Intravascular device-related infections prevention

Pearson, M. L., Guideline for prevention of intravascular device-related infections. Part 1. Intravascular device-related infections An overview. Part II. Recommendations for the prevention of nosocomial intravascular device-related infections, Am. J. Infect. Control, 1996 24(4) 262-293. 

This chapter will be focused on antimicrobial PUs for intravascular applications. First, a classification of the types of PU intravascular devices and their impact in the medical held will be inhoduced. Then, a survey of infections associated with intravascular devices in terms of incidence, etiology, and pathogenesis will be presented. Next, management of device-related infections and the role of modified PUs in preventing intravascular device-related infections will be discussed. Finally, the future direction of novel antimicrobial polymers as biomaterials for the development of devices preventing biofilm-based infections will be described. 

In the following sections, antifouling and antimicrobial PUs will be presented in relation to their application for preventing intravascular device-related infections. 

Dmg-releasing PUs can be considered the first milestone in the prevention of intravascular device-related infections. Already, their clinical application has contributed to decreasing infection risk, mortality rate, and patient morbidity. However, the use of these drag-releasing polymers has elicited concerns in terms of durability and possible local emergence of resistant microorganisms. 

A crucial feature required for a successful application of PUs as biomaterials is their ability to prevent microbial colonization. Indeed, any implanted biomaterial is known to have the potential to put the patient at high risk of infection. In case of intravascular devices, the development of device-related infections may result in life-threatening consequences for the patient. 

O Grady NP, Alexander M, Bums LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control May 2011 39(4 Suppl. l) Sl-34. Francolini 1, Donelli G. Prevention and control of biofilm-based medical-device-related infections. FEMS Immunol Med Microbiol August 2010 59(3) 227-38. 

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