Catheter-Related Infections: It's All About Biofilm

Marcia A. Ryder, PhD, MS, RN

Disclosures

Topics in Advanced Practice Nursing eJournal. 2005;5(3) 

In This Article

Summary

Revolutionary findings in microbiology have dramatically increased the understanding of the pathogenesis of vascular CRBSIs. As a survival mechanism, micro-organisms attach to the surface of a medical device and form biofilms, or microcolonies embedded in exopolymer substances. Chemical intercellular signaling and adaptive responses create a heterogeneous environment within the biofilm that affords protection against antimicrobial agents and host immune defenses. The radical changes in gene expression of biofilm cells provide the most significant explanation of antimicrobial resistance and heighten the understanding of the profound differences between adherent sessile organisms and their free-floating planktonic counterparts.

The understanding of biofilm ecology and recalcitrance to antimicrobials is paramount in directing prevention, diagnostic, and treatment interventions. Prevention is aimed at diverting access of micro-organisms to the external and internal surfaces of the catheter so that biofilm cannot form. Diagnosis must include accurate techniques that allow for quick recognition of the catheter as the source of infection, followed by prompt treatment strategies that are based on the organism(s) identified in the biofilm and the luminal source of infection.

Future developments in science and technology will provide answers to the control of biofilm formation and disease. In the meantime, healthcare providers must adopt established best practices to reduce the risk of catheter-related infections and associated morbidity and mortality. Prompt and accurate diagnosis and treatment of CRBSI will reduce the promotion of antimicrobial resistance and will help reduce healthcare costs.

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