I know this topic must seem like deja vu! Can you help me find articles that demonstrate a connection between fibrin or biofilm build up and CRBSI? At AVA in 2012 I remember a very interesting presentation, but I can't remember who gave it. He conducted research in which (might have been in sheep now that I think about it) he looked at catheters in a septic subject versus those in non septic subjects. The septic subjects all had biofilm build up in the catheter, while not all of the healthy subjects has Biofilm. This isn't the only study I was looking for as I would appreciate any study which concludes that intraluminal biofilm and/or catheter associated thrombus is associated with CRBSI.
Thank you in advance!
Keith
That information has not been widely published so I am not surprised you are having difficulty. In fact, I can not quickly recall a published study on it and I did not hear the AVA presentation you are talking about. We are just now getting the evidence need to make this connection and I do know that there is at least one published study but can't recall the info to give you the reference. Until now, it has been a wdely accepted theory about this connection. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you, Lynn!
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
Well I've done some literature searching and here's what I have found so far. Seems like there is a fair amount published on this topic in the past, but not so much recently. It's one of those things that I guess is considered common sense now, but I still want to see it in print!
Mehall JR, Saltzman DA, Jackson RJ, Smith SD. Fibrin sheath enhances central venous catheter infection. Crit Care Med. 2002;30(4):908-912.
Raad II, Luna M, Khalil SM, Costerton JW, Lam C, Bodey GP. The relationship between the thrombotic and infectious complications of central venous catheters. JAMA. 1994;271(13):1014-1016.
Timsit JF, Misset B, Carlet J, et al. Central vein catheter-related thrombosis in intensive care patients: incidence, risks factors, and relationship with catheter-related sepsis. Chest. 1998;114(1):207-213.
Biofilms and Device-Associated Infections. Emerg Infect Dis [serial on the Internet]. 2001 Mar-Apr [date] http://wwwnc.cdc.gov/eid/article/7/2/70-0277
By the way, I have begun to design a study looking at flushing techniques in my hospital. I have a lot of buy-in. I am looking forward to publishing the results. I think my goal will be to determine if there really is any advantage to turbulent flushing or if any interesting complications (malposition) increase or decrease due to a change in technique.
Keith
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
Look at the dates on those studies. Those are the ones that support the theory of a connection but do not provide any actual science examining the connection. Good luck on a flushing study. I am hoping it will be a great research design, preferably a randomized trial. That has the greatest weight but is the most difficult to conduct. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861