inoculation with S. aureus, catheters were observed for gross purulence and quantitatively cultured. Silicone catheters were found to have a greater risk of grossly apparent infection (purulence) and a greater number of organisms removed from catheters by quantitative culture than the other three catheter materials (P < .01). The risk of infection associated with silicone catheters decreased (P < .05) if the S. aureus inoculation was delayed for 2 days or if the catheters were preincubated in the subcutaneous space prior to insertion. The histology of the inflammatory response around the four catheter materials was evaluated at either 2 or 7 days after catheter insertion with or without S. aureus inoculation. Silicone catheters had greater associated inflammation (P < .05) with or without S. aureus inoculation. These results suggest that silicone catheter materials may have unique properties that increase the risk of infection after implantation. Further studies should be done to understand the mechanism(s) of these observations.
Sherertz
R J
RJ
Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Carruth
W A
WA
Marosok
R D
RD
Espeland
M A
MA
Johnson
R A
RA
Solomon
D D
DD
D000818:Animals; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D002404:Catheterization; D007249:Inflammation / Q000139:chemically induced / Q000473:pathology; D051379:Mice; D008813:Mice, Inbred ICR; D008855:Microscopy, Electron, Scanning; D011138:Polytetrafluoroethylene / Q000009:adverse effects; D011140:Polyurethanes / Q000009:adverse effects; D011143:Polyvinyl Chloride / Q000009:adverse effects; D016459:Prosthesis-Related Infections / Q000473:pathology*; D011817:Rabbits; D012306:Risk; D012828:Silicones / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000473:pathology; D013499:Surface Properties
D011140:Polyurethanes; D012828:Silicones; D011138:Polytetrafluoroethylene; D011143:Polyvinyl Chloride