Does the fibrin coat around a central venous catheter influence catheter-related sepsis?
The purpose of this study was to determine whether the fibrin sheath that develops around an intravenous silicone catheter influences catheter-related sepsis. A rat model with a central intravenous silicone catheter was used. Staphylococcus aureus, dose 1 x 10(7) colony forming units (cfu), were injected via the tail vein, either immediately after catheter insertion (group 1, n = 23) or after the catheter had been in situ for at least 7 days (group 2, n = 22). Blood cultures were done on at 24 hours and 7 days. Animals were killed on day 7 and the catheter was removed for culture (Maki and broth) and scanning electronmicroscopy (SEM). The was no significant difference (P > .05) between the number of positive blood cultures in groups 1 and 2 at 24 hours (16 v 9) and 7 days (12 v 6). In group 1 there were significantly more positive catheter cultures by both methods (23 v 16 in group 2; P < .05) and more cfu/per centimeter catheter (group 1 mean, 520, range, 197 to 600; group 2 mean 195, range 9 to 600; P < .001). In group 1, 12 animals had catheter sepsis compared with 5 in group 2 (P = NS). On SEM a fibrinous sheath was identified on all catheters removed on day 7 but not on 5 catheters inserted and removed after 10 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
Lloyd
D A
DA
Department of Child Health, University of Liverpool, England.
Shanbhogue
L K
LK
Doherty
P J
PJ
Sunderland
D
D
Hart
C A
CA
Williams
D F
DF
D000818:Animals; D016470:Bacteremia / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005337:Fibrin / Q000378:metabolism / Q000648:ultrastructure; D008297:Male; D008855:Microscopy, Electron, Scanning; D008954:Models, Biological; D011897:Random Allocation; D051381:Rats; D011919:Rats, Inbred Strains; D013203:Staphylococcal Infections / Q000209:etiology*
D005337:Fibrin