Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-12-01T01:46:07.178Z Has data issue: false hasContentIssue false

Tetrasodium EDTA as a Novel Central Venous Catheter Lock Solution Against Biofilm

Published online by Cambridge University Press:  21 June 2016

Steven L. Percival
Affiliation:
Department of Microbiology, Leeds Teaching Hospitals, Leeds, United Kingdom Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Peter Kite
Affiliation:
Department of Microbiology, Leeds Teaching Hospitals, Leeds, United Kingdom
Kerrie Eastwood
Affiliation:
Department of Microbiology, Leeds Teaching Hospitals, Leeds, United Kingdom
Ricardo Murga
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Janice Carr
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Matthew J. Arduino
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Rodney M. Donlan*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mail Stop C-16, Atlanta, GA 30333.[email protected]

Abstract

Background:

Central venous catheter (CVC)-related bloodstream infections (BSIs) are known to increase rates of morbidity and mortality in both inpatients and outpatients, including hematology-oncology patients and those undergoing hemodialysis or home infusion therapy. Biofilm-associated organisms on the lumens of these catheters have reduced susceptibility to antimicrobial chemotherapy. This study tested the efficacy of tetrasodium EDTA as a catheter lock solution on biofilms of several clinically relevant microorganisms.

Methods:

Biofilms of Staphylococcus epidermidis, methicillin-resistant S. aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and Candida albicans were grown to levels of approximately 1 × 105 colony-forming units (CFU)/cm−1 on CVC segments in a model system, then subjected to the tetrasodium EDTA lock treatment.

Results:

Comparisons of biofilms before and after exposure to the 40-mg/mL−1 tetrasodium EDTA lock for 21 hours showed that the biofilm viable cell counts of all organisms tested were significantly reduced (P < .05) after exposure to the treatment.

Conclusion:

Antimicrobial lock treatment using 40 mg/mL−1 of tetrasodium EDTA for at least 21 hours could significantly reduce or potentially eradicate CVC-associated bio-films of clinically relevant microorganisms (Infect Control Hosp Epidemiol 2005;26:515-519).

