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Adherent Microorganisms on Lumenal Surfaces of Long-term Intravenous CathetersImportance of Staphylococcus epidermidis in Patients With Cancer
James H. Tenney, MD;
Marcia R. Moody, PhD;
Kathryn A. Newman, RN, MS;
Stephen C. Schimpff, MD;
James C. Wade, MD;
John W. Costerton, PhD;
William P. Reed, MD
Arch Intern Med. 1986;146(10):1949-1954.
Abstract
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• Using electron microscopy, we prospectively evaluated how frequently adherent microorganisms colonized silicone rubber intravenous (Hickman) catheters removed from patients with cancer. Thirteen (87%) of 15 catheters had gram-positive cocci in glycocalyx adherent to the surface of the catheter lumen. Fungal elements or gram-negative bacilli were mixed with the gram-positive cocci in the glycocalyx on the lumens of three catheters. A consistent morphologic form was adherent to, and the same species was recovered from, the corresponding catheter for six of 27 organisms causing septicemia during catheterization: four of five Staphylococcus epidermidis bacteremias and the only Staphylococcus aureus bacteremia, and one of five candidemias. Three of these six septicemias were successfully treated without removal of the catheter. Although adherent organisms, particularly S epidermidis, were likely to be present on the surface of the lumen of long-term, indwelling, silicone intravenous catheters, septicemias potentially related to these organisms occurred infrequently (fewer than two per 1000 days of catheter use), and the suspect septicemias could sometimes be treated without removal of the catheter.
(Arch Intern Med 1986;146:1949-1954)
Author Affiliations
From the Hospital Epidemiology Unit, University of Maryland Hospital (Dr Tenney), the University of Maryland Cancer Center (Drs Tenney, Moody, Schimpff, Wade, and Reed and Ms Newman), and the Program of Surgical Oncology, University of Maryland School of Medicine (Dr Reed), Baltimore; and the Department of Biology, University of Calgary (Dr Costerton), Alberta, Canada.
Footnotes
Accepted for publication Jan 30, 1986.
Reprint requests to University of Maryland Hospital Epidemiology Unit, Room N3W136, 22 S Greene St, Baltimore, MD 21201 (Dr Tenney).
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