Novel strategies to prevent catheter-associated infections in oncology patients
| Autor: | J.M. Schierholz, D P König, G. Pulverer, A. F. E. Rump, J. Beuth |
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| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Lumen (anatomy) Biocompatible Materials Catheterization Immune system Anti-Infective Agents Risk Factors Neoplasms Medicine Humans Pharmacology (medical) Blood culture Intensive care medicine Pharmacology Cross Infection medicine.diagnostic_test business.industry Candidiasis Cancer Immunosuppression Drug Resistance Microbial Staphylococcal Infections medicine.disease Antimicrobial Catheter Infectious Diseases Oncology Catheter-Associated Infections business |
| Zdroj: | Journal of chemotherapy (Florence, Italy). (1) |
| ISSN: | 1120-009X |
| Popis: | Aggressive cytotoxic treatment of cancer contributes to the growing number of life-threatening infections. Vascular catheters create predominant risks for staphylococcal, enterococcal and candida blood stream infections. Although the contaminating microorganisms may be few in number, the altered host immune response in the presence of such implants as well as disease-associated immunosuppression implies that even small bacterial counts have to be regarded as highly virulent species. Diagnosis of catheter-related infection (CRI) remains difficult before withdrawal of the suspected catheter. Positive culture of catheter surface, lumen and hub and positive peripheral blood probes (paired quantitative blood culture) are predictive for catheter related bacteremia (CRB). Diligent catheter care and effective antimicrobial catheters may reduce prolonged hospital stay, increased morbidity or mortality and serious economical consequences. The most promising approach features the incorporation of antimicrobial drugs into the polymer matrices that entrap but do not bind the drugs, allowing for extended release. For the efficacious prevention of colonization in the microenvironment of the implantable device the concentration of the antimicrobial substances must exceed usual antibiotic concentrations by a thousand-fold. This is the desired effect--high concentration near the device surface and very low systemic concentration. Incorporation of antimicrobials in the bulk material that constitutes a device can be effective as shown in several in vitro and in vivo studies. In the future, modification of both short-term and long-term catheters by biofilm-active antimicrobials creating slow delivery systems may provide an effective method to protect patients from nosocomial infection in oncology. |
| Databáze: | OpenAIRE |
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