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Centers for Disease Control and Prevention. Guidelines for the prevention of intravascular catheter-related infections. MMWR 2002;10:128.Google Scholar
2.Anaissie, EG, Samonis, G, Kontoyiannis, D, et al.Role of catheter colonization and infrequent hematogenous seeding in catheter-related infections. Eur J Clin Microbiol Infect Dis 1995;14:135137.Google Scholar
3.Dasgupta, MK. Biofilms and infection in dialysis patients. Semin Dial 2002;15:338346.Google Scholar
4.Maki, DG. Infections caused by intravascular devices used for infusion therapy: pathogenesis, prevention, and management. In: Bisno, AL, Waldvogel, FP, eds. Infections Associated With Indwelling Medical Devices, ed. 2. Washington, DC: American Society for Microbiology Press; 1994:155212.Google Scholar
5.Raad, I, Costerton, W, Sabharwal, U, Sacilowski, M, Annaissie, W, Brodey, GP. Ultrastructural analysis of indwelling vascular catheters: a quantitative relationship between luminal colonization and duration of placement. J Infect Dis 1993;168:400407.Google Scholar
6.Donlan, RM, Murga, R, Bell, M, et al.Protocol for detection of biofilms on needleless connectors attached to central venous catheters. J Clin Microbiol 2001;39:750753.CrossRefGoogle ScholarPubMed
7.Maki, DG, Goldman, DA, Rhame, FS. Infection control in intravenous therapy. Ann Intern Med 1973;79:867887.CrossRefGoogle ScholarPubMed
8.Raad, I. Intravascular-catheter-related infections. Lancet 1998:351:893898.CrossRefGoogle ScholarPubMed
9.Carratala, J. The antibiotic-lock technique for therapy of “highly needed” infected catheters. Clin Microbiol Infect 2000;8:282289.Google Scholar
10.Henrickson, KJ, Axtell, RA, Hoover, SM, et al.Prevention of central venous catheter-related infections and thrombotic vents in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solution: a randomised, multicenter, double blind trial. J Clin Oncol 2000;18:12691278.Google Scholar
11.Berrington, A, Gould, FK. Use of antibiotic locks to treat colonized central venous catheters. J Antimicrob Chemother 2001;48:597603.CrossRefGoogle ScholarPubMed
12.Mermel, LA. Prevention of intravascular catheter-related infections. Ann Intern Med 2000;132:391402.Google Scholar
13.Carratala, J, Niubo, J, Fernandez-Sevilla, A, et al.Randomized, double-blind trial of an antibiotic-lock technique for prevention of gram-positive central venous catheter-related infection in neutropenic patients with cancer. Antimicrob Agents Chemother 1999;43:22002204.CrossRefGoogle ScholarPubMed
14.Schwartz, C, Henrickson, KJ, Roghmann, K, Powell, K. Prevention of bacteremia attributed to luminal colonization of tunnelled central venous catheters with vancomycin-susceptible organisms. J Clin Oncol 1990;8:15911597.CrossRefGoogle ScholarPubMed
15.Rackoff, WR, Weiman, M, Jakobowski, D, et al.A randomized, controlled trial of the efficacy of a heparin and vancomycin solution in preventing central venous catheter infections in children. J Pediatr 1995;127:147151.CrossRefGoogle ScholarPubMed
16.Mermel, LA, Farr, BM, Sheretz, RJ, et al.Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 2001; 32:12491272.CrossRefGoogle ScholarPubMed
17.Schwalbe, RS, Stapleton, JT, Gilligan, PH. Emergence of vancomycin resistance in coagulase-negative staphylococci. N Engl J Med 1987;316: 927931.CrossRefGoogle ScholarPubMed
18.Kaplan, AH, Gilligan, PH, Facklam, RR. Recovery of resistant enterococci during vancomycin prophylaxis. J Clin Microbiol 1988;26:12161218.Google Scholar
19.Sieradzki, K, Leski, T, Dick, J, Borio, L, Tomasz, A. Evolution of a vancomycin-intermediate Staphylococcus aureus strain in vivo: multiple changes in the antibiotic resistance phenotypes of a single lineage of methicillin-resistant S. aureus under the impact of antibiotics administered for chemotherapy. J Clin Microbiol 2003;41:16871693.Google Scholar
20.Shah, CB, Mittelman, MW, Costerton, JW, et al.Antimicrobial activity of a novel catheter lock solution. Antimicrob Agents Chemother 2002;46:16741679.Google Scholar
21.Root, JL, McIntyre, OR, Jacobs, NJ, Daghlian, CP. Inhibitory effect of disodium EDTA upon the growth of Staphylococcus epidermidis in vitro: relation to infection prophylaxis of Hickman catheters. Antimicrob Agents Chemother 1988;32:16271631.Google Scholar
22.Raad, I, Buzaid, A, Rhyne, J, et al.Minocycline and ethylenediaminetet-raacetate for the prevention of recurrent vascular catheter infections. Clin Infect Dis 1997;25:149151.Google Scholar
23.Kite, P, Eastwood, K, Sugden, S, Percival, SL. Use of in vivo-generated biofilms from hemodialysis catheters to test the efficacy of a novel antimicrobial catheter lock for biofilm eradication in vitro. J Clin Microbiol 2004;42:30733076.Google Scholar
24.Russell, AD. Ethylenediaminetetra-acetic acid. In: Hugo, WB, ed. Inhibition and Destruction of the Microbial Cell. New York: Academic Press; 1971:209224.Google Scholar
25.Hukari, R, Heiander, IM, Vaara, M. Chain length heterogeneity of lipo-polysaccharide released from Salmonella typhimurium by ethylene-diaminetetraacetic acid or polycations. Eur J Biochem 1986;154:673676.CrossRefGoogle ScholarPubMed
26.Said, AA, Livermore, DM, Williams, RJ. Expression of HI outer-membrane protein of Pseudomonas aeruginosa in relation to sensitivity to EDTA and polymyxin. J Med Microbiol 1987;24:267274.Google Scholar
27.Nakaido, H, Vaara, M. Molecular basis of bacterial outer membrane permeability. Microbiol Rev 1985;49:132.CrossRefGoogle Scholar
28.Gil, ML, Casanova, M, Martinez, JP. Changes in the cell wall glycoprotein composition of Candida albicans associated to the inhibition of germ tube formation by EDTA. Arch Microbiol 1994;161:489494.Google Scholar
29.Sen, BH, Akdeniz, BG, Denizei, AA. The effect of ethylenediamine-tet-raacetic acid on Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:651655.Google Scholar
30.Turakhia, MH, Cooksey, KE, Characklis, WG. Influence of a calcium-specific chelant on biofilm removal. Appl Environ Microbiol 1983;46: 12361238.Google Scholar
31.Tokars, JI, Miller, ER, Stein, G. New national surveillance system for hemodialysis-associated infections: initial results. Am J Infect Control 2002;30:288295.Google Scholar