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External ventricular drainage catheters : effect of surface heparinization on bacterial colonization and infection

Lundberg, F LU ; Wady, L LU ; Söderström, S ; Siesjö, P LU ; Larm, O and Ljungh, A LU (2000) In Acta Neurochirurgica 142(12). p.1377-1383
Abstract

Surface heparinization of central venous catheters has earlier been shown to reduce the frequency of bacterial colonization and septicaemia. The present study was undertaken to investigate the benefit of surface heparinization of external ventricular drainage (EVD) catheters in relation to bacterial colonization, as measured by bacterial growth and examination by a 16S-rRNA PCR assay, of catheters and of samples of cerebrospinal fluid (CSF). Ninety-eight heparinized and one hundred unheparinized EVD catheters from the same batch of catheters were used. Twenty point five percent of the heparinized and 22.8% (p = 0.63) of the unheparinized EVD catheters were colonized with bacteria. Culture of CSF, which is the definition of clinical... (More)

Surface heparinization of central venous catheters has earlier been shown to reduce the frequency of bacterial colonization and septicaemia. The present study was undertaken to investigate the benefit of surface heparinization of external ventricular drainage (EVD) catheters in relation to bacterial colonization, as measured by bacterial growth and examination by a 16S-rRNA PCR assay, of catheters and of samples of cerebrospinal fluid (CSF). Ninety-eight heparinized and one hundred unheparinized EVD catheters from the same batch of catheters were used. Twenty point five percent of the heparinized and 22.8% (p = 0.63) of the unheparinized EVD catheters were colonized with bacteria. Culture of CSF, which is the definition of clinical infection in this study, yielded growth in 10.3% of patients with heparinized and in 6.3% (p = 0.18) of those with unheparinized catheters. PCR examination yielded positive signal in 31.3% of patients with heparinized catheters and in 37.7% (p = 0.061) of patients without (CSF and catheters). In the subgroup of patients with subarachnoid haemorrhages, there was a tendency, though not statistically significant, towards a lowered frequency of colonization with 23.1% for heparinized and 33.3% (p = 0.31) for unheparinized catheters. PCR examination did not contribute any further to the diagnostic procedure in the patients concerned. The EVD catheters are skin-penetrating devices and contamination from the skin flora is common. Skin cultures, obtained after skin disinfection and insertion of catheters, showed growth of bacteria in 62% of the patients.

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author
; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bacteria/drug effects, Bacterial Infections/prevention & control, Catheterization, Cerebral Ventricles/surgery, Coated Materials, Biocompatible, Double-Blind Method, Drainage/instrumentation, Equipment Contamination, Heparin/administration & dosage, Humans, Polymerase Chain Reaction, Prospective Studies, RNA, Ribosomal, 16S/analysis
in
Acta Neurochirurgica
volume
142
issue
12
pages
1377 - 1383
publisher
Springer
external identifiers
  • scopus:0034469648
  • pmid:11214632
ISSN
0001-6268
DOI
10.1007/s007010070008
language
English
LU publication?
no
id
d2302b90-d3c9-4be7-910f-302f4db2ea6a
date added to LUP
2019-06-27 10:15:03
date last changed
2020-01-13 02:07:59
@article{d2302b90-d3c9-4be7-910f-302f4db2ea6a,
  abstract     = {<p>Surface heparinization of central venous catheters has earlier been shown to reduce the frequency of bacterial colonization and septicaemia. The present study was undertaken to investigate the benefit of surface heparinization of external ventricular drainage (EVD) catheters in relation to bacterial colonization, as measured by bacterial growth and examination by a 16S-rRNA PCR assay, of catheters and of samples of cerebrospinal fluid (CSF). Ninety-eight heparinized and one hundred unheparinized EVD catheters from the same batch of catheters were used. Twenty point five percent of the heparinized and 22.8% (p = 0.63) of the unheparinized EVD catheters were colonized with bacteria. Culture of CSF, which is the definition of clinical infection in this study, yielded growth in 10.3% of patients with heparinized and in 6.3% (p = 0.18) of those with unheparinized catheters. PCR examination yielded positive signal in 31.3% of patients with heparinized catheters and in 37.7% (p = 0.061) of patients without (CSF and catheters). In the subgroup of patients with subarachnoid haemorrhages, there was a tendency, though not statistically significant, towards a lowered frequency of colonization with 23.1% for heparinized and 33.3% (p = 0.31) for unheparinized catheters. PCR examination did not contribute any further to the diagnostic procedure in the patients concerned. The EVD catheters are skin-penetrating devices and contamination from the skin flora is common. Skin cultures, obtained after skin disinfection and insertion of catheters, showed growth of bacteria in 62% of the patients.</p>},
  author       = {Lundberg, F and Wady, L and Söderström, S and Siesjö, P and Larm, O and Ljungh, A},
  issn         = {0001-6268},
  language     = {eng},
  number       = {12},
  pages        = {1377--1383},
  publisher    = {Springer},
  series       = {Acta Neurochirurgica},
  title        = {External ventricular drainage catheters : effect of surface heparinization on bacterial colonization and infection},
  url          = {http://dx.doi.org/10.1007/s007010070008},
  doi          = {10.1007/s007010070008},
  volume       = {142},
  year         = {2000},
}