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Comparative study of microbial colonization of catheters for prolonged regional anesthesia when using different fixation methods

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1. Title Title of document Comparative study of microbial colonization of catheters for prolonged regional anesthesia when using different fixation methods
2. Creator Author's name, affiliation, country Ekaterina S. Yakovleva; Research and Clinical Center of Pediatric Psychoneurology Moscow Department of Public Health; Russian Federation
2. Creator Author's name, affiliation, country Andrey V. Diordiev; Research and Clinical Center of Pediatric Psychoneurology Moscow Department of Public Health; Russian Federation
2. Creator Author's name, affiliation, country Elena A. Adkina; Research and Clinical Center of Pediatric Psychoneurology Moscow Department of Public Health; Russian Federation
2. Creator Author's name, affiliation, country Roman V. Shagurin; Research and Clinical Center of Pediatric Psychoneurology Moscow Department of Public Health; Russian Federation
2. Creator Author's name, affiliation, country Sergey V. Yakovlev; Sechenov First Moscow State Medical University; Russian Federation
2. Creator Author's name, affiliation, country Yuliya M. Kulagina; Research and Clinical Center of Pediatric Psychoneurology Moscow Department of Public Health; Russian Federation
2. Creator Author's name, affiliation, country Nadezhda A. Golovinskaya; Research and Clinical Center of Pediatric Psychoneurology Moscow Department of Public Health; Russian Federation
3. Subject Discipline(s)
3. Subject Keyword(s) catheter; regional anesthesia; infectious complications
4. Description Abstract

BACKGROUND: Infectious complications related to prolonged epidural and peripheral regional anesthesia are quite rare. However, this does not exclude the necessity of strict adherence to measures aimed at preventing microbial colonization of catheters for regional anesthesia. Microbial colonization of the catheter is not always accompanied by the development of infectious complications but increases the likelihood of their occurrence.

AIM: To determine the frequency of colonization, the qualitative and quantitative composition of the microflora depending on the various methods of fixing of the catheter and the duration of its use.

MATERIALS AND METHODS: 76 patients from 2 to 18 years old with prolonged epidural or peripheral anesthesia were included in an comparative, prospective, randomized, single-center study. Patients were divided into the groups according to the method of catheter fixation - adhesive sticker (AS), adhesive sticker and antimicrobial coating Desitol B (AS+D) and tunneling (T). Determination of microbial contamination of catheters was carried out using classical bacteriological studies.

RESULTS: None of the 76 patients had signs of a local or systemic infection. The difference in the frequency of colonization between the AS and T groups was statistically significant: χ2 (1, n = 54) = 5.5381 (p = 0.018), between the AS and AS+D groups it was not significant. The relative risk of colonization of the skin of the catheter with adhesive fixation was 2.14 times higher than with catheter tunneling: RR = 2.14, p = 0.05 (95% CI 1.0–4.49). In the AS+D group, colonization of both the skin and the inner part of the catheter was observed significantly earlier than in the T group: skin part: U = 5.5; Ucr = 8 (p = 0.02); inner part: U = 5.5; Ucr = 6 (p = 0.04). The growth of Staphylococcus epidermidis (48.3%) and Staphylococcus aureus (20.7%) was fixed mainly when positive results of microbiological culture takes place.

CONCLUSIONS: Tunneling is the preferred method of fixation of the catheter when the postoperative pain relief period is more than 3 days.

5. Publisher Organizing agency, location Eco-Vector
6. Contributor Sponsor(s)
7. Date (DD-MM-YYYY) 27.11.2022
8. Type Status & genre Peer-reviewed Article
8. Type Type Research Article
9. Format File format
10. Identifier Uniform Resource Identifier https://journals.eco-vector.com/pediatr/article/view/114928
10. Identifier Digital Object Identifier (DOI) 10.17816/PED13441-52
10. Identifier Digital Object Identifier (DOI) (PDF (Rus)) 10.17816/PED114928-89701
11. Source Title; vol., no. (year) Pediatrician (St. Petersburg); Vol 13, No 4 (2022)
12. Language English=en ru
13. Relation Supp. Files Fig. 1. Catheter tunneling (82KB) doi: 10.17816/PED114928-76479
Fig. 2. Tunneled catheter after tightening the loop (127KB) doi: 10.17816/PED114928-76480
Fig. 3. Growth rates of microflora on the outer part of the catheter (129KB) doi: 10.17816/PED114928-76481
Fig. 4. Growth rates of microflora on the inner part of the catheter (132KB) doi: 10.17816/PED114928-76482
Fig. 5. Results of bacteriological examination of microflora with positive results of bacteriological analysis (120KB) doi: 10.17816/PED114928-76483
14. Coverage Geo-spatial location, chronological period, research sample (gender, age, etc.)
15. Rights Copyright and permissions Copyright (c) 2022 Eco-Vector