Impact of microbial attachment on intravascular catheter-related infections.
Impact of microbial attachment on intravascular catheter-related infections.
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微生物附着对血管内导管相关感染的影响。
DOI：
10.1016/j.ijantimicag.2011.01.020
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发表时间：
2011
影响因子：
10.8
通讯作者：
C. Rickard
中科院分区：
文献类型：
--
作者：
Li Zhang;J. Gowardman;C. Rickard
血管内导管（IVC）是医院中最常用的医疗器械。然而，它们与危及生命的IVC相关血流感染（IVC-BSI）相关，IVC-BSI是主要的医院获得性感染之一，并且继续与发病率、死亡率和额外的医疗费用相关。大多数已发表的研究都集中在测量IVC-BSI的发生率并说明其重要性，但只有少数研究提到了微生物进入血液的可能途径，这将有助于开发有效的预防方法，并且缺乏大型试验研究。一些关于IVC-BSI的研究报告了最常分离的微生物，但需要谨慎，因为许多挑剔的微生物在当前的实验室条件下没有分离出来。尽管已知微生物在IVC表面定植并形成生物膜，导致IVC-BSI，但微生物生物膜与患者症状或结果的关系仍不清楚。在这里，我们讨论了从其他（非IVC）医学和非医学应用中的微生物研究中获得的知识，这些知识可能有助于理解IVC的背景。此外，发表的理论和数据，特别是在IVC的微生物定植和生物膜的发展进行审查。需要更多的研究来探索IVC-BSI的机制，并提供更好的上级预防策略。
Intravascular catheters (IVCs) are the most frequently used medical devices in hospitals. However, they are associated with life-threatening IVC-related bloodstream infection (IVC-BSI), which is one of the main hospital-acquired infections, and continue to be associated with morbidity, mortality and additional medical cost. Most published studies focus on measuring the rate of IVC-BSIs and addressing their importance, but only a few studies have mentioned the possible routes for microbes entering the bloodstream, which would help in developing effective prevention methods, and large trial studies are lacking. Some studies on IVC-BSIs have reported the most frequently isolated microbes, but caution needs to be made since many fastidious microbes are not isolated under current laboratory conditions. Although it is known that microbes colonise IVC surfaces and develop biofilms, leading to IVC-BSI, the relationships of microbial biofilms with patients’ symptoms or outcomes remain unclear. Here we discuss the knowledge gained from microbial research in other (non-IVC) medical and non-medical applications that may be helpful in understanding the IVC context. In addition, published theory and data regarding microbial colonisation and biofilm development specifically in IVCs are reviewed. More research is needed to explore mechanisms of IVC-BSI and to provide superior prevention strategies.