Triple lumen catheters. Technological advance or setback?

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Vascular Access Devices

Background:

• Multilumen central venous catheters (CVCs) are frequently utilized in hospitalized patients for various therapeutic interventions.
• The indwelling nature of CVCs presents a potential route for microbial colonization and subsequent bloodstream infections.
• Assessing the microbial burden on removed CVC tips is crucial for understanding catheter-related infection risks.

Purpose of the Study:

• To evaluate the incidence of bacterial and fungal contamination and infection on the tips of removed multilumen central venous catheters.
• To determine the association between catheter use, particularly for nutritional support, and microbial growth.
• To provide evidence-based recommendations for the optimal use of CVCs in clinical practice.

Main Methods:

• A prospective study involving the microbiological analysis of 119 removed multilumen central venous catheters.
• Catheter tips were cultured to quantify bacterial and fungal growth, differentiating between contamination (<15 colonies) and infection (≥15 colonies).
• Data were collected on reasons for catheter removal, including mechanical failure, elective removal, and suspected catheter sepsis.

Main Results:

• An overall catheter contamination rate of 23.5% was observed (defined as <15 colonies).
• A significant catheter infection rate of 14.3% was identified (defined as ≥15 colonies).
• Microbial growth was detected on catheter tips removed for various reasons, highlighting the risk of colonization.

Conclusions:

• Multilumen central venous catheters are prone to bacterial and fungal colonization and infection.
• The findings suggest that the use of these catheters for delivering nutritional support solutions should be minimized or avoided due to elevated infection risks.
• Further research into alternative vascular access methods or improved catheter care protocols may be warranted.