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Pulsative flushing as a strategy to prevent bacterial colonization of vascular access devices.

Ferroni A, Gaudin F, Guiffant G, Flaud P, Durussel JJ, Descamps P, Berche P, Nassif X, Merckx J - Med Devices (Auckl) (2014)

Bottom Line: Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs.Each catheter was cultivated.Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively.

View Article: PubMed Central - PubMed

Affiliation: Assistance Publique-Hôpitaux de Paris, Laboratory of Microbiology, University Teaching Hospital Necker-Enfants Malades, Paris, France.

ABSTRACT
Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs. The aim of this study was to prove the efficacy of pulsatile flushing to prevent the bacterial colonization of vascular access devices. One hundred and forty four tests using 576 polyurethane short venous access catheters were performed. Four catheters per test were polluted with a fibronectin-serum albumin solution. Three were filled with a Staphylococcus aureus broth; one served as negative control. One contaminated catheter was not flushed (positive control), and two were flushed (10 mL.sec(-1)) with normal saline solution, either by ten successive boluses of 1 mL each or by one bolus of 10 mL. Each catheter was cultivated. The S. aureus quantity observed after continuous flushing was significantly higher than that observed after pulsative flushing (P<0.001). Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively. Pulsative flushing was at least twice as effective as continuous flushing in reducing the S. aureus count. Pulsative flushing is more effective than continuous flushing in reducing the endoluminal contamination. Pulsative flushing is a simple, effective, and inexpensive technique to reduce catheter bacterial colonization.

No MeSH data available.


Related in: MedlinePlus

Design of the protocol.Abbreviations: FN, fibronectin; BSA, bovine serum albumin; CFU, colony forming units; S. aureus, Staphylococcus aureus.
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f1-mder-7-379: Design of the protocol.Abbreviations: FN, fibronectin; BSA, bovine serum albumin; CFU, colony forming units; S. aureus, Staphylococcus aureus.

Mentions: The experiment was designed as a set of 144 tests. A total of 576 catheters were used (four catheters per test). Each test lasted 4 days. At day 1, the four catheters were flushed with a 0.1% solution of sodium dodecylsulfate in pure water then filled with the FN solution, incubated at 35°C for 2 hours, and emptied by gravity. In a second phase, the catheters were filled with the bovine serum albumin solution, incubated at 35°C for 24 hours and emptied by gravity. Three catheters were filled with the S. aureus solution. The fourth catheter was used as a negative control (no bacterial pollution, no flushing). The four catheters were then incubated at 35°C for 24 hours. The three contaminated catheters were emptied. Of these three catheters, one served as a contamination positive control and was not flushed. The two other test catheters were flushed: one by ten successive bolus of 1 mL normal saline solution (pulsative flushing), the other by a single bolus of 10 mL (continuous flushing). The steps are summarized in Figure 1.


Pulsative flushing as a strategy to prevent bacterial colonization of vascular access devices.

Ferroni A, Gaudin F, Guiffant G, Flaud P, Durussel JJ, Descamps P, Berche P, Nassif X, Merckx J - Med Devices (Auckl) (2014)

Design of the protocol.Abbreviations: FN, fibronectin; BSA, bovine serum albumin; CFU, colony forming units; S. aureus, Staphylococcus aureus.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230174&req=5

f1-mder-7-379: Design of the protocol.Abbreviations: FN, fibronectin; BSA, bovine serum albumin; CFU, colony forming units; S. aureus, Staphylococcus aureus.
Mentions: The experiment was designed as a set of 144 tests. A total of 576 catheters were used (four catheters per test). Each test lasted 4 days. At day 1, the four catheters were flushed with a 0.1% solution of sodium dodecylsulfate in pure water then filled with the FN solution, incubated at 35°C for 2 hours, and emptied by gravity. In a second phase, the catheters were filled with the bovine serum albumin solution, incubated at 35°C for 24 hours and emptied by gravity. Three catheters were filled with the S. aureus solution. The fourth catheter was used as a negative control (no bacterial pollution, no flushing). The four catheters were then incubated at 35°C for 24 hours. The three contaminated catheters were emptied. Of these three catheters, one served as a contamination positive control and was not flushed. The two other test catheters were flushed: one by ten successive bolus of 1 mL normal saline solution (pulsative flushing), the other by a single bolus of 10 mL (continuous flushing). The steps are summarized in Figure 1.

Bottom Line: Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs.Each catheter was cultivated.Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively.

View Article: PubMed Central - PubMed

Affiliation: Assistance Publique-Hôpitaux de Paris, Laboratory of Microbiology, University Teaching Hospital Necker-Enfants Malades, Paris, France.

ABSTRACT
Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs. The aim of this study was to prove the efficacy of pulsatile flushing to prevent the bacterial colonization of vascular access devices. One hundred and forty four tests using 576 polyurethane short venous access catheters were performed. Four catheters per test were polluted with a fibronectin-serum albumin solution. Three were filled with a Staphylococcus aureus broth; one served as negative control. One contaminated catheter was not flushed (positive control), and two were flushed (10 mL.sec(-1)) with normal saline solution, either by ten successive boluses of 1 mL each or by one bolus of 10 mL. Each catheter was cultivated. The S. aureus quantity observed after continuous flushing was significantly higher than that observed after pulsative flushing (P<0.001). Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively. Pulsative flushing was at least twice as effective as continuous flushing in reducing the S. aureus count. Pulsative flushing is more effective than continuous flushing in reducing the endoluminal contamination. Pulsative flushing is a simple, effective, and inexpensive technique to reduce catheter bacterial colonization.

No MeSH data available.


Related in: MedlinePlus