The role of polymer surface degradation and barium sulphate release in the pathogenesis of catheter-related infection.
Nephrol Dial Transplant
; 25(4): 1207-13, 2010 Apr.
Article
en En
| MEDLINE
| ID: mdl-19934097
ABSTRACT
BACKGROUND:
Susceptibility to infection and thrombosis of intravascular catheters is increased by surface irregularities, which might be prevented by coating.METHODS:
BaSO4 release from conventional haemodialysis catheters (CC) and modified catheters (MC) which had been coated with a surface-modifying additive (SMA) was assessed in vivo and in vitro. For the in vivo part, patients were randomized to receive a temporary CC or MC, with crossover after 1 week. After retrieval, catheters were examined using scanning electron microscopy to assess surface integrity, and an in vitro model of catheter exposure to the bloodstream was used to evaluate surface morphology and susceptibility to bacterial adhesion and proliferation.RESULTS:
BaSO(4) moieties covered 14.7 +/- 3.7% of the surface of unused CC. After in vivo use in 16 patients, 62.7 +/- 32.9 x 10(3) holes/mm(2) were detected, indicating BaSO(4) detachment from 3.3 +/- 1.7% of the catheter surface. No defects were observed in unused CC and in MC, whether used or unused. After incubation of four catheters (two of each type) with Staphylococcus epidermidis, the two degraded CC showed an immediate and strong bacterial growth as indicated by an increase in medium impedance of 0.512%/10 min compared to -0.021%/10 min in MC (P < 0.001).CONCLUSIONS:
Short-term exposure of CC to the bloodstream causes BaSO(4) particle release, resulting in surface irregularities predisposing to bacterial proliferation. BaSO(4) release can be prevented by SMA coating.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Polímeros
/
Infecciones Estafilocócicas
/
Staphylococcus epidermidis
/
Sulfato de Bario
/
Catéteres de Permanencia
/
Materiales Biocompatibles Revestidos
/
Infecciones Relacionadas con Catéteres
Tipo de estudio:
Clinical_trials
/
Etiology_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Nephrol Dial Transplant
Asunto de la revista:
NEFROLOGIA
/
TRANSPLANTE
Año:
2010
Tipo del documento:
Article
País de afiliación:
Bélgica