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The role of polymer surface degradation and barium sulphate release in the pathogenesis of catheter-related infection

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Abstract
Background. Susceptibility to infection and thrombosis of intravascular catheters is increased by surface irregularities, which might be prevented by coating. Methods. BaSO4 release from conventional haemodialysis catheters (CC) and modified catheters (MC) which had been coated with a surface-modifying additive (SMA) was assessed in vivo and in vitro. For the in vivo part, patients were randomized to receive a temporary CC or MC, with crossover after 1 week. After retrieval, catheters were examined using scanning electron microscopy to assess surface integrity, and an in vitro model of catheter exposure to the bloodstream was used to evaluate surface morphology and susceptibility to bacterial adhesion and proliferation. Results. BaSO4 moieties covered 14.7 +/- 3.7% of the surface of unused CC. After in vivo use in 16 patients, 62.7 +/- 32.9 x 10(3) holes/mm-were detected, indicating BaSO4 detachment from 3.3 +/- 1.7% of the catheter surface. No defects were observed in unused CC and in MC, whether used or unused. After incubation of four catheters (two of each type) with Staphylococcus epidermidis, the two degraded CC showed an immediate and strong bacterial growth as indicated by an increase in medium impedance of 0.512%/10 min compared to -0.021%/10 min in MC (P < 0.001). Conclusions. Short-term exposure of CC to the bloodstream causes BaSO4 particle release, resulting in surface irregularities predisposing to bacterial proliferation. BaSO4 release can be prevented by SMA coating.
Keywords
catheter infection, haemodialysis, polydimethylsiloxane, surface roughness, surface modification, SCANNING-ELECTRON-MICROSCOPY, MICROORGANISMS, HEMODIALYSIS, INTRAVASCULAR CATHETERS, ADHESION, BIOFILMS, MANAGEMENT, BACTEREMIA, MECHANISMS, POLYURETHANE

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Chicago
Verbeke, Francis, Ulrike Haug, Annemieke Dhondt, Werner Beck, Andrea Schnell, Ruth Dietrich, Reinhold Deppisch, and Raymond Vanholder. 2010. “The Role of Polymer Surface Degradation and Barium Sulphate Release in the Pathogenesis of Catheter-related Infection.” Nephrology Dialysis Transplantation 25 (4): 1207–1213.
APA
Verbeke, Francis, Haug, U., Dhondt, A., Beck, W., Schnell, A., Dietrich, R., Deppisch, R., et al. (2010). The role of polymer surface degradation and barium sulphate release in the pathogenesis of catheter-related infection. NEPHROLOGY DIALYSIS TRANSPLANTATION, 25(4), 1207–1213.
Vancouver
1.
Verbeke F, Haug U, Dhondt A, Beck W, Schnell A, Dietrich R, et al. The role of polymer surface degradation and barium sulphate release in the pathogenesis of catheter-related infection. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2010;25(4):1207–13.
MLA
Verbeke, Francis, Ulrike Haug, Annemieke Dhondt, et al. “The Role of Polymer Surface Degradation and Barium Sulphate Release in the Pathogenesis of Catheter-related Infection.” NEPHROLOGY DIALYSIS TRANSPLANTATION 25.4 (2010): 1207–1213. Print.
@article{1068924,
  abstract     = {Background. Susceptibility to infection and thrombosis of intravascular catheters is increased by surface irregularities, which might be prevented by coating.
Methods. BaSO4 release from conventional haemodialysis catheters (CC) and modified catheters (MC) which had been coated with a surface-modifying additive (SMA) was assessed in vivo and in vitro. For the in vivo part, patients were randomized to receive a temporary CC or MC, with crossover after 1 week. After retrieval, catheters were examined using scanning electron microscopy to assess surface integrity, and an in vitro model of catheter exposure to the bloodstream was used to evaluate surface morphology and susceptibility to bacterial adhesion and proliferation.
Results. BaSO4 moieties covered 14.7 +/- 3.7\% of the surface of unused CC. After in vivo use in 16 patients, 62.7 +/- 32.9 x 10(3) holes/mm-were detected, indicating BaSO4 detachment from 3.3 +/- 1.7\% of the catheter surface. No defects were observed in unused CC and in MC, whether used or unused. After incubation of four catheters (two of each type) with Staphylococcus epidermidis, the two degraded CC showed an immediate and strong bacterial growth as indicated by an increase in medium impedance of 0.512\%/10 min compared to -0.021\%/10 min in MC (P {\textlangle} 0.001).
Conclusions. Short-term exposure of CC to the bloodstream causes BaSO4 particle release, resulting in surface irregularities predisposing to bacterial proliferation. BaSO4 release can be prevented by SMA coating.},
  author       = {Verbeke, Francis and Haug, Ulrike and Dhondt, Annemieke and Beck, Werner and Schnell, Andrea and Dietrich, Ruth and Deppisch, Reinhold and Vanholder, Raymond},
  issn         = {0931-0509},
  journal      = {NEPHROLOGY DIALYSIS TRANSPLANTATION},
  keyword      = {catheter infection,haemodialysis,polydimethylsiloxane,surface roughness,surface modification,SCANNING-ELECTRON-MICROSCOPY,MICROORGANISMS,HEMODIALYSIS,INTRAVASCULAR CATHETERS,ADHESION,BIOFILMS,MANAGEMENT,BACTEREMIA,MECHANISMS,POLYURETHANE},
  language     = {eng},
  number       = {4},
  pages        = {1207--1213},
  title        = {The role of polymer surface degradation and barium sulphate release in the pathogenesis of catheter-related infection},
  url          = {http://dx.doi.org/10.1093/ndt/gfp638},
  volume       = {25},
  year         = {2010},
}

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