Tissue around catheters is a niche for bacteria associated with medical device infection

被引:33
作者
Broekhuizen, Corine A. N. [1 ]
Schultz, Marcus J. [2 ,3 ]
van der Wal, Allard C. [4 ]
Boszhard, Laura [1 ]
de Boer, Leonie [1 ]
Vandenbroucke-Grauls, Christina M. J. E. [1 ,5 ]
Zaat, Sebastian A. J. [1 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Med Microbiol, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Ctr Infect & Immun Amsterdam CINIMA, Dept Intens Care Med, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Lab Expt Intens Care & Anesthesiol, NL-1105 AZ Amsterdam, Netherlands
[4] Univ Amsterdam, Acad Med Ctr, Dept Pathol, NL-1105 AZ Amsterdam, Netherlands
[5] VU Med Ctr, Dept Med Microbiol & Infect Dis, Amsterdam, Netherlands
关键词
biomaterial-associated infection; pathogenesis; Staphylococcus epidermidis; catheter; Enterococcus faecalis; tissue;
D O I
10.1097/CCM.0b013e3181818268
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective. To investigate whether pericatheter tissue is an additional niche for bacteria potentially causing catheter-associated infections in humans. Design: Postmortem patient study. Setting: Intensive care unit, autopsy room, and microbiological laboratory in a university hospital. Patients: Eighteen deceased patients from whom 35 catheters plus surrounding tissues were collected. Interventions: Under axenic conditions catheters and surrounding tissue were excised from deceased intensive care unit patients. The excised parts of the catheters and samples of surrounding tissue were quantitatively cultured and bacteria identified, and tissue histology/immunohistochemistry was performed. Measurements and main results. Nine of the 35 (26%) pericatheter tissue samples tested were highly culture positive. The corresponding catheter segments were culture negative or yielded only low numbers of bacteria. Bacteria cultured from different sites of the catheter and surrounding tissues almost all were coagulase-negative staphylococci (predominantly Staphylococcus epidermidis) and Enterococcus faecalis. In histology, bacteria were seen in tissue, intercellularly and associated with host phagocytes. Conclusions. Tissue surrounding biomedical devices forms a niche for bacteria. This is an as yet nonrecognized element in the pathogenesis of catheter-associated infections, with possible consequences for strategies of prevention and treatment of these infections.
引用
收藏
页码:2395 / 2402
页数:8
相关论文
共 47 条
[1]   BASIC LOCAL ALIGNMENT SEARCH TOOL [J].
ALTSCHUL, SF ;
GISH, W ;
MILLER, W ;
MYERS, EW ;
LIPMAN, DJ .
JOURNAL OF MOLECULAR BIOLOGY, 1990, 215 (03) :403-410
[2]  
Anderson, 2000, INFECT ASS INDWELLIN, P89, DOI DOI 10.1128/9781555818067.CH5
[3]  
ARCHER GL, 2005, MANDELL DOUGLAS BENN, P2352
[4]  
Beekmann SE, 2005, MANDELL DOUGLAS BENN, P3347
[5]   Enhanced susceptibility to subcutaneous abscess formation and persistent infection around catheters is associated with sustained interleukin-1β levels [J].
Boelens, JJ ;
Zaat, SAJ ;
Murk, JL ;
Weening, JJ ;
van der Poll, T ;
Dankert, J .
INFECTION AND IMMUNITY, 2000, 68 (03) :1692-1695
[6]  
Boelens JJ, 2000, J BIOMED MATER RES, V50, P546, DOI 10.1002/(SICI)1097-4636(20000615)50:4<546::AID-JBM10>3.0.CO
[7]  
2-Y
[8]   Biomaterial-associated persistence of Streptococcus epidermidis in pericatheter macrophages [J].
Boelens, JJ ;
Dankert, J ;
Murk, JL ;
Weening, JJ ;
van der Poll, T ;
Dingemans, KP ;
Koole, L ;
Laman, JD ;
Zaat, SAJ .
JOURNAL OF INFECTIOUS DISEASES, 2000, 181 (04) :1337-1349
[9]   The challenge of anticipating catheter tip colonization in major heart surgery patients in the intensive care unit:: Are surface cultures useful? [J].
Bouza, Emilio ;
Munoz, Patricia ;
Burillo, Almudena ;
Lopez-Rodriguez, Javier ;
Fernandez-Perez, Cristina ;
Perez, Maria Jesos ;
Rincon, Cristina .
CRITICAL CARE MEDICINE, 2005, 33 (09) :1953-1960
[10]   Peri-implant tissue is an important niche for Staphylococcus epidermidis in experimental biomaterial-associated infection in mice [J].
Broekhuizen, Corine A. N. ;
de Boer, Leonie ;
Schipper, Kim ;
Jones, Christopher D. ;
Quadir, Shan ;
Feldman, Roger G. ;
Dankert, Jacob ;
Vandenbroucke-Grauls, Christina M. J. E. ;
Weening, Jan J. ;
Zaat, Sebastian A. J. .
INFECTION AND IMMUNITY, 2007, 75 (03) :1129-1136