Indwelling Device-associated Biofilms

Healthcare associated infections linked to the use of indwelling medical devices increase hospital morbidity, mortality and the Intensive Care treatment costs. The essential strategy for mitigating these consequences are prompt source identifcation and control, with appropriate antimicrobial therapy initiation as soon as possible. Removing the source is one of the golden rule for infection control. Early identification of the responsible germs is the other major guiding element for the appropriate anti-infectious treatment. Despite multiple detection/identification methods, there are no clear recommendations for biofilm identification in clinical practice. The gold standard method is bacterial/fungal culturing, with disadvantages related to late results, especially for slow growing, fastidious germs or related to the existence of uncultivable strains. In order to obtain more sensitive, specific results and to increase the chances of better biofilm characterization, in the present study the investigators compare biofilm identification results obtained by standard cultivation methods with those by DNA amplification and next generation gene sequencing. The studied biofilm is associated to four criticallly ill oncological patients indwelling devices (endotracheal tube, central venous catheter, arterial catheter and urinary catheter).

Sex

All

Minimum age

18 Years

Inclusion criteria:

1. Signed informed consent;
2. Age ≥18 years;
3. Suspected/proven sepsis/septic shock (Supplemental file 2);
4. APACHE II score ≥10 (Supplemental file 3);
5. Predictable invasive ventilatory support ≥ 48 hours;
6. Patient estimated survival ≥ 4 days.

Exclusion criteria:

1. Patient/legal representative refusal;
2. Age \<18 years;
3. Chronic psychiatric/neurological disease with impaired decision-making capacity;
4. Pregnancy;
5. Invasive ventilatory support \< 2 days;
6. Death in less than 4 days after ICU admission.