Biofilm related infections: is there a place for conservative treatment of port-related bloodstream infections?
Vascular catheters are the most frequently used indwelling medical devices and have become necessary tools for patients with chronic or critical illness. Surgically or percutaneously placed venous access ports are used to facilitate long-term intravenous therapy. The widespread use of these devices has resulted in a dramatic increase in catheter-related infections. It implies considerable morbidity, occasional mortality, and an increase in medical costs derived from its diagnosis, treatment, and mainly, prolongation of the patient's in-hospital stay. Treatment of such infections is often difficult due to the presence of biofilms on the port inner surface; inside the biofilms, bacteria are less vulnerable to antimicrobial agents. Current diagnostic strategies are suboptimal, and most successful treatment options require removal of the infected device followed by a course of antimicrobial therapy. There are limited data concerning the efficacy of antibiotic treatment of port-related bloodstream infections without catheter removal.
del Pozo
J L
JL
Division of Infectious Diseases and Clinical Microbiology, University Clinic of Navarra, Pamplona, Spain. jldelpozo@unav.es
Serrera
A
A
Martinez-Cuesta
A
A
Leiva
J
J
Penades
J
J
Lasa
I
I
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D018441:Biofilms; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004866:Equipment Contamination; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents